10A NCAC 09 .0902 · Violation

Name of Operation: EAST COAST EARLY LEARNING ACADEMY Facility ID: 28000275 Consultant: MARJORIE WHITE Operation Type: Center Case Number: Visit Date: 1/5/2026 Number Present: 24 Completed Date: 1/5/2026 Age: From 0 To 5 Total Minutes: 420 Time In: 09:00 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced * The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit and provide technical assistance on the QRIS rules in Section .3200. D. Titus-Johnson, Administrator, assisted me with the visit. Your program currently operates with a five-star license, issued 2/23/22, earning 6 points in the education component, 6 points in the program standards component (meeting enhanced ratios and space) and 1 quality point for staff benefits and parent involvement. The program was also monitored for compliance with implementing an approved curriculum as required for all four- and five-star licensed facilities where four-year-old children are enrolled. The program uses Creative Curriculum. The last annual compliance visit was conducted 2/11/25. The sanitation inspection was completed 12/3/25 with a “Superior” classification. The last fire inspection was conducted 3/18/25 with a “Passed” rating and approved for daytime care only. Three-year water testing is due 7/5/27. The center's compliance history was reviewed with the operator. The program’s compliance history was seventy-seven percent as of 1/2/26. This facility is owned by East Coast Academies, Inc. The NC Secretary of State website was reviewed on 1/2/26 and the owner was listed as current- active. License and contact information were current. Contact me to request any changes to your license or contact information. I monitored the classrooms and spaces used for child care and outdoor play areas 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 five staff records, three children’s records and all program records. Infants and toddlers, enrolled in Space 1 were playing with toys and materials accessible to them on low shelves. The infant was crawling and furniture surfing. Documentation of safe sleep checks was available. The children, one and two years of age, in Space 2, were also engaged in free play with both teachers assisting them with materials and social/emotional skills. The children, three through five years of age in Space 3 were learning about dental health and glued cotton balls to a cut out of a tooth. Groups went outdoors at different times. Proper hand-washing techniques and diaper changing procedures were observed. Lunch was observed and consisted of fish sticks with rolls, corn, applesauce and milk. I observed and documented the following violations during today’s visit. Violation Number Comment Rule 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. (omit posting for centers located in a residence). A feeding plan for a child, ten months of age, was not updated to reflect a change in dietary needs as the child transitioned from bottles only to solid foods. 10A NCAC 09 .0902(a) 721 All equipment and furnishings were not in good repair. Manufacturer instructions for a Safari Truck Climber and a Skyward Summit climber stated that the equipment could only be used with the anchor stakes in place. Neither piece of climbing equipment was anchored. G.S. 110-91(6); .0601(b) 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. In Space 1, a medication permission form for Desitin expired on December 11, 2025. The medication was neither returned to the parent nor the permission form was updated. .0803(12) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). The qualification letter for a staff member expired on November 12, 2025. A new qualification letter was not completed and available until January 5, 2026. G.S. 110-90.2(b) & .2703(n)&(o) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. In one of three children's files reviewed, documentation of immunizations for a child enrolled on May 19, 2025 was not available until October 8, 2025. 10A NCAC 09 .0302(d)(2) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. Documentation of an emergency drill completed for the last quarter of 2025 was not available. The most recent emergency drill was dated September 12, 2025. .0604(u);.0302(d)(8) 1898 Staff did not complete the health and safety training within one year of employment. A new staff person hired on November 4, 2024 did not complete health and safety training by November 4, 2025 and was missing the medication administration module. .1102(a) * Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violations documented may impact the compliance history score. The violations documented must be corrected immediately. On or before 1/19/2026, I must receive a written, dated, and signed compliance letter that describes accurately and in detail how and when the violations were corrected. Please be aware that any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Marjorie White, Child Care Consultant PO Box 116 Aydlett, NC 27916 Email – marjorie.white@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE which serves as your signature, heidi.riden@ecelearningacademy.com, and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance With Documented Violations: Infant Feeding Plans – Written feeding plans are critical for caregivers of infants and young toddlers because they provide the parents’ specific instructions on when, how, and how much to feed the infant. Parents are required to update them as the child’s dietary requirements change. A written feeding plan was available for an infant (KM), nine months of age, but did not reflect the transition from bottles only to solid foods. You stated that the parent of KM started providing food other than bottles a few weeks ago and you just forgot to have her update the feeding plan. For your compliance letter, state the date the parent of KM updates the feeding plan to reflect what he is currently eating. *Feeding plans are required to be posted. (Safe sleep checks do not have to be posted, but they must be available for documentation and review.) Playground Equipment – The manufacturers’ instructions for installing playground equipment provides details on how to safely install new equipment to keep children safe when playing on it. You recently updated your playground and added a Safari Truck climber (designed to be used for children, 2 – 6 years of age) and a Skyward Summit climber (designed to be used for children, 4 – 8 years of age). The manufacturers’ instructions for both pieces of equipment stated, “This product may only be used with anchor stakes in place.” Neither piece of equipment was anchored. You stated that both pieces had been recently installed. You looked for the anchor stakes but could not locate them. You are going to make them inaccessible for use until you can purchase new anchor stakes and install them according to the manufacturers’ instructions. Each piece of equipment has a critical height over 30 inches and requires a six-foot fall zone from the border and from the other piece of equipment. This means that you will need to place them so that they are 12 feet apart, providing each piece of equipment with its own six-foot fall zone. We moved them around today to position them to meet fall zone requirements. Your playground is used by all ages of children in the center at different times to accommodate the different age groups. Note that the Safari Truck climber may not be used by the children younger than two years of age, and the Skyward Summit climber may not be used by children younger than four years of age. Teachers need to be aware of these age restrictions and need to ensure that the equipment is not being used by children who are younger than the intended age range. You may want to reconsider if the equipment truly meets the developmental needs of the children enrolled in your center. Look at your stationery and portable equipment and determine if items need to be added for the children, one and two years of age. For your compliance letter, state the date when you have added anchor stakes to the Safari Truck climber and Skyward Summit climber. Please include a picture of each that shows the stakes are installed according to the manufacturer’s instructions. Expired Medication Permission Form – Not having current authorization to administer medication, could create medical or liability issues if there are changes to the child’s medication, dosage, or instructions for administration. In Space 1, a 12-month medication permission form for Desitin was dated 12/11/24 – 12/11/25 and was expired. The diaper cream was not returned to the parent, and the medication permission form was not reauthorized. The lead teacher stated that she thought she had checked the medication box but had missed the expired permission form. Either return the diaper cream to the parent or have the parent review and update the medication permission form or complete a new form if any of the instructions have changed. For your compliance letter, state the date when the Desitin is either returned to the parent or an updated medication administration form is on file. Criminal Background Check (CBC) – Criminal Background Checks ensure that staff have not committed any crimes which could potentially make them unsafe to be around children and other staff. Because Abuse and Neglect registries are also checked, it helps to ensure that children are protected from physical, mental, and sexual abuse. Performing diligent background screenings also protects the child care facility against future legal challenges. O. Roughton’s qualifying letter expired on 11/12/2025. A new qualifying letter was not available until 1/5/2026. You stated that you thought she had completed the application but had only completed a connecting application. Once you realized this, you had her do a five-year reapplication. This violation has been corrected but note that multiple violations related to criminal background checks may result in an administrative action. *Note that K. Ellington’s five-year CBC is due by 1/14/26 and D. Titus-Johnson’s five-year CBC is due 4/8/26. Children’s Immunizations - Maintaining accurate records on the children in your care helps to ensure their health and safety, informs families of rules you are required to follow and your center’s policies, and provides a certain transfer of knowledge so that you can provide the best care possible for their children. In one of three children’s files reviewed, documentation of immunizations for a child (KM) enrolled on 5/19/25 was not received until 10/8/25. You stated the mother chose not to vaccinate the child on the recommended immunization schedule. Use Children’s File Checklist to verify you have received all required enrollment documents. Build in time to review enrollment documents with families explaining that they need to be fully completed, signed and dated. This violation has been corrected, but to avoid future violations, consider requiring immunizations (and the children’s medical report) at enrollment even though parents have 30 days. Fire Drills and Emergency Drills - Practicing and documenting fire drills monthly and lock-down or shelter-in-place drills quarterly is critical to teaching and reminding staff and children the procedures for evacuating the building safely in case of a fire or staying safe inside in the event of an intruder or tornado. It is a good idea to practice fire and emergency drills at different times during the day including meal time and nap time. The posted Fire and Emergency Drill Log showed that the last emergency drill was completed on 9/12/2025 and a new drill was not completed within the next three months. You stated that with the holidays between Thanksgiving and Christmas, it just slipped past you. You completed a lock-down drill today and documented it on the Emergency Drill Log. This item has been corrected but ensure that future drills are completed so that children and staff know how to respond in an emergency. Health & Safety Training – Health & Safety (H&S) Training includes training in 9 topic areas plus Recognizing and Responding to Suspicions of Child Maltreatment and CPR/First Aid. These topic areas provide a foundation for maintaining a safe and healthy environment for children and staff. A. Drenning was hired on 11/4/24 and required to complete H&S Trainings by 11/4/25. She completed all modules except for Medication Administration. She stated that she had forgotten about it because it was in a separate section from the other modules on Moodle. New staff are required to complete H&S Training within one year of hire (CPR/First Aid and Recognizing and Responding to Suspicions of Child Maltreatment within 3 months of hire) and then complete training in all topic areas every five years. A. Drenning needs to complete Medication Administration by 1/19/2026. Send a copy of the certificate with the compliance letter. Resources: 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 following resources are available to you: 1. DCDEE website, www.ncchildcare.ncdhhs.gov – current laws and rules regarding child care facilities in North Carolina, “What’s New” tab, Items Number Listing which you can use as a checklist for your program. 2. Raise NC Newsletter – weekly newsletter emailed to facility email including relevant information from the Division, training opportunities, grants, and more. You can sign up to receive Raise NC on the What’s New tab. 3. Your local Child Care Resource & Referral Agencies and Child Care Health Consultants. *Children & Youth Partnership for Dare County: Phone - (252) 441-0614; website - www.darekids.org. *Albemarle Alliance for Children and Families (AACF) and Region 1 Child Care Resource and Referral: Phone – (252) 333-1233; website - www.aacfnc.org . *Healthy Behaviors Specialist: P. White – Phone (252) 333-1233; pam@aacfnc.org *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 CEUs. 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 - You have completed the ABCMS Provider Portal Training and are now authorized to log in the ABCMS Provider Portal https://ncabcms.nc.gov/DCDEE/ using your Business NCID. *The following staff have been connected to the center license number but need to be hired to your roster: A. Drenning, K. Ellington, A. Tiillett. *The following staff need to be connected to the center license number and hired to the roster: N. Basnight, O. Roughton, H. Riden, T. Riden Staff Worksheets – 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 and Five (5) Year Cycle Tracking Requirements – Review Row 17 on Staff Worksheet for initial and five-year H&S Training renewal dates. New staff need to complete Recognizing and Responding to Suspicions of Child Maltreatment and CPR/First Aid within three months of hire and the rest of the training modules within twelve months. * 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 2/11/26 (anniversary of last Annual Compliance visit) or by 1/5/27, anniversary of today’s Annual Compliance visit). If they have not completed the required number of on-going training hours, they have until 2/11/26 to complete them and I will check at the next monitoring visit. Staff Education and Works – A. Drenning needs to submit original, official transcripts for EDU 119 to Works. O. Roughton needs to submit transcripts for her AAS-ECE degree to Works. Emergency Preparedness – Your Emergency Preparedness and Response (EPR) Plan along with your Ready-to-Go File, Emergency Medical Care Plan (EMCP) and consistent practice of Fire and Emergency Drills are your center’s foundation for emergency preparedness. *Review your EPR Plan at least annually in the NC Risk Management Portal and update, if needed. Print updated plan or updated cover sheet and page 28. (Per your request I will email instructions on how to update your EPR Plan. *At the same time, review and update your Emergency Medical Care Plan, if needed. *Ensure your Ready-to-Go File is current and includes the following: a copy of the Emergency Preparedness and Response Plan, child's Application for Child Care (includes health & emergency information, contacts, authorization to seek emergency medical care), medication authorizations and instructions, any action plans for children with special health care needs, a list of any known food allergies of children and staff, staff contact information, Incident Report forms, an area map, and emergency telephone numbers. *EPR Plan – last updated in Portal – updated 10/29/25 *Ready-to-Go File – current, available in office *Emergency Medical Care Plan – update to remove owner’s name *Fire and Emergency Drills – current as of 1/5/26 Feeding Chairs – While infants eat on their own schedules, toddlers tend to start following the center’s meal and snack schedule. Because of this, you need to have enough feeding chairs so that all toddlers can eat at the scheduled meal or snack time. Additional Comments: 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. Sex Offender Registry and Notification Email - North Carolina General Statute 14-208 requires sex offenders to register with the North Carolina Department of Justice. The law states that a sex offender shall not knowingly reside within 1,000 feet of the property on which any public or nonpublic school or child care center is located. This does not apply to child care centers that are located on or within 1,000 feet of property of an institution of higher education where the registrant is a student or is employed. All licensed child care centers must register to receive e-mail notification when a registered sex offender moves within a one-mile radius of the center. (§14-208.19) To register for the e-mail notification, go to http://sexoffender.ncsbi.gov. If you have any questions, please contact your local sheriff's department. QRIS (Quality Rating Improvement System) Technical Assistance: D. Titus-Johnson, Owner/Administrator, and I discussed the facility’s plan for completing a rated license assessment using the new QRIS rules found in Section .3200 of the NC Child Care Rules. All information on the QRIS rated license assessments and documents will be posted at https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization and will also be provided through emails and Raise NC newsletters. During the visit we completed the QRIS Conversation Template with a focus on the selected pathway. Pathway 3: Accreditation and Head Start Today you stated that you are in the process of applying for and achieving Cognia Accreditation with the expectation to complete by 12/31/2026. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. Contact me, Marjorie White, by phone at (252) 373-9385 or by e-mail at Marjorie.White@dhhs.nc.gov, or Jennifer Linhardt, Licensing Supervisor, at (252) 373-4199 or Jennifer.Linhardt@dhhs.nc.gov if you have questions. 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 .0302 · Violation

Name of Operation: EAST COAST EARLY LEARNING ACADEMY Facility ID: 28000275 Consultant: MARJORIE WHITE Operation Type: Center Case Number: Visit Date: 1/5/2026 Number Present: 24 Completed Date: 1/5/2026 Age: From 0 To 5 Total Minutes: 420 Time In: 09:00 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced * The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit and provide technical assistance on the QRIS rules in Section .3200. D. Titus-Johnson, Administrator, assisted me with the visit. Your program currently operates with a five-star license, issued 2/23/22, earning 6 points in the education component, 6 points in the program standards component (meeting enhanced ratios and space) and 1 quality point for staff benefits and parent involvement. The program was also monitored for compliance with implementing an approved curriculum as required for all four- and five-star licensed facilities where four-year-old children are enrolled. The program uses Creative Curriculum. The last annual compliance visit was conducted 2/11/25. The sanitation inspection was completed 12/3/25 with a “Superior” classification. The last fire inspection was conducted 3/18/25 with a “Passed” rating and approved for daytime care only. Three-year water testing is due 7/5/27. The center's compliance history was reviewed with the operator. The program’s compliance history was seventy-seven percent as of 1/2/26. This facility is owned by East Coast Academies, Inc. The NC Secretary of State website was reviewed on 1/2/26 and the owner was listed as current- active. License and contact information were current. Contact me to request any changes to your license or contact information. I monitored the classrooms and spaces used for child care and outdoor play areas 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 five staff records, three children’s records and all program records. Infants and toddlers, enrolled in Space 1 were playing with toys and materials accessible to them on low shelves. The infant was crawling and furniture surfing. Documentation of safe sleep checks was available. The children, one and two years of age, in Space 2, were also engaged in free play with both teachers assisting them with materials and social/emotional skills. The children, three through five years of age in Space 3 were learning about dental health and glued cotton balls to a cut out of a tooth. Groups went outdoors at different times. Proper hand-washing techniques and diaper changing procedures were observed. Lunch was observed and consisted of fish sticks with rolls, corn, applesauce and milk. I observed and documented the following violations during today’s visit. Violation Number Comment Rule 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. (omit posting for centers located in a residence). A feeding plan for a child, ten months of age, was not updated to reflect a change in dietary needs as the child transitioned from bottles only to solid foods. 10A NCAC 09 .0902(a) 721 All equipment and furnishings were not in good repair. Manufacturer instructions for a Safari Truck Climber and a Skyward Summit climber stated that the equipment could only be used with the anchor stakes in place. Neither piece of climbing equipment was anchored. G.S. 110-91(6); .0601(b) 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. In Space 1, a medication permission form for Desitin expired on December 11, 2025. The medication was neither returned to the parent nor the permission form was updated. .0803(12) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). The qualification letter for a staff member expired on November 12, 2025. A new qualification letter was not completed and available until January 5, 2026. G.S. 110-90.2(b) & .2703(n)&(o) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. In one of three children's files reviewed, documentation of immunizations for a child enrolled on May 19, 2025 was not available until October 8, 2025. 10A NCAC 09 .0302(d)(2) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. Documentation of an emergency drill completed for the last quarter of 2025 was not available. The most recent emergency drill was dated September 12, 2025. .0604(u);.0302(d)(8) 1898 Staff did not complete the health and safety training within one year of employment. A new staff person hired on November 4, 2024 did not complete health and safety training by November 4, 2025 and was missing the medication administration module. .1102(a) * Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violations documented may impact the compliance history score. The violations documented must be corrected immediately. On or before 1/19/2026, I must receive a written, dated, and signed compliance letter that describes accurately and in detail how and when the violations were corrected. Please be aware that any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Marjorie White, Child Care Consultant PO Box 116 Aydlett, NC 27916 Email – marjorie.white@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE which serves as your signature, heidi.riden@ecelearningacademy.com, and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance With Documented Violations: Infant Feeding Plans – Written feeding plans are critical for caregivers of infants and young toddlers because they provide the parents’ specific instructions on when, how, and how much to feed the infant. Parents are required to update them as the child’s dietary requirements change. A written feeding plan was available for an infant (KM), nine months of age, but did not reflect the transition from bottles only to solid foods. You stated that the parent of KM started providing food other than bottles a few weeks ago and you just forgot to have her update the feeding plan. For your compliance letter, state the date the parent of KM updates the feeding plan to reflect what he is currently eating. *Feeding plans are required to be posted. (Safe sleep checks do not have to be posted, but they must be available for documentation and review.) Playground Equipment – The manufacturers’ instructions for installing playground equipment provides details on how to safely install new equipment to keep children safe when playing on it. You recently updated your playground and added a Safari Truck climber (designed to be used for children, 2 – 6 years of age) and a Skyward Summit climber (designed to be used for children, 4 – 8 years of age). The manufacturers’ instructions for both pieces of equipment stated, “This product may only be used with anchor stakes in place.” Neither piece of equipment was anchored. You stated that both pieces had been recently installed. You looked for the anchor stakes but could not locate them. You are going to make them inaccessible for use until you can purchase new anchor stakes and install them according to the manufacturers’ instructions. Each piece of equipment has a critical height over 30 inches and requires a six-foot fall zone from the border and from the other piece of equipment. This means that you will need to place them so that they are 12 feet apart, providing each piece of equipment with its own six-foot fall zone. We moved them around today to position them to meet fall zone requirements. Your playground is used by all ages of children in the center at different times to accommodate the different age groups. Note that the Safari Truck climber may not be used by the children younger than two years of age, and the Skyward Summit climber may not be used by children younger than four years of age. Teachers need to be aware of these age restrictions and need to ensure that the equipment is not being used by children who are younger than the intended age range. You may want to reconsider if the equipment truly meets the developmental needs of the children enrolled in your center. Look at your stationery and portable equipment and determine if items need to be added for the children, one and two years of age. For your compliance letter, state the date when you have added anchor stakes to the Safari Truck climber and Skyward Summit climber. Please include a picture of each that shows the stakes are installed according to the manufacturer’s instructions. Expired Medication Permission Form – Not having current authorization to administer medication, could create medical or liability issues if there are changes to the child’s medication, dosage, or instructions for administration. In Space 1, a 12-month medication permission form for Desitin was dated 12/11/24 – 12/11/25 and was expired. The diaper cream was not returned to the parent, and the medication permission form was not reauthorized. The lead teacher stated that she thought she had checked the medication box but had missed the expired permission form. Either return the diaper cream to the parent or have the parent review and update the medication permission form or complete a new form if any of the instructions have changed. For your compliance letter, state the date when the Desitin is either returned to the parent or an updated medication administration form is on file. Criminal Background Check (CBC) – Criminal Background Checks ensure that staff have not committed any crimes which could potentially make them unsafe to be around children and other staff. Because Abuse and Neglect registries are also checked, it helps to ensure that children are protected from physical, mental, and sexual abuse. Performing diligent background screenings also protects the child care facility against future legal challenges. O. Roughton’s qualifying letter expired on 11/12/2025. A new qualifying letter was not available until 1/5/2026. You stated that you thought she had completed the application but had only completed a connecting application. Once you realized this, you had her do a five-year reapplication. This violation has been corrected but note that multiple violations related to criminal background checks may result in an administrative action. *Note that K. Ellington’s five-year CBC is due by 1/14/26 and D. Titus-Johnson’s five-year CBC is due 4/8/26. Children’s Immunizations - Maintaining accurate records on the children in your care helps to ensure their health and safety, informs families of rules you are required to follow and your center’s policies, and provides a certain transfer of knowledge so that you can provide the best care possible for their children. In one of three children’s files reviewed, documentation of immunizations for a child (KM) enrolled on 5/19/25 was not received until 10/8/25. You stated the mother chose not to vaccinate the child on the recommended immunization schedule. Use Children’s File Checklist to verify you have received all required enrollment documents. Build in time to review enrollment documents with families explaining that they need to be fully completed, signed and dated. This violation has been corrected, but to avoid future violations, consider requiring immunizations (and the children’s medical report) at enrollment even though parents have 30 days. Fire Drills and Emergency Drills - Practicing and documenting fire drills monthly and lock-down or shelter-in-place drills quarterly is critical to teaching and reminding staff and children the procedures for evacuating the building safely in case of a fire or staying safe inside in the event of an intruder or tornado. It is a good idea to practice fire and emergency drills at different times during the day including meal time and nap time. The posted Fire and Emergency Drill Log showed that the last emergency drill was completed on 9/12/2025 and a new drill was not completed within the next three months. You stated that with the holidays between Thanksgiving and Christmas, it just slipped past you. You completed a lock-down drill today and documented it on the Emergency Drill Log. This item has been corrected but ensure that future drills are completed so that children and staff know how to respond in an emergency. Health & Safety Training – Health & Safety (H&S) Training includes training in 9 topic areas plus Recognizing and Responding to Suspicions of Child Maltreatment and CPR/First Aid. These topic areas provide a foundation for maintaining a safe and healthy environment for children and staff. A. Drenning was hired on 11/4/24 and required to complete H&S Trainings by 11/4/25. She completed all modules except for Medication Administration. She stated that she had forgotten about it because it was in a separate section from the other modules on Moodle. New staff are required to complete H&S Training within one year of hire (CPR/First Aid and Recognizing and Responding to Suspicions of Child Maltreatment within 3 months of hire) and then complete training in all topic areas every five years. A. Drenning needs to complete Medication Administration by 1/19/2026. Send a copy of the certificate with the compliance letter. Resources: 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 following resources are available to you: 1. DCDEE website, www.ncchildcare.ncdhhs.gov – current laws and rules regarding child care facilities in North Carolina, “What’s New” tab, Items Number Listing which you can use as a checklist for your program. 2. Raise NC Newsletter – weekly newsletter emailed to facility email including relevant information from the Division, training opportunities, grants, and more. You can sign up to receive Raise NC on the What’s New tab. 3. Your local Child Care Resource & Referral Agencies and Child Care Health Consultants. *Children & Youth Partnership for Dare County: Phone - (252) 441-0614; website - www.darekids.org. *Albemarle Alliance for Children and Families (AACF) and Region 1 Child Care Resource and Referral: Phone – (252) 333-1233; website - www.aacfnc.org . *Healthy Behaviors Specialist: P. White – Phone (252) 333-1233; pam@aacfnc.org *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 CEUs. 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 - You have completed the ABCMS Provider Portal Training and are now authorized to log in the ABCMS Provider Portal https://ncabcms.nc.gov/DCDEE/ using your Business NCID. *The following staff have been connected to the center license number but need to be hired to your roster: A. Drenning, K. Ellington, A. Tiillett. *The following staff need to be connected to the center license number and hired to the roster: N. Basnight, O. Roughton, H. Riden, T. Riden Staff Worksheets – 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 and Five (5) Year Cycle Tracking Requirements – Review Row 17 on Staff Worksheet for initial and five-year H&S Training renewal dates. New staff need to complete Recognizing and Responding to Suspicions of Child Maltreatment and CPR/First Aid within three months of hire and the rest of the training modules within twelve months. * 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 2/11/26 (anniversary of last Annual Compliance visit) or by 1/5/27, anniversary of today’s Annual Compliance visit). If they have not completed the required number of on-going training hours, they have until 2/11/26 to complete them and I will check at the next monitoring visit. Staff Education and Works – A. Drenning needs to submit original, official transcripts for EDU 119 to Works. O. Roughton needs to submit transcripts for her AAS-ECE degree to Works. Emergency Preparedness – Your Emergency Preparedness and Response (EPR) Plan along with your Ready-to-Go File, Emergency Medical Care Plan (EMCP) and consistent practice of Fire and Emergency Drills are your center’s foundation for emergency preparedness. *Review your EPR Plan at least annually in the NC Risk Management Portal and update, if needed. Print updated plan or updated cover sheet and page 28. (Per your request I will email instructions on how to update your EPR Plan. *At the same time, review and update your Emergency Medical Care Plan, if needed. *Ensure your Ready-to-Go File is current and includes the following: a copy of the Emergency Preparedness and Response Plan, child's Application for Child Care (includes health & emergency information, contacts, authorization to seek emergency medical care), medication authorizations and instructions, any action plans for children with special health care needs, a list of any known food allergies of children and staff, staff contact information, Incident Report forms, an area map, and emergency telephone numbers. *EPR Plan – last updated in Portal – updated 10/29/25 *Ready-to-Go File – current, available in office *Emergency Medical Care Plan – update to remove owner’s name *Fire and Emergency Drills – current as of 1/5/26 Feeding Chairs – While infants eat on their own schedules, toddlers tend to start following the center’s meal and snack schedule. Because of this, you need to have enough feeding chairs so that all toddlers can eat at the scheduled meal or snack time. Additional Comments: 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. Sex Offender Registry and Notification Email - North Carolina General Statute 14-208 requires sex offenders to register with the North Carolina Department of Justice. The law states that a sex offender shall not knowingly reside within 1,000 feet of the property on which any public or nonpublic school or child care center is located. This does not apply to child care centers that are located on or within 1,000 feet of property of an institution of higher education where the registrant is a student or is employed. All licensed child care centers must register to receive e-mail notification when a registered sex offender moves within a one-mile radius of the center. (§14-208.19) To register for the e-mail notification, go to http://sexoffender.ncsbi.gov. If you have any questions, please contact your local sheriff's department. QRIS (Quality Rating Improvement System) Technical Assistance: D. Titus-Johnson, Owner/Administrator, and I discussed the facility’s plan for completing a rated license assessment using the new QRIS rules found in Section .3200 of the NC Child Care Rules. All information on the QRIS rated license assessments and documents will be posted at https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization and will also be provided through emails and Raise NC newsletters. During the visit we completed the QRIS Conversation Template with a focus on the selected pathway. Pathway 3: Accreditation and Head Start Today you stated that you are in the process of applying for and achieving Cognia Accreditation with the expectation to complete by 12/31/2026. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. Contact me, Marjorie White, by phone at (252) 373-9385 or by e-mail at Marjorie.White@dhhs.nc.gov, or Jennifer Linhardt, Licensing Supervisor, at (252) 373-4199 or Jennifer.Linhardt@dhhs.nc.gov if you have questions. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: EAST COAST EARLY LEARNING ACADEMY Facility ID: 28000275 Consultant: MARJORIE WHITE Operation Type: Center Case Number: Visit Date: 1/5/2026 Number Present: 24 Completed Date: 1/5/2026 Age: From 0 To 5 Total Minutes: 420 Time In: 09:00 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced * The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit and provide technical assistance on the QRIS rules in Section .3200. D. Titus-Johnson, Administrator, assisted me with the visit. Your program currently operates with a five-star license, issued 2/23/22, earning 6 points in the education component, 6 points in the program standards component (meeting enhanced ratios and space) and 1 quality point for staff benefits and parent involvement. The program was also monitored for compliance with implementing an approved curriculum as required for all four- and five-star licensed facilities where four-year-old children are enrolled. The program uses Creative Curriculum. The last annual compliance visit was conducted 2/11/25. The sanitation inspection was completed 12/3/25 with a “Superior” classification. The last fire inspection was conducted 3/18/25 with a “Passed” rating and approved for daytime care only. Three-year water testing is due 7/5/27. The center's compliance history was reviewed with the operator. The program’s compliance history was seventy-seven percent as of 1/2/26. This facility is owned by East Coast Academies, Inc. The NC Secretary of State website was reviewed on 1/2/26 and the owner was listed as current- active. License and contact information were current. Contact me to request any changes to your license or contact information. I monitored the classrooms and spaces used for child care and outdoor play areas 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 five staff records, three children’s records and all program records. Infants and toddlers, enrolled in Space 1 were playing with toys and materials accessible to them on low shelves. The infant was crawling and furniture surfing. Documentation of safe sleep checks was available. The children, one and two years of age, in Space 2, were also engaged in free play with both teachers assisting them with materials and social/emotional skills. The children, three through five years of age in Space 3 were learning about dental health and glued cotton balls to a cut out of a tooth. Groups went outdoors at different times. Proper hand-washing techniques and diaper changing procedures were observed. Lunch was observed and consisted of fish sticks with rolls, corn, applesauce and milk. I observed and documented the following violations during today’s visit. Violation Number Comment Rule 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. (omit posting for centers located in a residence). A feeding plan for a child, ten months of age, was not updated to reflect a change in dietary needs as the child transitioned from bottles only to solid foods. 10A NCAC 09 .0902(a) 721 All equipment and furnishings were not in good repair. Manufacturer instructions for a Safari Truck Climber and a Skyward Summit climber stated that the equipment could only be used with the anchor stakes in place. Neither piece of climbing equipment was anchored. G.S. 110-91(6); .0601(b) 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. In Space 1, a medication permission form for Desitin expired on December 11, 2025. The medication was neither returned to the parent nor the permission form was updated. .0803(12) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). The qualification letter for a staff member expired on November 12, 2025. A new qualification letter was not completed and available until January 5, 2026. G.S. 110-90.2(b) & .2703(n)&(o) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. In one of three children's files reviewed, documentation of immunizations for a child enrolled on May 19, 2025 was not available until October 8, 2025. 10A NCAC 09 .0302(d)(2) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. Documentation of an emergency drill completed for the last quarter of 2025 was not available. The most recent emergency drill was dated September 12, 2025. .0604(u);.0302(d)(8) 1898 Staff did not complete the health and safety training within one year of employment. A new staff person hired on November 4, 2024 did not complete health and safety training by November 4, 2025 and was missing the medication administration module. .1102(a) * Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violations documented may impact the compliance history score. The violations documented must be corrected immediately. On or before 1/19/2026, I must receive a written, dated, and signed compliance letter that describes accurately and in detail how and when the violations were corrected. Please be aware that any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Marjorie White, Child Care Consultant PO Box 116 Aydlett, NC 27916 Email – marjorie.white@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE which serves as your signature, heidi.riden@ecelearningacademy.com, and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance With Documented Violations: Infant Feeding Plans – Written feeding plans are critical for caregivers of infants and young toddlers because they provide the parents’ specific instructions on when, how, and how much to feed the infant. Parents are required to update them as the child’s dietary requirements change. A written feeding plan was available for an infant (KM), nine months of age, but did not reflect the transition from bottles only to solid foods. You stated that the parent of KM started providing food other than bottles a few weeks ago and you just forgot to have her update the feeding plan. For your compliance letter, state the date the parent of KM updates the feeding plan to reflect what he is currently eating. *Feeding plans are required to be posted. (Safe sleep checks do not have to be posted, but they must be available for documentation and review.) Playground Equipment – The manufacturers’ instructions for installing playground equipment provides details on how to safely install new equipment to keep children safe when playing on it. You recently updated your playground and added a Safari Truck climber (designed to be used for children, 2 – 6 years of age) and a Skyward Summit climber (designed to be used for children, 4 – 8 years of age). The manufacturers’ instructions for both pieces of equipment stated, “This product may only be used with anchor stakes in place.” Neither piece of equipment was anchored. You stated that both pieces had been recently installed. You looked for the anchor stakes but could not locate them. You are going to make them inaccessible for use until you can purchase new anchor stakes and install them according to the manufacturers’ instructions. Each piece of equipment has a critical height over 30 inches and requires a six-foot fall zone from the border and from the other piece of equipment. This means that you will need to place them so that they are 12 feet apart, providing each piece of equipment with its own six-foot fall zone. We moved them around today to position them to meet fall zone requirements. Your playground is used by all ages of children in the center at different times to accommodate the different age groups. Note that the Safari Truck climber may not be used by the children younger than two years of age, and the Skyward Summit climber may not be used by children younger than four years of age. Teachers need to be aware of these age restrictions and need to ensure that the equipment is not being used by children who are younger than the intended age range. You may want to reconsider if the equipment truly meets the developmental needs of the children enrolled in your center. Look at your stationery and portable equipment and determine if items need to be added for the children, one and two years of age. For your compliance letter, state the date when you have added anchor stakes to the Safari Truck climber and Skyward Summit climber. Please include a picture of each that shows the stakes are installed according to the manufacturer’s instructions. Expired Medication Permission Form – Not having current authorization to administer medication, could create medical or liability issues if there are changes to the child’s medication, dosage, or instructions for administration. In Space 1, a 12-month medication permission form for Desitin was dated 12/11/24 – 12/11/25 and was expired. The diaper cream was not returned to the parent, and the medication permission form was not reauthorized. The lead teacher stated that she thought she had checked the medication box but had missed the expired permission form. Either return the diaper cream to the parent or have the parent review and update the medication permission form or complete a new form if any of the instructions have changed. For your compliance letter, state the date when the Desitin is either returned to the parent or an updated medication administration form is on file. Criminal Background Check (CBC) – Criminal Background Checks ensure that staff have not committed any crimes which could potentially make them unsafe to be around children and other staff. Because Abuse and Neglect registries are also checked, it helps to ensure that children are protected from physical, mental, and sexual abuse. Performing diligent background screenings also protects the child care facility against future legal challenges. O. Roughton’s qualifying letter expired on 11/12/2025. A new qualifying letter was not available until 1/5/2026. You stated that you thought she had completed the application but had only completed a connecting application. Once you realized this, you had her do a five-year reapplication. This violation has been corrected but note that multiple violations related to criminal background checks may result in an administrative action. *Note that K. Ellington’s five-year CBC is due by 1/14/26 and D. Titus-Johnson’s five-year CBC is due 4/8/26. Children’s Immunizations - Maintaining accurate records on the children in your care helps to ensure their health and safety, informs families of rules you are required to follow and your center’s policies, and provides a certain transfer of knowledge so that you can provide the best care possible for their children. In one of three children’s files reviewed, documentation of immunizations for a child (KM) enrolled on 5/19/25 was not received until 10/8/25. You stated the mother chose not to vaccinate the child on the recommended immunization schedule. Use Children’s File Checklist to verify you have received all required enrollment documents. Build in time to review enrollment documents with families explaining that they need to be fully completed, signed and dated. This violation has been corrected, but to avoid future violations, consider requiring immunizations (and the children’s medical report) at enrollment even though parents have 30 days. Fire Drills and Emergency Drills - Practicing and documenting fire drills monthly and lock-down or shelter-in-place drills quarterly is critical to teaching and reminding staff and children the procedures for evacuating the building safely in case of a fire or staying safe inside in the event of an intruder or tornado. It is a good idea to practice fire and emergency drills at different times during the day including meal time and nap time. The posted Fire and Emergency Drill Log showed that the last emergency drill was completed on 9/12/2025 and a new drill was not completed within the next three months. You stated that with the holidays between Thanksgiving and Christmas, it just slipped past you. You completed a lock-down drill today and documented it on the Emergency Drill Log. This item has been corrected but ensure that future drills are completed so that children and staff know how to respond in an emergency. Health & Safety Training – Health & Safety (H&S) Training includes training in 9 topic areas plus Recognizing and Responding to Suspicions of Child Maltreatment and CPR/First Aid. These topic areas provide a foundation for maintaining a safe and healthy environment for children and staff. A. Drenning was hired on 11/4/24 and required to complete H&S Trainings by 11/4/25. She completed all modules except for Medication Administration. She stated that she had forgotten about it because it was in a separate section from the other modules on Moodle. New staff are required to complete H&S Training within one year of hire (CPR/First Aid and Recognizing and Responding to Suspicions of Child Maltreatment within 3 months of hire) and then complete training in all topic areas every five years. A. Drenning needs to complete Medication Administration by 1/19/2026. Send a copy of the certificate with the compliance letter. Resources: 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 following resources are available to you: 1. DCDEE website, www.ncchildcare.ncdhhs.gov – current laws and rules regarding child care facilities in North Carolina, “What’s New” tab, Items Number Listing which you can use as a checklist for your program. 2. Raise NC Newsletter – weekly newsletter emailed to facility email including relevant information from the Division, training opportunities, grants, and more. You can sign up to receive Raise NC on the What’s New tab. 3. Your local Child Care Resource & Referral Agencies and Child Care Health Consultants. *Children & Youth Partnership for Dare County: Phone - (252) 441-0614; website - www.darekids.org. *Albemarle Alliance for Children and Families (AACF) and Region 1 Child Care Resource and Referral: Phone – (252) 333-1233; website - www.aacfnc.org . *Healthy Behaviors Specialist: P. White – Phone (252) 333-1233; pam@aacfnc.org *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 CEUs. 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 - You have completed the ABCMS Provider Portal Training and are now authorized to log in the ABCMS Provider Portal https://ncabcms.nc.gov/DCDEE/ using your Business NCID. *The following staff have been connected to the center license number but need to be hired to your roster: A. Drenning, K. Ellington, A. Tiillett. *The following staff need to be connected to the center license number and hired to the roster: N. Basnight, O. Roughton, H. Riden, T. Riden Staff Worksheets – 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 and Five (5) Year Cycle Tracking Requirements – Review Row 17 on Staff Worksheet for initial and five-year H&S Training renewal dates. New staff need to complete Recognizing and Responding to Suspicions of Child Maltreatment and CPR/First Aid within three months of hire and the rest of the training modules within twelve months. * 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 2/11/26 (anniversary of last Annual Compliance visit) or by 1/5/27, anniversary of today’s Annual Compliance visit). If they have not completed the required number of on-going training hours, they have until 2/11/26 to complete them and I will check at the next monitoring visit. Staff Education and Works – A. Drenning needs to submit original, official transcripts for EDU 119 to Works. O. Roughton needs to submit transcripts for her AAS-ECE degree to Works. Emergency Preparedness – Your Emergency Preparedness and Response (EPR) Plan along with your Ready-to-Go File, Emergency Medical Care Plan (EMCP) and consistent practice of Fire and Emergency Drills are your center’s foundation for emergency preparedness. *Review your EPR Plan at least annually in the NC Risk Management Portal and update, if needed. Print updated plan or updated cover sheet and page 28. (Per your request I will email instructions on how to update your EPR Plan. *At the same time, review and update your Emergency Medical Care Plan, if needed. *Ensure your Ready-to-Go File is current and includes the following: a copy of the Emergency Preparedness and Response Plan, child's Application for Child Care (includes health & emergency information, contacts, authorization to seek emergency medical care), medication authorizations and instructions, any action plans for children with special health care needs, a list of any known food allergies of children and staff, staff contact information, Incident Report forms, an area map, and emergency telephone numbers. *EPR Plan – last updated in Portal – updated 10/29/25 *Ready-to-Go File – current, available in office *Emergency Medical Care Plan – update to remove owner’s name *Fire and Emergency Drills – current as of 1/5/26 Feeding Chairs – While infants eat on their own schedules, toddlers tend to start following the center’s meal and snack schedule. Because of this, you need to have enough feeding chairs so that all toddlers can eat at the scheduled meal or snack time. Additional Comments: 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. Sex Offender Registry and Notification Email - North Carolina General Statute 14-208 requires sex offenders to register with the North Carolina Department of Justice. The law states that a sex offender shall not knowingly reside within 1,000 feet of the property on which any public or nonpublic school or child care center is located. This does not apply to child care centers that are located on or within 1,000 feet of property of an institution of higher education where the registrant is a student or is employed. All licensed child care centers must register to receive e-mail notification when a registered sex offender moves within a one-mile radius of the center. (§14-208.19) To register for the e-mail notification, go to http://sexoffender.ncsbi.gov. If you have any questions, please contact your local sheriff's department. QRIS (Quality Rating Improvement System) Technical Assistance: D. Titus-Johnson, Owner/Administrator, and I discussed the facility’s plan for completing a rated license assessment using the new QRIS rules found in Section .3200 of the NC Child Care Rules. All information on the QRIS rated license assessments and documents will be posted at https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization and will also be provided through emails and Raise NC newsletters. During the visit we completed the QRIS Conversation Template with a focus on the selected pathway. Pathway 3: Accreditation and Head Start Today you stated that you are in the process of applying for and achieving Cognia Accreditation with the expectation to complete by 12/31/2026. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. Contact me, Marjorie White, by phone at (252) 373-9385 or by e-mail at Marjorie.White@dhhs.nc.gov, or Jennifer Linhardt, Licensing Supervisor, at (252) 373-4199 or Jennifer.Linhardt@dhhs.nc.gov if you have questions. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-91 · Violation

Name of Operation: EAST COAST EARLY LEARNING ACADEMY Facility ID: 28000275 Consultant: MARJORIE WHITE Operation Type: Center Case Number: Visit Date: 1/5/2026 Number Present: 24 Completed Date: 1/5/2026 Age: From 0 To 5 Total Minutes: 420 Time In: 09:00 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced * The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit and provide technical assistance on the QRIS rules in Section .3200. D. Titus-Johnson, Administrator, assisted me with the visit. Your program currently operates with a five-star license, issued 2/23/22, earning 6 points in the education component, 6 points in the program standards component (meeting enhanced ratios and space) and 1 quality point for staff benefits and parent involvement. The program was also monitored for compliance with implementing an approved curriculum as required for all four- and five-star licensed facilities where four-year-old children are enrolled. The program uses Creative Curriculum. The last annual compliance visit was conducted 2/11/25. The sanitation inspection was completed 12/3/25 with a “Superior” classification. The last fire inspection was conducted 3/18/25 with a “Passed” rating and approved for daytime care only. Three-year water testing is due 7/5/27. The center's compliance history was reviewed with the operator. The program’s compliance history was seventy-seven percent as of 1/2/26. This facility is owned by East Coast Academies, Inc. The NC Secretary of State website was reviewed on 1/2/26 and the owner was listed as current- active. License and contact information were current. Contact me to request any changes to your license or contact information. I monitored the classrooms and spaces used for child care and outdoor play areas 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 five staff records, three children’s records and all program records. Infants and toddlers, enrolled in Space 1 were playing with toys and materials accessible to them on low shelves. The infant was crawling and furniture surfing. Documentation of safe sleep checks was available. The children, one and two years of age, in Space 2, were also engaged in free play with both teachers assisting them with materials and social/emotional skills. The children, three through five years of age in Space 3 were learning about dental health and glued cotton balls to a cut out of a tooth. Groups went outdoors at different times. Proper hand-washing techniques and diaper changing procedures were observed. Lunch was observed and consisted of fish sticks with rolls, corn, applesauce and milk. I observed and documented the following violations during today’s visit. Violation Number Comment Rule 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. (omit posting for centers located in a residence). A feeding plan for a child, ten months of age, was not updated to reflect a change in dietary needs as the child transitioned from bottles only to solid foods. 10A NCAC 09 .0902(a) 721 All equipment and furnishings were not in good repair. Manufacturer instructions for a Safari Truck Climber and a Skyward Summit climber stated that the equipment could only be used with the anchor stakes in place. Neither piece of climbing equipment was anchored. G.S. 110-91(6); .0601(b) 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. In Space 1, a medication permission form for Desitin expired on December 11, 2025. The medication was neither returned to the parent nor the permission form was updated. .0803(12) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). The qualification letter for a staff member expired on November 12, 2025. A new qualification letter was not completed and available until January 5, 2026. G.S. 110-90.2(b) & .2703(n)&(o) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. In one of three children's files reviewed, documentation of immunizations for a child enrolled on May 19, 2025 was not available until October 8, 2025. 10A NCAC 09 .0302(d)(2) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. Documentation of an emergency drill completed for the last quarter of 2025 was not available. The most recent emergency drill was dated September 12, 2025. .0604(u);.0302(d)(8) 1898 Staff did not complete the health and safety training within one year of employment. A new staff person hired on November 4, 2024 did not complete health and safety training by November 4, 2025 and was missing the medication administration module. .1102(a) * Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violations documented may impact the compliance history score. The violations documented must be corrected immediately. On or before 1/19/2026, I must receive a written, dated, and signed compliance letter that describes accurately and in detail how and when the violations were corrected. Please be aware that any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Marjorie White, Child Care Consultant PO Box 116 Aydlett, NC 27916 Email – marjorie.white@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE which serves as your signature, heidi.riden@ecelearningacademy.com, and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance With Documented Violations: Infant Feeding Plans – Written feeding plans are critical for caregivers of infants and young toddlers because they provide the parents’ specific instructions on when, how, and how much to feed the infant. Parents are required to update them as the child’s dietary requirements change. A written feeding plan was available for an infant (KM), nine months of age, but did not reflect the transition from bottles only to solid foods. You stated that the parent of KM started providing food other than bottles a few weeks ago and you just forgot to have her update the feeding plan. For your compliance letter, state the date the parent of KM updates the feeding plan to reflect what he is currently eating. *Feeding plans are required to be posted. (Safe sleep checks do not have to be posted, but they must be available for documentation and review.) Playground Equipment – The manufacturers’ instructions for installing playground equipment provides details on how to safely install new equipment to keep children safe when playing on it. You recently updated your playground and added a Safari Truck climber (designed to be used for children, 2 – 6 years of age) and a Skyward Summit climber (designed to be used for children, 4 – 8 years of age). The manufacturers’ instructions for both pieces of equipment stated, “This product may only be used with anchor stakes in place.” Neither piece of equipment was anchored. You stated that both pieces had been recently installed. You looked for the anchor stakes but could not locate them. You are going to make them inaccessible for use until you can purchase new anchor stakes and install them according to the manufacturers’ instructions. Each piece of equipment has a critical height over 30 inches and requires a six-foot fall zone from the border and from the other piece of equipment. This means that you will need to place them so that they are 12 feet apart, providing each piece of equipment with its own six-foot fall zone. We moved them around today to position them to meet fall zone requirements. Your playground is used by all ages of children in the center at different times to accommodate the different age groups. Note that the Safari Truck climber may not be used by the children younger than two years of age, and the Skyward Summit climber may not be used by children younger than four years of age. Teachers need to be aware of these age restrictions and need to ensure that the equipment is not being used by children who are younger than the intended age range. You may want to reconsider if the equipment truly meets the developmental needs of the children enrolled in your center. Look at your stationery and portable equipment and determine if items need to be added for the children, one and two years of age. For your compliance letter, state the date when you have added anchor stakes to the Safari Truck climber and Skyward Summit climber. Please include a picture of each that shows the stakes are installed according to the manufacturer’s instructions. Expired Medication Permission Form – Not having current authorization to administer medication, could create medical or liability issues if there are changes to the child’s medication, dosage, or instructions for administration. In Space 1, a 12-month medication permission form for Desitin was dated 12/11/24 – 12/11/25 and was expired. The diaper cream was not returned to the parent, and the medication permission form was not reauthorized. The lead teacher stated that she thought she had checked the medication box but had missed the expired permission form. Either return the diaper cream to the parent or have the parent review and update the medication permission form or complete a new form if any of the instructions have changed. For your compliance letter, state the date when the Desitin is either returned to the parent or an updated medication administration form is on file. Criminal Background Check (CBC) – Criminal Background Checks ensure that staff have not committed any crimes which could potentially make them unsafe to be around children and other staff. Because Abuse and Neglect registries are also checked, it helps to ensure that children are protected from physical, mental, and sexual abuse. Performing diligent background screenings also protects the child care facility against future legal challenges. O. Roughton’s qualifying letter expired on 11/12/2025. A new qualifying letter was not available until 1/5/2026. You stated that you thought she had completed the application but had only completed a connecting application. Once you realized this, you had her do a five-year reapplication. This violation has been corrected but note that multiple violations related to criminal background checks may result in an administrative action. *Note that K. Ellington’s five-year CBC is due by 1/14/26 and D. Titus-Johnson’s five-year CBC is due 4/8/26. Children’s Immunizations - Maintaining accurate records on the children in your care helps to ensure their health and safety, informs families of rules you are required to follow and your center’s policies, and provides a certain transfer of knowledge so that you can provide the best care possible for their children. In one of three children’s files reviewed, documentation of immunizations for a child (KM) enrolled on 5/19/25 was not received until 10/8/25. You stated the mother chose not to vaccinate the child on the recommended immunization schedule. Use Children’s File Checklist to verify you have received all required enrollment documents. Build in time to review enrollment documents with families explaining that they need to be fully completed, signed and dated. This violation has been corrected, but to avoid future violations, consider requiring immunizations (and the children’s medical report) at enrollment even though parents have 30 days. Fire Drills and Emergency Drills - Practicing and documenting fire drills monthly and lock-down or shelter-in-place drills quarterly is critical to teaching and reminding staff and children the procedures for evacuating the building safely in case of a fire or staying safe inside in the event of an intruder or tornado. It is a good idea to practice fire and emergency drills at different times during the day including meal time and nap time. The posted Fire and Emergency Drill Log showed that the last emergency drill was completed on 9/12/2025 and a new drill was not completed within the next three months. You stated that with the holidays between Thanksgiving and Christmas, it just slipped past you. You completed a lock-down drill today and documented it on the Emergency Drill Log. This item has been corrected but ensure that future drills are completed so that children and staff know how to respond in an emergency. Health & Safety Training – Health & Safety (H&S) Training includes training in 9 topic areas plus Recognizing and Responding to Suspicions of Child Maltreatment and CPR/First Aid. These topic areas provide a foundation for maintaining a safe and healthy environment for children and staff. A. Drenning was hired on 11/4/24 and required to complete H&S Trainings by 11/4/25. She completed all modules except for Medication Administration. She stated that she had forgotten about it because it was in a separate section from the other modules on Moodle. New staff are required to complete H&S Training within one year of hire (CPR/First Aid and Recognizing and Responding to Suspicions of Child Maltreatment within 3 months of hire) and then complete training in all topic areas every five years. A. Drenning needs to complete Medication Administration by 1/19/2026. Send a copy of the certificate with the compliance letter. Resources: 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 following resources are available to you: 1. DCDEE website, www.ncchildcare.ncdhhs.gov – current laws and rules regarding child care facilities in North Carolina, “What’s New” tab, Items Number Listing which you can use as a checklist for your program. 2. Raise NC Newsletter – weekly newsletter emailed to facility email including relevant information from the Division, training opportunities, grants, and more. You can sign up to receive Raise NC on the What’s New tab. 3. Your local Child Care Resource & Referral Agencies and Child Care Health Consultants. *Children & Youth Partnership for Dare County: Phone - (252) 441-0614; website - www.darekids.org. *Albemarle Alliance for Children and Families (AACF) and Region 1 Child Care Resource and Referral: Phone – (252) 333-1233; website - www.aacfnc.org . *Healthy Behaviors Specialist: P. White – Phone (252) 333-1233; pam@aacfnc.org *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 CEUs. 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 - You have completed the ABCMS Provider Portal Training and are now authorized to log in the ABCMS Provider Portal https://ncabcms.nc.gov/DCDEE/ using your Business NCID. *The following staff have been connected to the center license number but need to be hired to your roster: A. Drenning, K. Ellington, A. Tiillett. *The following staff need to be connected to the center license number and hired to the roster: N. Basnight, O. Roughton, H. Riden, T. Riden Staff Worksheets – 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 and Five (5) Year Cycle Tracking Requirements – Review Row 17 on Staff Worksheet for initial and five-year H&S Training renewal dates. New staff need to complete Recognizing and Responding to Suspicions of Child Maltreatment and CPR/First Aid within three months of hire and the rest of the training modules within twelve months. * 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 2/11/26 (anniversary of last Annual Compliance visit) or by 1/5/27, anniversary of today’s Annual Compliance visit). If they have not completed the required number of on-going training hours, they have until 2/11/26 to complete them and I will check at the next monitoring visit. Staff Education and Works – A. Drenning needs to submit original, official transcripts for EDU 119 to Works. O. Roughton needs to submit transcripts for her AAS-ECE degree to Works. Emergency Preparedness – Your Emergency Preparedness and Response (EPR) Plan along with your Ready-to-Go File, Emergency Medical Care Plan (EMCP) and consistent practice of Fire and Emergency Drills are your center’s foundation for emergency preparedness. *Review your EPR Plan at least annually in the NC Risk Management Portal and update, if needed. Print updated plan or updated cover sheet and page 28. (Per your request I will email instructions on how to update your EPR Plan. *At the same time, review and update your Emergency Medical Care Plan, if needed. *Ensure your Ready-to-Go File is current and includes the following: a copy of the Emergency Preparedness and Response Plan, child's Application for Child Care (includes health & emergency information, contacts, authorization to seek emergency medical care), medication authorizations and instructions, any action plans for children with special health care needs, a list of any known food allergies of children and staff, staff contact information, Incident Report forms, an area map, and emergency telephone numbers. *EPR Plan – last updated in Portal – updated 10/29/25 *Ready-to-Go File – current, available in office *Emergency Medical Care Plan – update to remove owner’s name *Fire and Emergency Drills – current as of 1/5/26 Feeding Chairs – While infants eat on their own schedules, toddlers tend to start following the center’s meal and snack schedule. Because of this, you need to have enough feeding chairs so that all toddlers can eat at the scheduled meal or snack time. Additional Comments: 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. Sex Offender Registry and Notification Email - North Carolina General Statute 14-208 requires sex offenders to register with the North Carolina Department of Justice. The law states that a sex offender shall not knowingly reside within 1,000 feet of the property on which any public or nonpublic school or child care center is located. This does not apply to child care centers that are located on or within 1,000 feet of property of an institution of higher education where the registrant is a student or is employed. All licensed child care centers must register to receive e-mail notification when a registered sex offender moves within a one-mile radius of the center. (§14-208.19) To register for the e-mail notification, go to http://sexoffender.ncsbi.gov. If you have any questions, please contact your local sheriff's department. QRIS (Quality Rating Improvement System) Technical Assistance: D. Titus-Johnson, Owner/Administrator, and I discussed the facility’s plan for completing a rated license assessment using the new QRIS rules found in Section .3200 of the NC Child Care Rules. All information on the QRIS rated license assessments and documents will be posted at https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization and will also be provided through emails and Raise NC newsletters. During the visit we completed the QRIS Conversation Template with a focus on the selected pathway. Pathway 3: Accreditation and Head Start Today you stated that you are in the process of applying for and achieving Cognia Accreditation with the expectation to complete by 12/31/2026. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. Contact me, Marjorie White, by phone at (252) 373-9385 or by e-mail at Marjorie.White@dhhs.nc.gov, or Jennifer Linhardt, Licensing Supervisor, at (252) 373-4199 or Jennifer.Linhardt@dhhs.nc.gov if you have questions. 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: EAST COAST EARLY LEARNING ACADEMY Facility ID: 28000275 Consultant: MARJORIE WHITE Operation Type: Center Case Number: Visit Date: 1/5/2026 Number Present: 24 Completed Date: 1/5/2026 Age: From 0 To 5 Total Minutes: 420 Time In: 09:00 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced * The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit and provide technical assistance on the QRIS rules in Section .3200. D. Titus-Johnson, Administrator, assisted me with the visit. Your program currently operates with a five-star license, issued 2/23/22, earning 6 points in the education component, 6 points in the program standards component (meeting enhanced ratios and space) and 1 quality point for staff benefits and parent involvement. The program was also monitored for compliance with implementing an approved curriculum as required for all four- and five-star licensed facilities where four-year-old children are enrolled. The program uses Creative Curriculum. The last annual compliance visit was conducted 2/11/25. The sanitation inspection was completed 12/3/25 with a “Superior” classification. The last fire inspection was conducted 3/18/25 with a “Passed” rating and approved for daytime care only. Three-year water testing is due 7/5/27. The center's compliance history was reviewed with the operator. The program’s compliance history was seventy-seven percent as of 1/2/26. This facility is owned by East Coast Academies, Inc. The NC Secretary of State website was reviewed on 1/2/26 and the owner was listed as current- active. License and contact information were current. Contact me to request any changes to your license or contact information. I monitored the classrooms and spaces used for child care and outdoor play areas 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 five staff records, three children’s records and all program records. Infants and toddlers, enrolled in Space 1 were playing with toys and materials accessible to them on low shelves. The infant was crawling and furniture surfing. Documentation of safe sleep checks was available. The children, one and two years of age, in Space 2, were also engaged in free play with both teachers assisting them with materials and social/emotional skills. The children, three through five years of age in Space 3 were learning about dental health and glued cotton balls to a cut out of a tooth. Groups went outdoors at different times. Proper hand-washing techniques and diaper changing procedures were observed. Lunch was observed and consisted of fish sticks with rolls, corn, applesauce and milk. I observed and documented the following violations during today’s visit. Violation Number Comment Rule 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. (omit posting for centers located in a residence). A feeding plan for a child, ten months of age, was not updated to reflect a change in dietary needs as the child transitioned from bottles only to solid foods. 10A NCAC 09 .0902(a) 721 All equipment and furnishings were not in good repair. Manufacturer instructions for a Safari Truck Climber and a Skyward Summit climber stated that the equipment could only be used with the anchor stakes in place. Neither piece of climbing equipment was anchored. G.S. 110-91(6); .0601(b) 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. In Space 1, a medication permission form for Desitin expired on December 11, 2025. The medication was neither returned to the parent nor the permission form was updated. .0803(12) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). The qualification letter for a staff member expired on November 12, 2025. A new qualification letter was not completed and available until January 5, 2026. G.S. 110-90.2(b) & .2703(n)&(o) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. In one of three children's files reviewed, documentation of immunizations for a child enrolled on May 19, 2025 was not available until October 8, 2025. 10A NCAC 09 .0302(d)(2) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. Documentation of an emergency drill completed for the last quarter of 2025 was not available. The most recent emergency drill was dated September 12, 2025. .0604(u);.0302(d)(8) 1898 Staff did not complete the health and safety training within one year of employment. A new staff person hired on November 4, 2024 did not complete health and safety training by November 4, 2025 and was missing the medication administration module. .1102(a) * Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violations documented may impact the compliance history score. The violations documented must be corrected immediately. On or before 1/19/2026, I must receive a written, dated, and signed compliance letter that describes accurately and in detail how and when the violations were corrected. Please be aware that any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Marjorie White, Child Care Consultant PO Box 116 Aydlett, NC 27916 Email – marjorie.white@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE which serves as your signature, heidi.riden@ecelearningacademy.com, and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance With Documented Violations: Infant Feeding Plans – Written feeding plans are critical for caregivers of infants and young toddlers because they provide the parents’ specific instructions on when, how, and how much to feed the infant. Parents are required to update them as the child’s dietary requirements change. A written feeding plan was available for an infant (KM), nine months of age, but did not reflect the transition from bottles only to solid foods. You stated that the parent of KM started providing food other than bottles a few weeks ago and you just forgot to have her update the feeding plan. For your compliance letter, state the date the parent of KM updates the feeding plan to reflect what he is currently eating. *Feeding plans are required to be posted. (Safe sleep checks do not have to be posted, but they must be available for documentation and review.) Playground Equipment – The manufacturers’ instructions for installing playground equipment provides details on how to safely install new equipment to keep children safe when playing on it. You recently updated your playground and added a Safari Truck climber (designed to be used for children, 2 – 6 years of age) and a Skyward Summit climber (designed to be used for children, 4 – 8 years of age). The manufacturers’ instructions for both pieces of equipment stated, “This product may only be used with anchor stakes in place.” Neither piece of equipment was anchored. You stated that both pieces had been recently installed. You looked for the anchor stakes but could not locate them. You are going to make them inaccessible for use until you can purchase new anchor stakes and install them according to the manufacturers’ instructions. Each piece of equipment has a critical height over 30 inches and requires a six-foot fall zone from the border and from the other piece of equipment. This means that you will need to place them so that they are 12 feet apart, providing each piece of equipment with its own six-foot fall zone. We moved them around today to position them to meet fall zone requirements. Your playground is used by all ages of children in the center at different times to accommodate the different age groups. Note that the Safari Truck climber may not be used by the children younger than two years of age, and the Skyward Summit climber may not be used by children younger than four years of age. Teachers need to be aware of these age restrictions and need to ensure that the equipment is not being used by children who are younger than the intended age range. You may want to reconsider if the equipment truly meets the developmental needs of the children enrolled in your center. Look at your stationery and portable equipment and determine if items need to be added for the children, one and two years of age. For your compliance letter, state the date when you have added anchor stakes to the Safari Truck climber and Skyward Summit climber. Please include a picture of each that shows the stakes are installed according to the manufacturer’s instructions. Expired Medication Permission Form – Not having current authorization to administer medication, could create medical or liability issues if there are changes to the child’s medication, dosage, or instructions for administration. In Space 1, a 12-month medication permission form for Desitin was dated 12/11/24 – 12/11/25 and was expired. The diaper cream was not returned to the parent, and the medication permission form was not reauthorized. The lead teacher stated that she thought she had checked the medication box but had missed the expired permission form. Either return the diaper cream to the parent or have the parent review and update the medication permission form or complete a new form if any of the instructions have changed. For your compliance letter, state the date when the Desitin is either returned to the parent or an updated medication administration form is on file. Criminal Background Check (CBC) – Criminal Background Checks ensure that staff have not committed any crimes which could potentially make them unsafe to be around children and other staff. Because Abuse and Neglect registries are also checked, it helps to ensure that children are protected from physical, mental, and sexual abuse. Performing diligent background screenings also protects the child care facility against future legal challenges. O. Roughton’s qualifying letter expired on 11/12/2025. A new qualifying letter was not available until 1/5/2026. You stated that you thought she had completed the application but had only completed a connecting application. Once you realized this, you had her do a five-year reapplication. This violation has been corrected but note that multiple violations related to criminal background checks may result in an administrative action. *Note that K. Ellington’s five-year CBC is due by 1/14/26 and D. Titus-Johnson’s five-year CBC is due 4/8/26. Children’s Immunizations - Maintaining accurate records on the children in your care helps to ensure their health and safety, informs families of rules you are required to follow and your center’s policies, and provides a certain transfer of knowledge so that you can provide the best care possible for their children. In one of three children’s files reviewed, documentation of immunizations for a child (KM) enrolled on 5/19/25 was not received until 10/8/25. You stated the mother chose not to vaccinate the child on the recommended immunization schedule. Use Children’s File Checklist to verify you have received all required enrollment documents. Build in time to review enrollment documents with families explaining that they need to be fully completed, signed and dated. This violation has been corrected, but to avoid future violations, consider requiring immunizations (and the children’s medical report) at enrollment even though parents have 30 days. Fire Drills and Emergency Drills - Practicing and documenting fire drills monthly and lock-down or shelter-in-place drills quarterly is critical to teaching and reminding staff and children the procedures for evacuating the building safely in case of a fire or staying safe inside in the event of an intruder or tornado. It is a good idea to practice fire and emergency drills at different times during the day including meal time and nap time. The posted Fire and Emergency Drill Log showed that the last emergency drill was completed on 9/12/2025 and a new drill was not completed within the next three months. You stated that with the holidays between Thanksgiving and Christmas, it just slipped past you. You completed a lock-down drill today and documented it on the Emergency Drill Log. This item has been corrected but ensure that future drills are completed so that children and staff know how to respond in an emergency. Health & Safety Training – Health & Safety (H&S) Training includes training in 9 topic areas plus Recognizing and Responding to Suspicions of Child Maltreatment and CPR/First Aid. These topic areas provide a foundation for maintaining a safe and healthy environment for children and staff. A. Drenning was hired on 11/4/24 and required to complete H&S Trainings by 11/4/25. She completed all modules except for Medication Administration. She stated that she had forgotten about it because it was in a separate section from the other modules on Moodle. New staff are required to complete H&S Training within one year of hire (CPR/First Aid and Recognizing and Responding to Suspicions of Child Maltreatment within 3 months of hire) and then complete training in all topic areas every five years. A. Drenning needs to complete Medication Administration by 1/19/2026. Send a copy of the certificate with the compliance letter. Resources: 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 following resources are available to you: 1. DCDEE website, www.ncchildcare.ncdhhs.gov – current laws and rules regarding child care facilities in North Carolina, “What’s New” tab, Items Number Listing which you can use as a checklist for your program. 2. Raise NC Newsletter – weekly newsletter emailed to facility email including relevant information from the Division, training opportunities, grants, and more. You can sign up to receive Raise NC on the What’s New tab. 3. Your local Child Care Resource & Referral Agencies and Child Care Health Consultants. *Children & Youth Partnership for Dare County: Phone - (252) 441-0614; website - www.darekids.org. *Albemarle Alliance for Children and Families (AACF) and Region 1 Child Care Resource and Referral: Phone – (252) 333-1233; website - www.aacfnc.org . *Healthy Behaviors Specialist: P. White – Phone (252) 333-1233; pam@aacfnc.org *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 CEUs. 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 - You have completed the ABCMS Provider Portal Training and are now authorized to log in the ABCMS Provider Portal https://ncabcms.nc.gov/DCDEE/ using your Business NCID. *The following staff have been connected to the center license number but need to be hired to your roster: A. Drenning, K. Ellington, A. Tiillett. *The following staff need to be connected to the center license number and hired to the roster: N. Basnight, O. Roughton, H. Riden, T. Riden Staff Worksheets – 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 and Five (5) Year Cycle Tracking Requirements – Review Row 17 on Staff Worksheet for initial and five-year H&S Training renewal dates. New staff need to complete Recognizing and Responding to Suspicions of Child Maltreatment and CPR/First Aid within three months of hire and the rest of the training modules within twelve months. * 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 2/11/26 (anniversary of last Annual Compliance visit) or by 1/5/27, anniversary of today’s Annual Compliance visit). If they have not completed the required number of on-going training hours, they have until 2/11/26 to complete them and I will check at the next monitoring visit. Staff Education and Works – A. Drenning needs to submit original, official transcripts for EDU 119 to Works. O. Roughton needs to submit transcripts for her AAS-ECE degree to Works. Emergency Preparedness – Your Emergency Preparedness and Response (EPR) Plan along with your Ready-to-Go File, Emergency Medical Care Plan (EMCP) and consistent practice of Fire and Emergency Drills are your center’s foundation for emergency preparedness. *Review your EPR Plan at least annually in the NC Risk Management Portal and update, if needed. Print updated plan or updated cover sheet and page 28. (Per your request I will email instructions on how to update your EPR Plan. *At the same time, review and update your Emergency Medical Care Plan, if needed. *Ensure your Ready-to-Go File is current and includes the following: a copy of the Emergency Preparedness and Response Plan, child's Application for Child Care (includes health & emergency information, contacts, authorization to seek emergency medical care), medication authorizations and instructions, any action plans for children with special health care needs, a list of any known food allergies of children and staff, staff contact information, Incident Report forms, an area map, and emergency telephone numbers. *EPR Plan – last updated in Portal – updated 10/29/25 *Ready-to-Go File – current, available in office *Emergency Medical Care Plan – update to remove owner’s name *Fire and Emergency Drills – current as of 1/5/26 Feeding Chairs – While infants eat on their own schedules, toddlers tend to start following the center’s meal and snack schedule. Because of this, you need to have enough feeding chairs so that all toddlers can eat at the scheduled meal or snack time. Additional Comments: 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. Sex Offender Registry and Notification Email - North Carolina General Statute 14-208 requires sex offenders to register with the North Carolina Department of Justice. The law states that a sex offender shall not knowingly reside within 1,000 feet of the property on which any public or nonpublic school or child care center is located. This does not apply to child care centers that are located on or within 1,000 feet of property of an institution of higher education where the registrant is a student or is employed. All licensed child care centers must register to receive e-mail notification when a registered sex offender moves within a one-mile radius of the center. (§14-208.19) To register for the e-mail notification, go to http://sexoffender.ncsbi.gov. If you have any questions, please contact your local sheriff's department. QRIS (Quality Rating Improvement System) Technical Assistance: D. Titus-Johnson, Owner/Administrator, and I discussed the facility’s plan for completing a rated license assessment using the new QRIS rules found in Section .3200 of the NC Child Care Rules. All information on the QRIS rated license assessments and documents will be posted at https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization and will also be provided through emails and Raise NC newsletters. During the visit we completed the QRIS Conversation Template with a focus on the selected pathway. Pathway 3: Accreditation and Head Start Today you stated that you are in the process of applying for and achieving Cognia Accreditation with the expectation to complete by 12/31/2026. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. Contact me, Marjorie White, by phone at (252) 373-9385 or by e-mail at Marjorie.White@dhhs.nc.gov, or Jennifer Linhardt, Licensing Supervisor, at (252) 373-4199 or Jennifer.Linhardt@dhhs.nc.gov if you have questions. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2818 · Violation

Name of Operation: EAST COAST EARLY LEARNING ACADEMY Facility ID: 28000275 Consultant: MARJORIE WHITE Operation Type: Center Case Number: 0625-138L Visit Date: 7/14/2025 Number Present: 25 Completed Date: 7/14/2025 Age: From 0 To 5 Total Minutes: 210 Time In: 11:00 AM Time Out: 02:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Follow-Up Announced/Unannounced: Unannounced * The purpose of today’s visit was to verify correction of violations documented during a Complaint Follow-up visit on 7/7/2025. D. Titus-Johnson, administrator, assisted me during the visit. Children participated in developmentally appropriate activities and routines. Lunch was chicken salad with pasta, green beans, applies, and milk. I monitored the following violations documented on 7/7/2025 during today’s visit. #904: Inappropriate Discipline (Rough Handling) – A teacher was observed forcefully pulling a child by their arm to get the child to come out from under the portable climber on the playground. I observed staff supervising and interacting positively with children indoors and outdoors. The administrator provided me with a compliance letter and a roster documenting review of the discipline policy with staff. The compliance letter stated that she has scheduled the following training for her staff: 7/23/25 - “The Infants and Toddlers: Early Childhood Development and Resources” with S. Rosser, Child Care Health Consultant *This training will cover infant/toddler milestones with a focus on typical vs. atypical development, communicating developmental concerns with parents, resources available to staff and families, and ideas for collaboration. An additional training on “Infant and Child Social and Emotional Wellbeing for Early Educators and Safe Handling” may be scheduled after this training is completed. 8/5/25 – “Challenging Behaviors” with P. White, Region 1 Healthy Behaviors Specialist This item was observed to be in compliance today. #1756: Enhanced Staff/Child Ratios – Teachers reported that on June 12, 2025, one teacher was left alone on the playground with nine children, one and two years of age, while the other teacher went indoors to bring out a water pitcher and cups. The compliance letter stated that you reminded staff of staff/child ratios and that they were to notify you if they needed assistance in the classroom to maintain staff/child ratios; however, when I arrived, a teacher from Space 3 was in Space 2 leaving the second teacher in Space 3 with fifteen (15) children, two – five years of age for approximately thirty seconds. See below for more details. This was not observed to be in compliance today. As stated in the Complaint Follow-up visit summary on 7/7/25, you were instructed to correct the violations immediately and send a Compliance Verification Email to me by 7/21/2025. You provided me with a copy of your compliance letter today when I arrived. Due to the nature of the complaint and the repeated staff/child ratio violation, an administrative action may be recommended per NC Child Care Rule 10 NCAC 09 .2203 (1) and (3)(c). I observed and documented the following violation during today’s visit. Violation Number Comment Rule 1756 Enhanced staff/child ratios and group sizes were not met. A teacher from Space 3 left the second teacher alone for thirty (30) seconds with fifteen (15) children, two through five years of age when she left the classroom to retrieve diapering supplies for a child. 10A NCAC 09 .2818 * 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, D. Titus-Johnson, Administrator. We reviewed the visit summary and violation(s) documented during today’s visit. Correct these immediately. Send evidence of correction to me so that I receive it no later than 7/28/25. Your compliance verification letter needs to include the following: 1. Name of facility and facility license # 2. Name of person writing compliance letter and position 3. Date of monitoring visit when violations were documented 4. Date compliance letter written 5. List each violation by Item # and describe when and how each violation has been corrected. 6. Send compliance verification letter in an email from your center’s official email address heidi.riden@ecelearningacademy.com to my email address, Marjorie.White@dhhs.nc.gov. If sent from another email address, the center’s official address must be Cc’d in the compliance email. 7. You may include the compliance verification as an attachment or in the body of the email. 8. If sufficient information is not received by the due date, a follow-up visit may be conducted. *I will email a sample compliance verification letter to you. *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. A violation was documented that requires a follow-up visit. An unannounced visit will be made soon to verify correction of violations. 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 or Jennifer.Linhardt@dhhs.nc.gov. Technical Assistance with Documented Violations: #1756: Enhanced Staff/Child Ratios – Staff/child ratios and group sizes based on the age of the children in care help to ensure the safety of children and allow staff to provide care, attention, and learning opportunities for each child. When I arrived today, I observed a teacher leave Space 3 (preschool classroom) and go to Space 2 (toddler/two classroom), leaving the second teacher in Space 3 alone with fifteen (15) children, two through five years of age, for approximately 30 seconds. The teacher in Space 3 informed me that the administrator was in the office. I informed the administrator that the teacher had left the classroom out of staff/child ratio. She replied that they had discussed staff/child ratios the previous week due to the violation documented on 7/7/2025 and that she had reminded the teachers to call for her to step in and assist when they needed to leave the classroom. When I spoke to the teacher, she stated that she had gone to the classroom next door to pick up undershorts for a child, two years of age, who had been temporarily regrouped to her classroom because the second teacher from Space 2 was late. When she was changing the child’s diaper, she realized that the child had on a dress and diapers but no underpants, and she was just trying to prevent a future diaper blowout later in the day. She also stated that she knew she should have contacted the administrator to either pick up the undershorts or step into the classroom to maintain staff/child ratios. While you are staffed to meet staff/child ratios, staffing has been a challenge due to staff needing time off for vacation or personal needs. You currently do not have a cook/floater to handle meals and snacks and provide breaks for classroom teachers, leaving you, the administrator, responsible for these tasks along with your administrative duties. You have managed staff absences or tardies by assisting in the classrooms and by regrouping children from the toddler/two classroom to the infant classroom and the preschool classroom which has been documented on your attendance sheets. This has been possible because of the typical summer absences due to family vacations and relatives visiting. We reviewed your staff handbook today. There is not a specific staff/child ratio policy. You stated that you are going to develop one that addresses the importance of maintaining staff/child ratios and what staff need to do to maintain staff/child ratios. You are going to meet with staff either as a group or individually and review the staff/child ratio policy and the Staff/Child Ratio and Space Capacity poster for their classrooms. Also consider creating a birthday list for each classroom so that teachers can review names and ages and know who can be regrouped to another classroom, if needed. Consultation: Healthy Social Behaviors Resources for ECE Teachers - Learn how the statewide team of Healthy Social Behaviors (HSB) Coaches help ECE teachers in NC prevent and address challenging behaviors in the classroom. A free, talk-to-the-experts webinar, presented by Healthy Social Behaviors Helpline advisors! (No on-going training credit awarded.) Tuesday, July 15 | 7-8 pm Meeting Link: https://ccrinc.zoom.us/j/3677997738 Meeting ID: 367 799 7738 (Added 7/14/25) Setting Up an Effective Classroom Environment - Join us to talk about ideal ways to set up your classroom, daily schedules, how to organize centers, making rules, and job charts. Join us in the discussion of strategies to use in the new year. A free, talk-to-the-experts webinar, presented by Healthy Social Behaviors Helpline advisors! (No on-going training credit awarded.) Tuesday, August 19 | 7-8 p.m. Meeting Link: https://ccrinc.zoom.us/j/3677997738 Meeting ID: 367 799 7738 (Added 7/14/25) Reminders: Five-year Criminal Background Check – H. Riden, Owner, is due for her five-year Criminal Background Check renewal by 8/6/2025. This requires a new application on the ABCMS Applicant Portal and fingerprints. Out-of-state checks are required if the applicant has not lived in North Carolina for the previous five years. I reviewed the facility’s compliance history with the administrator. The 18-month compliance history from 1/12/2024 – 7/11/2025 = 78%. Please be aware that any information received during this investigation and any violations documented may be included in any future administrative actions. Violations of child care requirements, particularly repeated violations, could result in a civil penalty and/or administrative action that could jeopardize the status of the license for the child care facility. Please also refer to sections labeled Technical Assistance and Consultation for a refresher of our discussions today. If you have any questions, do not hesitate to contact 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.

NC GS 110-90 · Violation

Name of Operation: EAST COAST EARLY LEARNING ACADEMY Facility ID: 28000275 Consultant: MARJORIE WHITE Operation Type: Center Case Number: 0625-138L Visit Date: 7/14/2025 Number Present: 25 Completed Date: 7/14/2025 Age: From 0 To 5 Total Minutes: 210 Time In: 11:00 AM Time Out: 02:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Follow-Up Announced/Unannounced: Unannounced * The purpose of today’s visit was to verify correction of violations documented during a Complaint Follow-up visit on 7/7/2025. D. Titus-Johnson, administrator, assisted me during the visit. Children participated in developmentally appropriate activities and routines. Lunch was chicken salad with pasta, green beans, applies, and milk. I monitored the following violations documented on 7/7/2025 during today’s visit. #904: Inappropriate Discipline (Rough Handling) – A teacher was observed forcefully pulling a child by their arm to get the child to come out from under the portable climber on the playground. I observed staff supervising and interacting positively with children indoors and outdoors. The administrator provided me with a compliance letter and a roster documenting review of the discipline policy with staff. The compliance letter stated that she has scheduled the following training for her staff: 7/23/25 - “The Infants and Toddlers: Early Childhood Development and Resources” with S. Rosser, Child Care Health Consultant *This training will cover infant/toddler milestones with a focus on typical vs. atypical development, communicating developmental concerns with parents, resources available to staff and families, and ideas for collaboration. An additional training on “Infant and Child Social and Emotional Wellbeing for Early Educators and Safe Handling” may be scheduled after this training is completed. 8/5/25 – “Challenging Behaviors” with P. White, Region 1 Healthy Behaviors Specialist This item was observed to be in compliance today. #1756: Enhanced Staff/Child Ratios – Teachers reported that on June 12, 2025, one teacher was left alone on the playground with nine children, one and two years of age, while the other teacher went indoors to bring out a water pitcher and cups. The compliance letter stated that you reminded staff of staff/child ratios and that they were to notify you if they needed assistance in the classroom to maintain staff/child ratios; however, when I arrived, a teacher from Space 3 was in Space 2 leaving the second teacher in Space 3 with fifteen (15) children, two – five years of age for approximately thirty seconds. See below for more details. This was not observed to be in compliance today. As stated in the Complaint Follow-up visit summary on 7/7/25, you were instructed to correct the violations immediately and send a Compliance Verification Email to me by 7/21/2025. You provided me with a copy of your compliance letter today when I arrived. Due to the nature of the complaint and the repeated staff/child ratio violation, an administrative action may be recommended per NC Child Care Rule 10 NCAC 09 .2203 (1) and (3)(c). I observed and documented the following violation during today’s visit. Violation Number Comment Rule 1756 Enhanced staff/child ratios and group sizes were not met. A teacher from Space 3 left the second teacher alone for thirty (30) seconds with fifteen (15) children, two through five years of age when she left the classroom to retrieve diapering supplies for a child. 10A NCAC 09 .2818 * 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, D. Titus-Johnson, Administrator. We reviewed the visit summary and violation(s) documented during today’s visit. Correct these immediately. Send evidence of correction to me so that I receive it no later than 7/28/25. Your compliance verification letter needs to include the following: 1. Name of facility and facility license # 2. Name of person writing compliance letter and position 3. Date of monitoring visit when violations were documented 4. Date compliance letter written 5. List each violation by Item # and describe when and how each violation has been corrected. 6. Send compliance verification letter in an email from your center’s official email address heidi.riden@ecelearningacademy.com to my email address, Marjorie.White@dhhs.nc.gov. If sent from another email address, the center’s official address must be Cc’d in the compliance email. 7. You may include the compliance verification as an attachment or in the body of the email. 8. If sufficient information is not received by the due date, a follow-up visit may be conducted. *I will email a sample compliance verification letter to you. *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. A violation was documented that requires a follow-up visit. An unannounced visit will be made soon to verify correction of violations. 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 or Jennifer.Linhardt@dhhs.nc.gov. Technical Assistance with Documented Violations: #1756: Enhanced Staff/Child Ratios – Staff/child ratios and group sizes based on the age of the children in care help to ensure the safety of children and allow staff to provide care, attention, and learning opportunities for each child. When I arrived today, I observed a teacher leave Space 3 (preschool classroom) and go to Space 2 (toddler/two classroom), leaving the second teacher in Space 3 alone with fifteen (15) children, two through five years of age, for approximately 30 seconds. The teacher in Space 3 informed me that the administrator was in the office. I informed the administrator that the teacher had left the classroom out of staff/child ratio. She replied that they had discussed staff/child ratios the previous week due to the violation documented on 7/7/2025 and that she had reminded the teachers to call for her to step in and assist when they needed to leave the classroom. When I spoke to the teacher, she stated that she had gone to the classroom next door to pick up undershorts for a child, two years of age, who had been temporarily regrouped to her classroom because the second teacher from Space 2 was late. When she was changing the child’s diaper, she realized that the child had on a dress and diapers but no underpants, and she was just trying to prevent a future diaper blowout later in the day. She also stated that she knew she should have contacted the administrator to either pick up the undershorts or step into the classroom to maintain staff/child ratios. While you are staffed to meet staff/child ratios, staffing has been a challenge due to staff needing time off for vacation or personal needs. You currently do not have a cook/floater to handle meals and snacks and provide breaks for classroom teachers, leaving you, the administrator, responsible for these tasks along with your administrative duties. You have managed staff absences or tardies by assisting in the classrooms and by regrouping children from the toddler/two classroom to the infant classroom and the preschool classroom which has been documented on your attendance sheets. This has been possible because of the typical summer absences due to family vacations and relatives visiting. We reviewed your staff handbook today. There is not a specific staff/child ratio policy. You stated that you are going to develop one that addresses the importance of maintaining staff/child ratios and what staff need to do to maintain staff/child ratios. You are going to meet with staff either as a group or individually and review the staff/child ratio policy and the Staff/Child Ratio and Space Capacity poster for their classrooms. Also consider creating a birthday list for each classroom so that teachers can review names and ages and know who can be regrouped to another classroom, if needed. Consultation: Healthy Social Behaviors Resources for ECE Teachers - Learn how the statewide team of Healthy Social Behaviors (HSB) Coaches help ECE teachers in NC prevent and address challenging behaviors in the classroom. A free, talk-to-the-experts webinar, presented by Healthy Social Behaviors Helpline advisors! (No on-going training credit awarded.) Tuesday, July 15 | 7-8 pm Meeting Link: https://ccrinc.zoom.us/j/3677997738 Meeting ID: 367 799 7738 (Added 7/14/25) Setting Up an Effective Classroom Environment - Join us to talk about ideal ways to set up your classroom, daily schedules, how to organize centers, making rules, and job charts. Join us in the discussion of strategies to use in the new year. A free, talk-to-the-experts webinar, presented by Healthy Social Behaviors Helpline advisors! (No on-going training credit awarded.) Tuesday, August 19 | 7-8 p.m. Meeting Link: https://ccrinc.zoom.us/j/3677997738 Meeting ID: 367 799 7738 (Added 7/14/25) Reminders: Five-year Criminal Background Check – H. Riden, Owner, is due for her five-year Criminal Background Check renewal by 8/6/2025. This requires a new application on the ABCMS Applicant Portal and fingerprints. Out-of-state checks are required if the applicant has not lived in North Carolina for the previous five years. I reviewed the facility’s compliance history with the administrator. The 18-month compliance history from 1/12/2024 – 7/11/2025 = 78%. Please be aware that any information received during this investigation and any violations documented may be included in any future administrative actions. Violations of child care requirements, particularly repeated violations, could result in a civil penalty and/or administrative action that could jeopardize the status of the license for the child care facility. Please also refer to sections labeled Technical Assistance and Consultation for a refresher of our discussions today. If you have any questions, do not hesitate to contact 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 .2818 · Violation

Name of Operation: EAST COAST EARLY LEARNING ACADEMY Facility ID: 28000275 Consultant: MARJORIE WHITE Operation Type: Center Case Number: 0625-138L Visit Date: 7/7/2025 Number Present: 29 Completed Date: 7/7/2025 Age: From 0 To 5 Total Minutes: 180 Time In: 12:30 PM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Follow-Up Announced/Unannounced: Unannounced * The purpose of today's unannounced visit was to follow up on an allegation of a violation of child care requirements previously investigated during a Complaint visit on 6/23/2025. The allegation is as follows: 1. There is a concern of inappropriate discipline. D. Titus-Johnson, Administrator, assisted me with the visit. I completed a walk-through of the center and completed limited monitoring of child care requirements during the visit including staff/child ratios, supervision, adequate/approved space, permit restrictions, and license. I also reviewed attendance sheets for the week of 6/9/25 – 6/13/25. The following staff/child ratios (S/C) were observed: Space 1 - 3 children, ages 4 – 9 months (A. Drenning) s/c ratios = 1:3 Space 2 - 11 children, ages 1-2 years (T. Simerly; D. Swain) s/c ratios = 2:11 Space 3 - 15 children, ages 3 – 5 yrs (K. Ellington; D. Titus Johnson) s/c ratios = 2:15 Investigation: Regarding the allegation of inappropriate discipline, I completed an investigation on 6/23/2025 and could not confirm the allegation. After the visit, I received additional information to warrant a follow-up visit. I reinterviewed the administrator who confirmed that she was informed that a teacher in Space 2 had forcefully pulled a child by their arm to get the child to come out from under the portable climber on the playground. She stated that after being informed of the incident she spoke with the teacher and reminded her that children cannot be yanked or pulled by their arms when trying to move them. Based upon your statements and statements from a collateral contact, this allegation is confirmed. The following items were documented as violations during today’s visit: Violation Number Comment Rule 904 A child was handled in a rough way, including shaking, pushing, shoving, pinching, slapping, biting, kicking, or spanking. A teacher was observed forcefully pulling a child by their arm to get the child to come out from under the portable climber on the playground. .1803(a)(1) 1756 Enhanced staff/child ratios and group sizes were not met. Teachers reported that on June 12, 2025, one teacher was left alone on the playground with nine children, one and two years of age, while the other teacher went indoors to bring out a water pitcher and cups. 10A NCAC 09 .2818 * 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, D. Titus-Johnson, Administrator. We reviewed the visit summary and violation(s) documented during today’s visit. Correct these immediately. Send evidence of correction to me so that I receive it no later than 7/21/2025. Your compliance verification letter needs to include the following: 1. Name of facility and facility license # 2. Name of person writing compliance letter and position 3. Date of monitoring visit when violations were documented 4. Date compliance letter written 5. List each violation by Item # and describe when and how each violation has been corrected. 6. Send compliance verification letter in an email from your center’s official email address heidi.riden@ecelearningacademy.com to my email address, Marjorie.White@dhhs.nc.gov. If sent from another email address, the center’s official address must be Cc’d in the compliance email. 7. You may include the compliance verification as an attachment or in the body of the email. 8. If sufficient information is not received by the due date, a follow-up visit may be conducted. *I will email a sample compliance verification letter to you. *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. Violations were documented that require a follow-up visit. An unannounced visit will be made soon to verify correction of violations. Please be aware that confirmation of a complaint allegation may result in an administrative action. 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 or Jennifer.Linhardt@dhhs.nc.gov. Technical Assistance with Documented Violations: Inappropriate Discipline (Rough Handling) - Caring for children in a nurturing manner helps children to feel secure and create attachments to build positive social/emotional skills. Guidance strategies that are appropriate for the age of the child help the child learn and understand not only “what not to do” but also “what to do” which provides more options for future growth. The administrator was informed that a teacher was observed roughly handling a child by pulling them out from under a climber by their arms. Picking up children or pulling them by their arms is potentially harmful. It can lead to a common injury called nursemaid's elbow, or pulled elbow, where the radius bone in the lower arm partially dislocates at the elbow joint. It can also lead to rotator cuff injuries. This is especially risky for young children whose ligaments are still developing and relatively loose. You stated that you have reached out to Children & Youth Partnership for training and technical assistance, but the holidays have slowed the scheduling down. Look at a combination of different options for correcting this violation as soon as possible. 1. Have a staff meeting to review your center’s discipline policy. 2. P. Wilson, the Healthy Behavior Specialist at Albemarle Alliance for Children & Families (252) 333-1233, pam@aacfnc.org offers training behavior management and guidance. *“Behavioral Intervention Strategies; You Want Me to Do What?”. *“Developmentally Appropriate Behavior: But I'm Supposed to Act Like This!” 3. S. Rosser, Child Care Health Consultant, (252) 557-4208, stacy_rosser@unc.edu offers “Infant and Child Emotional and Social Wellbeing for Early Educators and Safe Handling.” 4. J. Davidson, Birth2Three Specialist, can continue to provide technical assistance with the infant and toddler teachers. Reach back out to her at joy@aacfnc.org . Enhanced Staff/Child Ratios - Staff/child ratios and group sizes based on the age of the children in care help to ensure the safety of children and allow staff to provide care, attention, and learning opportunities for each child. During an investigation for a report of inappropriate discipline, statements were shared from teachers that on June 12, 2025, one (1) teacher was left on the playground with children, one through two years of age, while the second teacher went indoors to bring out a water pitcher and cups for a water break. I checked attendance sheets from June 12, 2025. Nine (9) children, one and two years of age, were present in Space 2 that day with two (2) teachers. When the teacher went inside to pick up the water pitcher, she left the teacher on the playground with nine (9) children, one and two years of age. Enhanced staff/child ratios for groups with children one year of age is 1:6. You, the administrator stated that you usually bring out the water, but the children needed an earlier water break due to heat, and one of the teachers came inside for the water pitcher. You stated that you will remind staff that they are required to maintain staff/child ratios indoors and outdoors and need to contact you, the administrator, if a teacher needs to leave the group for any reason, if it will result in the group being out of staff/child ratios. Today, all three groups were in staff/child ratio. Some children from Space 2 were regrouped to Spaces 1 and 3 at naptime to allow for short lunch breaks. For your compliance letter, describe how you will work with staff to reinforce rules related to staff/child ratios. Consultation: Toddlers – Children who are one and two years of age are very active. They have learned to walk and run. They like to explore using their hands and mouths. They like to play by themselves and do not yet appreciate the value of sharing and taking turns. Everything is “mine”. The environment needs to be arranged to offer access to materials with duplicates of favorites. Short story times and singing and dancing times (aka group times) need to be interspersed with free play or small group play with lots of time built in for routines and transitions, especially because the bathroom and diaper changing table is not located in the classroom. Teachers need to be intentional in their daily activities to “converse” with the younger children to encourage vocabulary and conversation. Provide words that describe your actions or their actions. Name materials and adjectives to describe the materials. Use their names and praise their actions or attempts. Sing to them. Make up songs and rhymes. Because you have two teachers with more than six children, consider splitting the group into two for some activities…free play in one space and a short art activity in another. Play hard outdoors. Consider enrolling in and completing the New Introduction to Infant Toddler Orientation (NITTO) available on Moodle, a seven-week course (7 two-hour modules) to reinforce infant toddler routines and practices. Water Service – You are required to offer water breaks between meals and snacks. When the temperature is hot, it is even more important for children to stay hydrated. Water needs to be available on the playground as well as indoors. Consider using a thermal water jug with a spigot that you can fill with ice and water in the morning and place with paper cups under the shade structure on the playground before the first group goes out in the morning. You would need a table or flat surface for the water jug and a lined trash can for the paper cups. Children can also bring their own water bottles labeled with their name which they can fill up indoors before going outdoors. If toddlers are still drinking out of sippy cups and are not ready for paper cups or water bottles, put the sippy cups labeled with their names in a caddy to carry outside. Reusable sippy cups and water bottles need to go home daily to be cleaned and returned to the center with water. Compliance History: I reviewed the facility’s compliance history with the administrator. The 18-month compliance history from 1/3/2024 – 7/2/2025 = 80%. Please be aware that any information received during this investigation and any violations documented may be included in any future administrative actions. Violations of child care requirements, particularly repeated violations, could result in a civil penalty and/or administrative action that could jeopardize the status of the license for the child care facility. Please also refer to sections labeled Technical Assistance and Consultation for a refresher of our discussions today. If you have any questions, do not hesitate to contact 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.

NC GS 110-90 · Violation

Name of Operation: EAST COAST EARLY LEARNING ACADEMY Facility ID: 28000275 Consultant: MARJORIE WHITE Operation Type: Center Case Number: 0625-138L Visit Date: 7/7/2025 Number Present: 29 Completed Date: 7/7/2025 Age: From 0 To 5 Total Minutes: 180 Time In: 12:30 PM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Follow-Up Announced/Unannounced: Unannounced * The purpose of today's unannounced visit was to follow up on an allegation of a violation of child care requirements previously investigated during a Complaint visit on 6/23/2025. The allegation is as follows: 1. There is a concern of inappropriate discipline. D. Titus-Johnson, Administrator, assisted me with the visit. I completed a walk-through of the center and completed limited monitoring of child care requirements during the visit including staff/child ratios, supervision, adequate/approved space, permit restrictions, and license. I also reviewed attendance sheets for the week of 6/9/25 – 6/13/25. The following staff/child ratios (S/C) were observed: Space 1 - 3 children, ages 4 – 9 months (A. Drenning) s/c ratios = 1:3 Space 2 - 11 children, ages 1-2 years (T. Simerly; D. Swain) s/c ratios = 2:11 Space 3 - 15 children, ages 3 – 5 yrs (K. Ellington; D. Titus Johnson) s/c ratios = 2:15 Investigation: Regarding the allegation of inappropriate discipline, I completed an investigation on 6/23/2025 and could not confirm the allegation. After the visit, I received additional information to warrant a follow-up visit. I reinterviewed the administrator who confirmed that she was informed that a teacher in Space 2 had forcefully pulled a child by their arm to get the child to come out from under the portable climber on the playground. She stated that after being informed of the incident she spoke with the teacher and reminded her that children cannot be yanked or pulled by their arms when trying to move them. Based upon your statements and statements from a collateral contact, this allegation is confirmed. The following items were documented as violations during today’s visit: Violation Number Comment Rule 904 A child was handled in a rough way, including shaking, pushing, shoving, pinching, slapping, biting, kicking, or spanking. A teacher was observed forcefully pulling a child by their arm to get the child to come out from under the portable climber on the playground. .1803(a)(1) 1756 Enhanced staff/child ratios and group sizes were not met. Teachers reported that on June 12, 2025, one teacher was left alone on the playground with nine children, one and two years of age, while the other teacher went indoors to bring out a water pitcher and cups. 10A NCAC 09 .2818 * 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, D. Titus-Johnson, Administrator. We reviewed the visit summary and violation(s) documented during today’s visit. Correct these immediately. Send evidence of correction to me so that I receive it no later than 7/21/2025. Your compliance verification letter needs to include the following: 1. Name of facility and facility license # 2. Name of person writing compliance letter and position 3. Date of monitoring visit when violations were documented 4. Date compliance letter written 5. List each violation by Item # and describe when and how each violation has been corrected. 6. Send compliance verification letter in an email from your center’s official email address heidi.riden@ecelearningacademy.com to my email address, Marjorie.White@dhhs.nc.gov. If sent from another email address, the center’s official address must be Cc’d in the compliance email. 7. You may include the compliance verification as an attachment or in the body of the email. 8. If sufficient information is not received by the due date, a follow-up visit may be conducted. *I will email a sample compliance verification letter to you. *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. Violations were documented that require a follow-up visit. An unannounced visit will be made soon to verify correction of violations. Please be aware that confirmation of a complaint allegation may result in an administrative action. 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 or Jennifer.Linhardt@dhhs.nc.gov. Technical Assistance with Documented Violations: Inappropriate Discipline (Rough Handling) - Caring for children in a nurturing manner helps children to feel secure and create attachments to build positive social/emotional skills. Guidance strategies that are appropriate for the age of the child help the child learn and understand not only “what not to do” but also “what to do” which provides more options for future growth. The administrator was informed that a teacher was observed roughly handling a child by pulling them out from under a climber by their arms. Picking up children or pulling them by their arms is potentially harmful. It can lead to a common injury called nursemaid's elbow, or pulled elbow, where the radius bone in the lower arm partially dislocates at the elbow joint. It can also lead to rotator cuff injuries. This is especially risky for young children whose ligaments are still developing and relatively loose. You stated that you have reached out to Children & Youth Partnership for training and technical assistance, but the holidays have slowed the scheduling down. Look at a combination of different options for correcting this violation as soon as possible. 1. Have a staff meeting to review your center’s discipline policy. 2. P. Wilson, the Healthy Behavior Specialist at Albemarle Alliance for Children & Families (252) 333-1233, pam@aacfnc.org offers training behavior management and guidance. *“Behavioral Intervention Strategies; You Want Me to Do What?”. *“Developmentally Appropriate Behavior: But I'm Supposed to Act Like This!” 3. S. Rosser, Child Care Health Consultant, (252) 557-4208, stacy_rosser@unc.edu offers “Infant and Child Emotional and Social Wellbeing for Early Educators and Safe Handling.” 4. J. Davidson, Birth2Three Specialist, can continue to provide technical assistance with the infant and toddler teachers. Reach back out to her at joy@aacfnc.org . Enhanced Staff/Child Ratios - Staff/child ratios and group sizes based on the age of the children in care help to ensure the safety of children and allow staff to provide care, attention, and learning opportunities for each child. During an investigation for a report of inappropriate discipline, statements were shared from teachers that on June 12, 2025, one (1) teacher was left on the playground with children, one through two years of age, while the second teacher went indoors to bring out a water pitcher and cups for a water break. I checked attendance sheets from June 12, 2025. Nine (9) children, one and two years of age, were present in Space 2 that day with two (2) teachers. When the teacher went inside to pick up the water pitcher, she left the teacher on the playground with nine (9) children, one and two years of age. Enhanced staff/child ratios for groups with children one year of age is 1:6. You, the administrator stated that you usually bring out the water, but the children needed an earlier water break due to heat, and one of the teachers came inside for the water pitcher. You stated that you will remind staff that they are required to maintain staff/child ratios indoors and outdoors and need to contact you, the administrator, if a teacher needs to leave the group for any reason, if it will result in the group being out of staff/child ratios. Today, all three groups were in staff/child ratio. Some children from Space 2 were regrouped to Spaces 1 and 3 at naptime to allow for short lunch breaks. For your compliance letter, describe how you will work with staff to reinforce rules related to staff/child ratios. Consultation: Toddlers – Children who are one and two years of age are very active. They have learned to walk and run. They like to explore using their hands and mouths. They like to play by themselves and do not yet appreciate the value of sharing and taking turns. Everything is “mine”. The environment needs to be arranged to offer access to materials with duplicates of favorites. Short story times and singing and dancing times (aka group times) need to be interspersed with free play or small group play with lots of time built in for routines and transitions, especially because the bathroom and diaper changing table is not located in the classroom. Teachers need to be intentional in their daily activities to “converse” with the younger children to encourage vocabulary and conversation. Provide words that describe your actions or their actions. Name materials and adjectives to describe the materials. Use their names and praise their actions or attempts. Sing to them. Make up songs and rhymes. Because you have two teachers with more than six children, consider splitting the group into two for some activities…free play in one space and a short art activity in another. Play hard outdoors. Consider enrolling in and completing the New Introduction to Infant Toddler Orientation (NITTO) available on Moodle, a seven-week course (7 two-hour modules) to reinforce infant toddler routines and practices. Water Service – You are required to offer water breaks between meals and snacks. When the temperature is hot, it is even more important for children to stay hydrated. Water needs to be available on the playground as well as indoors. Consider using a thermal water jug with a spigot that you can fill with ice and water in the morning and place with paper cups under the shade structure on the playground before the first group goes out in the morning. You would need a table or flat surface for the water jug and a lined trash can for the paper cups. Children can also bring their own water bottles labeled with their name which they can fill up indoors before going outdoors. If toddlers are still drinking out of sippy cups and are not ready for paper cups or water bottles, put the sippy cups labeled with their names in a caddy to carry outside. Reusable sippy cups and water bottles need to go home daily to be cleaned and returned to the center with water. Compliance History: I reviewed the facility’s compliance history with the administrator. The 18-month compliance history from 1/3/2024 – 7/2/2025 = 80%. Please be aware that any information received during this investigation and any violations documented may be included in any future administrative actions. Violations of child care requirements, particularly repeated violations, could result in a civil penalty and/or administrative action that could jeopardize the status of the license for the child care facility. Please also refer to sections labeled Technical Assistance and Consultation for a refresher of our discussions today. If you have any questions, do not hesitate to contact 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: EAST COAST EARLY LEARNING ACADEMY Facility ID: 28000275 Consultant: MARJORIE WHITE Operation Type: Center Case Number: Visit Date: 2/11/2025 Number Present: 23 Completed Date: 2/11/2025 Age: From 0 To 5 Total Minutes: 405 Time In: 09:00 AM Time Out: 03:45 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. Last Annual Compliance visit – 3/25/24 18-month compliance history from 8/8/23 – 2/7/25 = 81% Last Sanitation Inspection – 11/19/24 - Approved Last Fire Inspection – 3/14/24 – Satisfactory; Daytime Care Only; getting ready to expire *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. D. Titus-Johnson, Administrator, was present and assisted me with the visit. H. Riden, Owner, stopped by for a few minutes to check in. The facility currently operates with a Five-Star Center License, issued 2/23/2022, earning points in the following components: Program (6 PTS) + Education (6 PTS) + Quality Point (1 PT) = 13 Points = 5 Stars *Quality Point met and remains in effect: Staff benefits and an infrastructure of parent involvement The program was also monitored for compliance with implementing an approved curriculum (Creative Curriculum 5th edition) as required for all four and five star facilities where four-year old children are enrolled. The next rated license assessment is due by 2/23/25, but new legislation (Senate Bill 425) has extended the “hold harmless” period until the new Quality Rating Improvement System (QRIS) is implemented. At this time, you may choose to complete a rated license assessment using the current rated license process or you may wait until the new QRIS is implemented. Note that the current program assessment tool is changing from the Early Childhood Environment Rating Scale – Revised (ECERS-R) to the Early Childhood Environment Rating Scale – 3 (ECERS-3) and ITERS-R to ITERS-3. Information and training on the new program assessment tools is available on the NC Rating License Assessment Project website at https://ncrlap.org/. The proposed QRIS Modernization rules have been published and are open for public comments. I encourage you to review these and share any feedback you may have with the Child Care Commission. See Additional Comments for links for the proposed rules and contact information for the Commission. This facility is owned by East Coast Academies, Inc. According to the NC Secretary of State's website, this corporation is current and active as of 2/7/25. Please contact me prior to any information change regarding the ownership of this facility. License information was current. Contact me to make any changes to address, phone, or email or to request changes to the license. I monitored the classrooms and spaces used for child care and outdoor play area for applicable child care center requirements using the Child Care Center Requirements, effective 11/1/2024 and Item Numbers Listing, effective 3/2024. I monitored six staff records, three children’s records and all program records. The facility does not offer transportation. Center Observations: It was very cold today due to the wind, but the children in Spaces 2 and 3 bundled up and went outdoors for outdoor playtime. They were able to play on the portable climber and car. Dramatic play materials and tricycles were also available along with other portable gross motor equipment. Indoors, one infant and two toddlers were in Space 1 with their teacher. When not sleeping or eating, they played on the floor and had access to toys or the teacher provided them to the infant who was not crawling yet. Documentation of safe sleep checks and feeding plans were posted. Activity plans were posted in each classroom and reflected individual free play and group time. The menu was posted at the entrance and in the kitchen. Lunch was beanie weenies, carrots, peaches, whole grain crackers, and milk. Allergies were posted in each classroom and in the kitchen. After lunch, children rested on linen-covered cots. 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. A power strip under the counter in Space 1 had two uncovered outlets. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. A container of Clorox Disinfecting Wipes was stored out of reach of children but was not locked. .2820(b) 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 staff member hired on August 12, 2024 did not have a staff medical report on file until September 6, 2024. A staff member hired on July 15, 2024 did not have a staff medical report on file until July 27, 2024. 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 staff member hired on August 12, 2024 did not have a TB screening or TB test on file until September 6, 2024. A staff member hired on November 20, 2024 did not have a TB screening or TB test on file until November 21, 2024 .0701(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. A staff member hired on August 12, 2024 did not provide documentation of current First Aid certification and did not complete a First Aid course until January 23, 2025. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. AA staff member hired on August 12, 2024 did not provide documentation of current CPR certification and did not complete a CPR course until January 23, 2025. .1102(d) 1316 Emergency medical care information did not contain information needed for safe medical treatment. A child's application was not updated to include new medical information related to recently diagnosed allergies and medication needed for an allergic reaction. .0802 (c)(4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. A medication permission form for an Auvi-Q was authorized to be administered from January 13, 2025 - January 13, 2026. A medical permission form for Albuterol was authorized to be administered from September 13, 2024 - Present. Neither form included a six-month authorization period. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-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, D. Titus-Johnson, Administrator. We reviewed the visit summary and the eight (8) violations documented during today’s visit. You corrected six (6) of these prior or during the visit. Correct the remaining two (2) violations immediately. Send evidence of correction to me so that I receive it no later than 2/25/25. 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. Send compliance verification letter in an email from your fcch’s official email address, heidi.riden@ecelearningacademy.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: 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. A power strip under the counter in Space 1 had two open outlets. You stated that this power strip used to be behind the refrigerator which you recently removed from the infant room. You immediately added two outlet covers to the power strip and will remind staff to cover outlets when not in use. This was corrected during the visit. Storage of Hazardous Items - Items with additional warning labels, including some personal care items, all cleaning supplies, and anything in an aerosol can are required to be locked including full-strength bleach, disinfecting wipes, aerosol disinfecting sprays, batteries, Hand soap may be accessible to children for hand washing but should be monitored. Even though hand sanitizer was used more during the COVID-19 pandemic, it must be stored out of reach of children. A container of Clorox Disinfecting Wipes was stored on a high shelf out of reach of children in Space 3 but was not locked. You stated that the staff had used it and forgotten to return to a locked cabinet. You corrected this immediately. You stated that you will remind staff to check spaces for cleaning supplies. Staff Medical Report – SMR and TB Screening or Test - A Staff Medical Report (SMR) 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 can complete the physical responsibilities needed to work in child care. The following staff did not have a Staff Medical Report on file by their first day of work – A. McCauley (hired 8/12/24; SMR received 9/6/24); O. Roughton (hired 7/15/24; SMR received 7/27/24); The following staff did not have documentation of a TB screening or negative TB test on file by their first day of work - A. McCauley (hired 8/12/24; TB test received 9/6/24); T. Simerly (hired 11/20/24; TB Test received 11/21/24). You stated that you did not realize that the staff medical report and TB test for AM could not be used because they were more than 12 months old. 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 so no further action is required except to ensure that staff medical reports and TB tests are received by an employee’s first day of work. First Aid and CPR – Early care and education programs with staff trained in pediatric first aid and CPR can mitigate the consequences of injury and reduce the potential for death from life-threatening conditions and emergencies. Repetitive training, coupled with the confidence to use these skills, is critically important to the outcome of an emergency. (Caring for Our Children, 4th Edition). A. McCauley was hired on 8/12/2024 and required to complete CPR/First Aid by 11/12/2024. Documentation available in the file reflects that she completed CPR/First aid on 1/23/25. You stated that AM had current CPR/First Aid when she was hired and recertified before it expired; however, there was no documentation of an earlier CPR/First Aid card in her file and the Staff File Checklist did not include the date of her previous CPR/First Aid certification. Ensure that staff provide you with copies of any current certifications, training, etc. at hire. If they do not have copies, register them for any required trainings within the required time frame. This has been corrected. No further action or documentation in required except to maintain current First Aid and CPR in the future. Repeated CPR/First Aid violations may result in an Administrative Action. *T. Simerly hired on 11/20/24 is due to complete CPR/First Aid by 2/20/25. *L. Freeman hire don 1/16/25 is due to complete CPR/First Aid by 4/15/25. *CPR/First Aid expires for D. Titus-Johnson and K. Ellington on 6/30/25. Child’s Application - Health Care Needs – The DCDEE form “Child’s Application for Enrollment” contains important information related to the care of children. This form is required at enrollment and needs to be updated at least annually or as information changes. A child’s application for AM in Space 2 was originally completed on 1/31/24 before starting on 2/5/24. The parent checked that there was not a medical action plan, and wrote n/a indicating the child had no allergies, medications other than Tylenol or Ibuprofen for teething, and no health care needs. A Medical Action Plan, dated 1/8/25, was added to the file (attached to the Child’s Medical Report – needs to be attached to the Child’s Application) reflecting that the child has been diagnosed with a food allergy requiring Auvi-Q. Auvi-Q for the child was observed in the center’s locked box in the office. The Child’s Application was not updated to reflect the changes to the child’s health information. You stated You have an Annual Update Form to update contact information. When this is completed, have families also review and update their Child’s Application to verify the child’s health information also. This should also be updated when a parent informs you of new health care needs for a child such as a diagnosed allergy or medical condition. For your compliance letter, provide the parent of AM with a blank Child’s Application to complete and update with the child’s new health care information. State the date the updated child’s application is available in the child’s file. Use this violation to have all families review and update their child’s applications to verify that information is current. Standing Authorization for Medication – Medication dosage for young children has to be updated more frequently because they are growing so quickly between infancy and preschool. The medication permission form for chronic conditions must be reauthorized every six months by the parent to verify that the listed dosage and other information are still correct The medication permission form for an Auvi-Q (MA – Space 2) was authorized to be administered from January 13, 2025 - January 13, 2026. A medical permission form for Albuterol (JC – Space 3) was authorized to be administered from September 13, 2024 - Present. Neither form included a six-month authorization period. You stated that the parents completed this information. Remember that it is your responsibility to review medication, medication permission forms and medical action plans before receiving them into your center. Have the parents reauthorize both medications for six months (2/11/25 – 8/11/25). Consider setting a standing six month authorization (January – July and July – January) where you have parents update six-month medications in January and July. 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. You told me that you receive the Raise NC Newsletter and have used it to keep up with the information related to the QRIS modernization. Encourage your staff to sign up for updates from DCDEE so they can be aware of breaking news and training. 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. *Children & Youth Partnership for Dare County: Phone - (252) 441-0614; website - www.darekids.org. *Child Care Health Consultant – S. Rosser - Office: (252) 557-4208 or stacy_rosser@unc.edu *Albemarle Alliance for Children and Families (AACF) and Region 1 Child Care Resource and Referral: Phone – (252) 333-1233; website - www.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 *Southwestern Child Development Commission, www.swcdcinc.org - offers DCDEE approved, on-line, self-paced training with affordable annual packages allowing you to take as many courses as you need or want for one price. Reminders: ABCMS Portal - The process of notifying the Division when you have new staff (or household members for family child care homes and centers licensed in a residence) has changed and is now captured in ABCMS, the new Criminal Background Check portal. You, D. Titus-Johnson, have completed the ABCMS Provider Portal Training and have received authorization to access the ABCMS Provider Portal where you can locate your provider codes. I reviewed your roster and saw that you have completed a Connecting Application for yourself and “hired” yourself to your roster. Continue to do this with the rest of your staff. When new staff are hired, they can connect during their initial application process or you can help them complete a connecting application within five days. If you need assistance, contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. I will review your facility roster to verify that current staff are listed at your next visit. 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. *Encourage staff to maintain copies of all initial hire documents, Qualifying Letters, training certificates, etc. in their own professional file maintained at home. *Make it easier on yourself and schedule annual updates for staff evaluations and professional development plans; health questionnaires and emergency information forms; EPR Plan and Emergency Medical Care Plan at the same time to streamline your staff updates. (Example, even if an employee was hired in January , and you update health questionnaires and emergency forms in August, have this employee go ahead and update in August with the rest of the staff to jump into the same cycle!) *We reviewed your staff worksheet. I highlighted items that were delinquent and items that are coming due in the next year. *Staff evaluations and professional development plans due – K. Ellington (February 2025); D. Titus-Johnson (May 2025) – *Annual Health Questionnaire & Emergency Information Forms updated by - K. Ellington (February 2025); D. Titus-Johnson (May 2025) Health and Safety Training and Five (5) Year Cycle Tracking Requirements –New staff need to complete Recognizing and Responding to Suspicions of Child Maltreatment and CPR/First Aid within three months of hire and the rest of the training modules within twelve months. CPR/First Aid – T. Simerly (due 2/20/25); L. Freeman (due 4/16/25); D. Titus-Johnson (exp 6/30/25); K. Ellington (exp 6/30/25) Recognizing and Responding to Suspicions of Child Maltreatment - T. Simerly (due 2/20/25); L. Freeman (due 4/16/25); O. Roughton (complete again) Rest of H&S Modules – due 12 months from hire and every five years – See Row 17 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 2/11/26 (anniversary to today’s Annual Compliance visit). *ECE college coursework or coursework leading to an ECE degree counts towards on-going training hours. Each semester credit counts as 16 hours so a 3-credit classes also earns 48 hours of on-going training. Lead Teacher Requirements – Lead Teachers who do not have the NC Early Childhood Credential (NCECC) or higher have six months to enroll in coursework that will lead to the NCECC (EDU 119 at the local community college) and eighteen months to complete it after enrollment. A. Drenning is enrolling in EDU 119. Fire and Emergency Drills – current Emergency Medical Care Plan – current and posted *The owner, H. Riden, is not on-site enough to be listed in the EPR Plan or the Emergency Medical care Plan. Update both of them to reflect staff who are consistently on-site. If you continue to list Ms. Riden, consider having additional staff listed as alternatives in the event that D. Titus-Johnson is not on-site EPR Plan – last updated 8/2024; next update due 8/2025 Outdoor Inspections - current Nutrition – Staff are required to model healthy eating habits when consuming food and beverages in front of children. Cans or bottles of soda pop (or cups from fast food restaurants) may not be visible in the classroom or in front of children. Include a grain with lunch (bread, crackers, roll). Infants – Safe sleep checks are required until the infant turns one year of age. Feeding plans are required for children Birth – 15 months of age. They need to be completed by the parent at enrollment and updated as the infant/toddler’s feeding habits transition from formula/breast milk to baby food to solid foods. Post in the room. Maintain open communication with families so that they inform you when they are adding different foods to their child’s diets so that you can update the feeding plan. Once a child turns 15 months of age, place the feeding plan in the child’s file. Hold or place infants and toddlers in appropriate feeding devices (high chair, low chair, small table and chair) when giving them food or beverages even if they can hold their own bottle. Infants and toddlers may not be given food or beverages in a bouncy seat, crib, or free style around the room. Cots – Remind staff to not place or store items on the cots when they are stacked and to not allow children to climb or sit on cots that are stacked. Cots must be at least 18 inches apart at naptime or separated by a solid barrier to reduce the spread of germs. Medication – You did a much better job with medication permission forms and medication storage. Just remember that topical ointments (diaper cream, sunscreen, lotion) can be authorized for 12 months. Medications for chronic medical conditions can be authorized for up to months. Additional Comments: I shared information on the following topics and emailed the information to you after the visit: 1. Update on QRIS Modernization – Proposed Rules Published, Open for Public Comments 2. Free Training – Logical Consequences – 2/18/25 3. Moodle Helpful Hints 4. NCID Tips 5. Health & Safety Resource Center – E New- Winter, Water and Safety 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: EAST COAST EARLY LEARNING ACADEMY Facility ID: 28000275 Consultant: MARJORIE WHITE Operation Type: Center Case Number: Visit Date: 2/11/2025 Number Present: 23 Completed Date: 2/11/2025 Age: From 0 To 5 Total Minutes: 405 Time In: 09:00 AM Time Out: 03:45 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. Last Annual Compliance visit – 3/25/24 18-month compliance history from 8/8/23 – 2/7/25 = 81% Last Sanitation Inspection – 11/19/24 - Approved Last Fire Inspection – 3/14/24 – Satisfactory; Daytime Care Only; getting ready to expire *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. D. Titus-Johnson, Administrator, was present and assisted me with the visit. H. Riden, Owner, stopped by for a few minutes to check in. The facility currently operates with a Five-Star Center License, issued 2/23/2022, earning points in the following components: Program (6 PTS) + Education (6 PTS) + Quality Point (1 PT) = 13 Points = 5 Stars *Quality Point met and remains in effect: Staff benefits and an infrastructure of parent involvement The program was also monitored for compliance with implementing an approved curriculum (Creative Curriculum 5th edition) as required for all four and five star facilities where four-year old children are enrolled. The next rated license assessment is due by 2/23/25, but new legislation (Senate Bill 425) has extended the “hold harmless” period until the new Quality Rating Improvement System (QRIS) is implemented. At this time, you may choose to complete a rated license assessment using the current rated license process or you may wait until the new QRIS is implemented. Note that the current program assessment tool is changing from the Early Childhood Environment Rating Scale – Revised (ECERS-R) to the Early Childhood Environment Rating Scale – 3 (ECERS-3) and ITERS-R to ITERS-3. Information and training on the new program assessment tools is available on the NC Rating License Assessment Project website at https://ncrlap.org/. The proposed QRIS Modernization rules have been published and are open for public comments. I encourage you to review these and share any feedback you may have with the Child Care Commission. See Additional Comments for links for the proposed rules and contact information for the Commission. This facility is owned by East Coast Academies, Inc. According to the NC Secretary of State's website, this corporation is current and active as of 2/7/25. Please contact me prior to any information change regarding the ownership of this facility. License information was current. Contact me to make any changes to address, phone, or email or to request changes to the license. I monitored the classrooms and spaces used for child care and outdoor play area for applicable child care center requirements using the Child Care Center Requirements, effective 11/1/2024 and Item Numbers Listing, effective 3/2024. I monitored six staff records, three children’s records and all program records. The facility does not offer transportation. Center Observations: It was very cold today due to the wind, but the children in Spaces 2 and 3 bundled up and went outdoors for outdoor playtime. They were able to play on the portable climber and car. Dramatic play materials and tricycles were also available along with other portable gross motor equipment. Indoors, one infant and two toddlers were in Space 1 with their teacher. When not sleeping or eating, they played on the floor and had access to toys or the teacher provided them to the infant who was not crawling yet. Documentation of safe sleep checks and feeding plans were posted. Activity plans were posted in each classroom and reflected individual free play and group time. The menu was posted at the entrance and in the kitchen. Lunch was beanie weenies, carrots, peaches, whole grain crackers, and milk. Allergies were posted in each classroom and in the kitchen. After lunch, children rested on linen-covered cots. 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. A power strip under the counter in Space 1 had two uncovered outlets. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. A container of Clorox Disinfecting Wipes was stored out of reach of children but was not locked. .2820(b) 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 staff member hired on August 12, 2024 did not have a staff medical report on file until September 6, 2024. A staff member hired on July 15, 2024 did not have a staff medical report on file until July 27, 2024. 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 staff member hired on August 12, 2024 did not have a TB screening or TB test on file until September 6, 2024. A staff member hired on November 20, 2024 did not have a TB screening or TB test on file until November 21, 2024 .0701(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. A staff member hired on August 12, 2024 did not provide documentation of current First Aid certification and did not complete a First Aid course until January 23, 2025. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. AA staff member hired on August 12, 2024 did not provide documentation of current CPR certification and did not complete a CPR course until January 23, 2025. .1102(d) 1316 Emergency medical care information did not contain information needed for safe medical treatment. A child's application was not updated to include new medical information related to recently diagnosed allergies and medication needed for an allergic reaction. .0802 (c)(4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. A medication permission form for an Auvi-Q was authorized to be administered from January 13, 2025 - January 13, 2026. A medical permission form for Albuterol was authorized to be administered from September 13, 2024 - Present. Neither form included a six-month authorization period. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-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, D. Titus-Johnson, Administrator. We reviewed the visit summary and the eight (8) violations documented during today’s visit. You corrected six (6) of these prior or during the visit. Correct the remaining two (2) violations immediately. Send evidence of correction to me so that I receive it no later than 2/25/25. 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. Send compliance verification letter in an email from your fcch’s official email address, heidi.riden@ecelearningacademy.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: 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. A power strip under the counter in Space 1 had two open outlets. You stated that this power strip used to be behind the refrigerator which you recently removed from the infant room. You immediately added two outlet covers to the power strip and will remind staff to cover outlets when not in use. This was corrected during the visit. Storage of Hazardous Items - Items with additional warning labels, including some personal care items, all cleaning supplies, and anything in an aerosol can are required to be locked including full-strength bleach, disinfecting wipes, aerosol disinfecting sprays, batteries, Hand soap may be accessible to children for hand washing but should be monitored. Even though hand sanitizer was used more during the COVID-19 pandemic, it must be stored out of reach of children. A container of Clorox Disinfecting Wipes was stored on a high shelf out of reach of children in Space 3 but was not locked. You stated that the staff had used it and forgotten to return to a locked cabinet. You corrected this immediately. You stated that you will remind staff to check spaces for cleaning supplies. Staff Medical Report – SMR and TB Screening or Test - A Staff Medical Report (SMR) 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 can complete the physical responsibilities needed to work in child care. The following staff did not have a Staff Medical Report on file by their first day of work – A. McCauley (hired 8/12/24; SMR received 9/6/24); O. Roughton (hired 7/15/24; SMR received 7/27/24); The following staff did not have documentation of a TB screening or negative TB test on file by their first day of work - A. McCauley (hired 8/12/24; TB test received 9/6/24); T. Simerly (hired 11/20/24; TB Test received 11/21/24). You stated that you did not realize that the staff medical report and TB test for AM could not be used because they were more than 12 months old. 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 so no further action is required except to ensure that staff medical reports and TB tests are received by an employee’s first day of work. First Aid and CPR – Early care and education programs with staff trained in pediatric first aid and CPR can mitigate the consequences of injury and reduce the potential for death from life-threatening conditions and emergencies. Repetitive training, coupled with the confidence to use these skills, is critically important to the outcome of an emergency. (Caring for Our Children, 4th Edition). A. McCauley was hired on 8/12/2024 and required to complete CPR/First Aid by 11/12/2024. Documentation available in the file reflects that she completed CPR/First aid on 1/23/25. You stated that AM had current CPR/First Aid when she was hired and recertified before it expired; however, there was no documentation of an earlier CPR/First Aid card in her file and the Staff File Checklist did not include the date of her previous CPR/First Aid certification. Ensure that staff provide you with copies of any current certifications, training, etc. at hire. If they do not have copies, register them for any required trainings within the required time frame. This has been corrected. No further action or documentation in required except to maintain current First Aid and CPR in the future. Repeated CPR/First Aid violations may result in an Administrative Action. *T. Simerly hired on 11/20/24 is due to complete CPR/First Aid by 2/20/25. *L. Freeman hire don 1/16/25 is due to complete CPR/First Aid by 4/15/25. *CPR/First Aid expires for D. Titus-Johnson and K. Ellington on 6/30/25. Child’s Application - Health Care Needs – The DCDEE form “Child’s Application for Enrollment” contains important information related to the care of children. This form is required at enrollment and needs to be updated at least annually or as information changes. A child’s application for AM in Space 2 was originally completed on 1/31/24 before starting on 2/5/24. The parent checked that there was not a medical action plan, and wrote n/a indicating the child had no allergies, medications other than Tylenol or Ibuprofen for teething, and no health care needs. A Medical Action Plan, dated 1/8/25, was added to the file (attached to the Child’s Medical Report – needs to be attached to the Child’s Application) reflecting that the child has been diagnosed with a food allergy requiring Auvi-Q. Auvi-Q for the child was observed in the center’s locked box in the office. The Child’s Application was not updated to reflect the changes to the child’s health information. You stated You have an Annual Update Form to update contact information. When this is completed, have families also review and update their Child’s Application to verify the child’s health information also. This should also be updated when a parent informs you of new health care needs for a child such as a diagnosed allergy or medical condition. For your compliance letter, provide the parent of AM with a blank Child’s Application to complete and update with the child’s new health care information. State the date the updated child’s application is available in the child’s file. Use this violation to have all families review and update their child’s applications to verify that information is current. Standing Authorization for Medication – Medication dosage for young children has to be updated more frequently because they are growing so quickly between infancy and preschool. The medication permission form for chronic conditions must be reauthorized every six months by the parent to verify that the listed dosage and other information are still correct The medication permission form for an Auvi-Q (MA – Space 2) was authorized to be administered from January 13, 2025 - January 13, 2026. A medical permission form for Albuterol (JC – Space 3) was authorized to be administered from September 13, 2024 - Present. Neither form included a six-month authorization period. You stated that the parents completed this information. Remember that it is your responsibility to review medication, medication permission forms and medical action plans before receiving them into your center. Have the parents reauthorize both medications for six months (2/11/25 – 8/11/25). Consider setting a standing six month authorization (January – July and July – January) where you have parents update six-month medications in January and July. 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. You told me that you receive the Raise NC Newsletter and have used it to keep up with the information related to the QRIS modernization. Encourage your staff to sign up for updates from DCDEE so they can be aware of breaking news and training. 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. *Children & Youth Partnership for Dare County: Phone - (252) 441-0614; website - www.darekids.org. *Child Care Health Consultant – S. Rosser - Office: (252) 557-4208 or stacy_rosser@unc.edu *Albemarle Alliance for Children and Families (AACF) and Region 1 Child Care Resource and Referral: Phone – (252) 333-1233; website - www.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 *Southwestern Child Development Commission, www.swcdcinc.org - offers DCDEE approved, on-line, self-paced training with affordable annual packages allowing you to take as many courses as you need or want for one price. Reminders: ABCMS Portal - The process of notifying the Division when you have new staff (or household members for family child care homes and centers licensed in a residence) has changed and is now captured in ABCMS, the new Criminal Background Check portal. You, D. Titus-Johnson, have completed the ABCMS Provider Portal Training and have received authorization to access the ABCMS Provider Portal where you can locate your provider codes. I reviewed your roster and saw that you have completed a Connecting Application for yourself and “hired” yourself to your roster. Continue to do this with the rest of your staff. When new staff are hired, they can connect during their initial application process or you can help them complete a connecting application within five days. If you need assistance, contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. I will review your facility roster to verify that current staff are listed at your next visit. 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. *Encourage staff to maintain copies of all initial hire documents, Qualifying Letters, training certificates, etc. in their own professional file maintained at home. *Make it easier on yourself and schedule annual updates for staff evaluations and professional development plans; health questionnaires and emergency information forms; EPR Plan and Emergency Medical Care Plan at the same time to streamline your staff updates. (Example, even if an employee was hired in January , and you update health questionnaires and emergency forms in August, have this employee go ahead and update in August with the rest of the staff to jump into the same cycle!) *We reviewed your staff worksheet. I highlighted items that were delinquent and items that are coming due in the next year. *Staff evaluations and professional development plans due – K. Ellington (February 2025); D. Titus-Johnson (May 2025) – *Annual Health Questionnaire & Emergency Information Forms updated by - K. Ellington (February 2025); D. Titus-Johnson (May 2025) Health and Safety Training and Five (5) Year Cycle Tracking Requirements –New staff need to complete Recognizing and Responding to Suspicions of Child Maltreatment and CPR/First Aid within three months of hire and the rest of the training modules within twelve months. CPR/First Aid – T. Simerly (due 2/20/25); L. Freeman (due 4/16/25); D. Titus-Johnson (exp 6/30/25); K. Ellington (exp 6/30/25) Recognizing and Responding to Suspicions of Child Maltreatment - T. Simerly (due 2/20/25); L. Freeman (due 4/16/25); O. Roughton (complete again) Rest of H&S Modules – due 12 months from hire and every five years – See Row 17 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 2/11/26 (anniversary to today’s Annual Compliance visit). *ECE college coursework or coursework leading to an ECE degree counts towards on-going training hours. Each semester credit counts as 16 hours so a 3-credit classes also earns 48 hours of on-going training. Lead Teacher Requirements – Lead Teachers who do not have the NC Early Childhood Credential (NCECC) or higher have six months to enroll in coursework that will lead to the NCECC (EDU 119 at the local community college) and eighteen months to complete it after enrollment. A. Drenning is enrolling in EDU 119. Fire and Emergency Drills – current Emergency Medical Care Plan – current and posted *The owner, H. Riden, is not on-site enough to be listed in the EPR Plan or the Emergency Medical care Plan. Update both of them to reflect staff who are consistently on-site. If you continue to list Ms. Riden, consider having additional staff listed as alternatives in the event that D. Titus-Johnson is not on-site EPR Plan – last updated 8/2024; next update due 8/2025 Outdoor Inspections - current Nutrition – Staff are required to model healthy eating habits when consuming food and beverages in front of children. Cans or bottles of soda pop (or cups from fast food restaurants) may not be visible in the classroom or in front of children. Include a grain with lunch (bread, crackers, roll). Infants – Safe sleep checks are required until the infant turns one year of age. Feeding plans are required for children Birth – 15 months of age. They need to be completed by the parent at enrollment and updated as the infant/toddler’s feeding habits transition from formula/breast milk to baby food to solid foods. Post in the room. Maintain open communication with families so that they inform you when they are adding different foods to their child’s diets so that you can update the feeding plan. Once a child turns 15 months of age, place the feeding plan in the child’s file. Hold or place infants and toddlers in appropriate feeding devices (high chair, low chair, small table and chair) when giving them food or beverages even if they can hold their own bottle. Infants and toddlers may not be given food or beverages in a bouncy seat, crib, or free style around the room. Cots – Remind staff to not place or store items on the cots when they are stacked and to not allow children to climb or sit on cots that are stacked. Cots must be at least 18 inches apart at naptime or separated by a solid barrier to reduce the spread of germs. Medication – You did a much better job with medication permission forms and medication storage. Just remember that topical ointments (diaper cream, sunscreen, lotion) can be authorized for 12 months. Medications for chronic medical conditions can be authorized for up to months. Additional Comments: I shared information on the following topics and emailed the information to you after the visit: 1. Update on QRIS Modernization – Proposed Rules Published, Open for Public Comments 2. Free Training – Logical Consequences – 2/18/25 3. Moodle Helpful Hints 4. NCID Tips 5. Health & Safety Resource Center – E New- Winter, Water and Safety 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: EAST COAST EARLY LEARNING ACADEMY Facility ID: 28000275 Consultant: MARJORIE WHITE Operation Type: Center Case Number: Visit Date: 2/11/2025 Number Present: 23 Completed Date: 2/11/2025 Age: From 0 To 5 Total Minutes: 405 Time In: 09:00 AM Time Out: 03:45 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. Last Annual Compliance visit – 3/25/24 18-month compliance history from 8/8/23 – 2/7/25 = 81% Last Sanitation Inspection – 11/19/24 - Approved Last Fire Inspection – 3/14/24 – Satisfactory; Daytime Care Only; getting ready to expire *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. D. Titus-Johnson, Administrator, was present and assisted me with the visit. H. Riden, Owner, stopped by for a few minutes to check in. The facility currently operates with a Five-Star Center License, issued 2/23/2022, earning points in the following components: Program (6 PTS) + Education (6 PTS) + Quality Point (1 PT) = 13 Points = 5 Stars *Quality Point met and remains in effect: Staff benefits and an infrastructure of parent involvement The program was also monitored for compliance with implementing an approved curriculum (Creative Curriculum 5th edition) as required for all four and five star facilities where four-year old children are enrolled. The next rated license assessment is due by 2/23/25, but new legislation (Senate Bill 425) has extended the “hold harmless” period until the new Quality Rating Improvement System (QRIS) is implemented. At this time, you may choose to complete a rated license assessment using the current rated license process or you may wait until the new QRIS is implemented. Note that the current program assessment tool is changing from the Early Childhood Environment Rating Scale – Revised (ECERS-R) to the Early Childhood Environment Rating Scale – 3 (ECERS-3) and ITERS-R to ITERS-3. Information and training on the new program assessment tools is available on the NC Rating License Assessment Project website at https://ncrlap.org/. The proposed QRIS Modernization rules have been published and are open for public comments. I encourage you to review these and share any feedback you may have with the Child Care Commission. See Additional Comments for links for the proposed rules and contact information for the Commission. This facility is owned by East Coast Academies, Inc. According to the NC Secretary of State's website, this corporation is current and active as of 2/7/25. Please contact me prior to any information change regarding the ownership of this facility. License information was current. Contact me to make any changes to address, phone, or email or to request changes to the license. I monitored the classrooms and spaces used for child care and outdoor play area for applicable child care center requirements using the Child Care Center Requirements, effective 11/1/2024 and Item Numbers Listing, effective 3/2024. I monitored six staff records, three children’s records and all program records. The facility does not offer transportation. Center Observations: It was very cold today due to the wind, but the children in Spaces 2 and 3 bundled up and went outdoors for outdoor playtime. They were able to play on the portable climber and car. Dramatic play materials and tricycles were also available along with other portable gross motor equipment. Indoors, one infant and two toddlers were in Space 1 with their teacher. When not sleeping or eating, they played on the floor and had access to toys or the teacher provided them to the infant who was not crawling yet. Documentation of safe sleep checks and feeding plans were posted. Activity plans were posted in each classroom and reflected individual free play and group time. The menu was posted at the entrance and in the kitchen. Lunch was beanie weenies, carrots, peaches, whole grain crackers, and milk. Allergies were posted in each classroom and in the kitchen. After lunch, children rested on linen-covered cots. 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. A power strip under the counter in Space 1 had two uncovered outlets. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. A container of Clorox Disinfecting Wipes was stored out of reach of children but was not locked. .2820(b) 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 staff member hired on August 12, 2024 did not have a staff medical report on file until September 6, 2024. A staff member hired on July 15, 2024 did not have a staff medical report on file until July 27, 2024. 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 staff member hired on August 12, 2024 did not have a TB screening or TB test on file until September 6, 2024. A staff member hired on November 20, 2024 did not have a TB screening or TB test on file until November 21, 2024 .0701(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. A staff member hired on August 12, 2024 did not provide documentation of current First Aid certification and did not complete a First Aid course until January 23, 2025. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. AA staff member hired on August 12, 2024 did not provide documentation of current CPR certification and did not complete a CPR course until January 23, 2025. .1102(d) 1316 Emergency medical care information did not contain information needed for safe medical treatment. A child's application was not updated to include new medical information related to recently diagnosed allergies and medication needed for an allergic reaction. .0802 (c)(4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. A medication permission form for an Auvi-Q was authorized to be administered from January 13, 2025 - January 13, 2026. A medical permission form for Albuterol was authorized to be administered from September 13, 2024 - Present. Neither form included a six-month authorization period. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-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, D. Titus-Johnson, Administrator. We reviewed the visit summary and the eight (8) violations documented during today’s visit. You corrected six (6) of these prior or during the visit. Correct the remaining two (2) violations immediately. Send evidence of correction to me so that I receive it no later than 2/25/25. 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. Send compliance verification letter in an email from your fcch’s official email address, heidi.riden@ecelearningacademy.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: 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. A power strip under the counter in Space 1 had two open outlets. You stated that this power strip used to be behind the refrigerator which you recently removed from the infant room. You immediately added two outlet covers to the power strip and will remind staff to cover outlets when not in use. This was corrected during the visit. Storage of Hazardous Items - Items with additional warning labels, including some personal care items, all cleaning supplies, and anything in an aerosol can are required to be locked including full-strength bleach, disinfecting wipes, aerosol disinfecting sprays, batteries, Hand soap may be accessible to children for hand washing but should be monitored. Even though hand sanitizer was used more during the COVID-19 pandemic, it must be stored out of reach of children. A container of Clorox Disinfecting Wipes was stored on a high shelf out of reach of children in Space 3 but was not locked. You stated that the staff had used it and forgotten to return to a locked cabinet. You corrected this immediately. You stated that you will remind staff to check spaces for cleaning supplies. Staff Medical Report – SMR and TB Screening or Test - A Staff Medical Report (SMR) 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 can complete the physical responsibilities needed to work in child care. The following staff did not have a Staff Medical Report on file by their first day of work – A. McCauley (hired 8/12/24; SMR received 9/6/24); O. Roughton (hired 7/15/24; SMR received 7/27/24); The following staff did not have documentation of a TB screening or negative TB test on file by their first day of work - A. McCauley (hired 8/12/24; TB test received 9/6/24); T. Simerly (hired 11/20/24; TB Test received 11/21/24). You stated that you did not realize that the staff medical report and TB test for AM could not be used because they were more than 12 months old. 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 so no further action is required except to ensure that staff medical reports and TB tests are received by an employee’s first day of work. First Aid and CPR – Early care and education programs with staff trained in pediatric first aid and CPR can mitigate the consequences of injury and reduce the potential for death from life-threatening conditions and emergencies. Repetitive training, coupled with the confidence to use these skills, is critically important to the outcome of an emergency. (Caring for Our Children, 4th Edition). A. McCauley was hired on 8/12/2024 and required to complete CPR/First Aid by 11/12/2024. Documentation available in the file reflects that she completed CPR/First aid on 1/23/25. You stated that AM had current CPR/First Aid when she was hired and recertified before it expired; however, there was no documentation of an earlier CPR/First Aid card in her file and the Staff File Checklist did not include the date of her previous CPR/First Aid certification. Ensure that staff provide you with copies of any current certifications, training, etc. at hire. If they do not have copies, register them for any required trainings within the required time frame. This has been corrected. No further action or documentation in required except to maintain current First Aid and CPR in the future. Repeated CPR/First Aid violations may result in an Administrative Action. *T. Simerly hired on 11/20/24 is due to complete CPR/First Aid by 2/20/25. *L. Freeman hire don 1/16/25 is due to complete CPR/First Aid by 4/15/25. *CPR/First Aid expires for D. Titus-Johnson and K. Ellington on 6/30/25. Child’s Application - Health Care Needs – The DCDEE form “Child’s Application for Enrollment” contains important information related to the care of children. This form is required at enrollment and needs to be updated at least annually or as information changes. A child’s application for AM in Space 2 was originally completed on 1/31/24 before starting on 2/5/24. The parent checked that there was not a medical action plan, and wrote n/a indicating the child had no allergies, medications other than Tylenol or Ibuprofen for teething, and no health care needs. A Medical Action Plan, dated 1/8/25, was added to the file (attached to the Child’s Medical Report – needs to be attached to the Child’s Application) reflecting that the child has been diagnosed with a food allergy requiring Auvi-Q. Auvi-Q for the child was observed in the center’s locked box in the office. The Child’s Application was not updated to reflect the changes to the child’s health information. You stated You have an Annual Update Form to update contact information. When this is completed, have families also review and update their Child’s Application to verify the child’s health information also. This should also be updated when a parent informs you of new health care needs for a child such as a diagnosed allergy or medical condition. For your compliance letter, provide the parent of AM with a blank Child’s Application to complete and update with the child’s new health care information. State the date the updated child’s application is available in the child’s file. Use this violation to have all families review and update their child’s applications to verify that information is current. Standing Authorization for Medication – Medication dosage for young children has to be updated more frequently because they are growing so quickly between infancy and preschool. The medication permission form for chronic conditions must be reauthorized every six months by the parent to verify that the listed dosage and other information are still correct The medication permission form for an Auvi-Q (MA – Space 2) was authorized to be administered from January 13, 2025 - January 13, 2026. A medical permission form for Albuterol (JC – Space 3) was authorized to be administered from September 13, 2024 - Present. Neither form included a six-month authorization period. You stated that the parents completed this information. Remember that it is your responsibility to review medication, medication permission forms and medical action plans before receiving them into your center. Have the parents reauthorize both medications for six months (2/11/25 – 8/11/25). Consider setting a standing six month authorization (January – July and July – January) where you have parents update six-month medications in January and July. 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. You told me that you receive the Raise NC Newsletter and have used it to keep up with the information related to the QRIS modernization. Encourage your staff to sign up for updates from DCDEE so they can be aware of breaking news and training. 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. *Children & Youth Partnership for Dare County: Phone - (252) 441-0614; website - www.darekids.org. *Child Care Health Consultant – S. Rosser - Office: (252) 557-4208 or stacy_rosser@unc.edu *Albemarle Alliance for Children and Families (AACF) and Region 1 Child Care Resource and Referral: Phone – (252) 333-1233; website - www.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 *Southwestern Child Development Commission, www.swcdcinc.org - offers DCDEE approved, on-line, self-paced training with affordable annual packages allowing you to take as many courses as you need or want for one price. Reminders: ABCMS Portal - The process of notifying the Division when you have new staff (or household members for family child care homes and centers licensed in a residence) has changed and is now captured in ABCMS, the new Criminal Background Check portal. You, D. Titus-Johnson, have completed the ABCMS Provider Portal Training and have received authorization to access the ABCMS Provider Portal where you can locate your provider codes. I reviewed your roster and saw that you have completed a Connecting Application for yourself and “hired” yourself to your roster. Continue to do this with the rest of your staff. When new staff are hired, they can connect during their initial application process or you can help them complete a connecting application within five days. If you need assistance, contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. I will review your facility roster to verify that current staff are listed at your next visit. 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. *Encourage staff to maintain copies of all initial hire documents, Qualifying Letters, training certificates, etc. in their own professional file maintained at home. *Make it easier on yourself and schedule annual updates for staff evaluations and professional development plans; health questionnaires and emergency information forms; EPR Plan and Emergency Medical Care Plan at the same time to streamline your staff updates. (Example, even if an employee was hired in January , and you update health questionnaires and emergency forms in August, have this employee go ahead and update in August with the rest of the staff to jump into the same cycle!) *We reviewed your staff worksheet. I highlighted items that were delinquent and items that are coming due in the next year. *Staff evaluations and professional development plans due – K. Ellington (February 2025); D. Titus-Johnson (May 2025) – *Annual Health Questionnaire & Emergency Information Forms updated by - K. Ellington (February 2025); D. Titus-Johnson (May 2025) Health and Safety Training and Five (5) Year Cycle Tracking Requirements –New staff need to complete Recognizing and Responding to Suspicions of Child Maltreatment and CPR/First Aid within three months of hire and the rest of the training modules within twelve months. CPR/First Aid – T. Simerly (due 2/20/25); L. Freeman (due 4/16/25); D. Titus-Johnson (exp 6/30/25); K. Ellington (exp 6/30/25) Recognizing and Responding to Suspicions of Child Maltreatment - T. Simerly (due 2/20/25); L. Freeman (due 4/16/25); O. Roughton (complete again) Rest of H&S Modules – due 12 months from hire and every five years – See Row 17 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 2/11/26 (anniversary to today’s Annual Compliance visit). *ECE college coursework or coursework leading to an ECE degree counts towards on-going training hours. Each semester credit counts as 16 hours so a 3-credit classes also earns 48 hours of on-going training. Lead Teacher Requirements – Lead Teachers who do not have the NC Early Childhood Credential (NCECC) or higher have six months to enroll in coursework that will lead to the NCECC (EDU 119 at the local community college) and eighteen months to complete it after enrollment. A. Drenning is enrolling in EDU 119. Fire and Emergency Drills – current Emergency Medical Care Plan – current and posted *The owner, H. Riden, is not on-site enough to be listed in the EPR Plan or the Emergency Medical care Plan. Update both of them to reflect staff who are consistently on-site. If you continue to list Ms. Riden, consider having additional staff listed as alternatives in the event that D. Titus-Johnson is not on-site EPR Plan – last updated 8/2024; next update due 8/2025 Outdoor Inspections - current Nutrition – Staff are required to model healthy eating habits when consuming food and beverages in front of children. Cans or bottles of soda pop (or cups from fast food restaurants) may not be visible in the classroom or in front of children. Include a grain with lunch (bread, crackers, roll). Infants – Safe sleep checks are required until the infant turns one year of age. Feeding plans are required for children Birth – 15 months of age. They need to be completed by the parent at enrollment and updated as the infant/toddler’s feeding habits transition from formula/breast milk to baby food to solid foods. Post in the room. Maintain open communication with families so that they inform you when they are adding different foods to their child’s diets so that you can update the feeding plan. Once a child turns 15 months of age, place the feeding plan in the child’s file. Hold or place infants and toddlers in appropriate feeding devices (high chair, low chair, small table and chair) when giving them food or beverages even if they can hold their own bottle. Infants and toddlers may not be given food or beverages in a bouncy seat, crib, or free style around the room. Cots – Remind staff to not place or store items on the cots when they are stacked and to not allow children to climb or sit on cots that are stacked. Cots must be at least 18 inches apart at naptime or separated by a solid barrier to reduce the spread of germs. Medication – You did a much better job with medication permission forms and medication storage. Just remember that topical ointments (diaper cream, sunscreen, lotion) can be authorized for 12 months. Medications for chronic medical conditions can be authorized for up to months. Additional Comments: I shared information on the following topics and emailed the information to you after the visit: 1. Update on QRIS Modernization – Proposed Rules Published, Open for Public Comments 2. Free Training – Logical Consequences – 2/18/25 3. Moodle Helpful Hints 4. NCID Tips 5. Health & Safety Resource Center – E New- Winter, Water and Safety 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 .0601 · Violation

Name of Operation: EAST COAST EARLY LEARNING ACADEMY Facility ID: 28000275 Consultant: MARJORIE WHITE Operation Type: Center Case Number: 1124-156L Visit Date: 11/21/2024 Number Present: 27 Completed Date: 11/21/2024 Age: From 0 To 5 Total Minutes: 270 Time In: 01:30 PM Time Out: 06:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced * The purpose of today's unannounced visit was to obtain information regarding alleged violations of child care requirements. The allegations are as follows: 1. There is a concern that effective measures are not being taken to prevent uncontained insects from being in the classrooms. 2. There is a concern that children are being cared for in an unsafe environment. D. Titus-Johnson, Administrator, and H. Riden, Owner, assisted me with the visit. I completed a walk-through of the center and completed limited monitoring of child care requirements during the visit. Supervision of children, staff/child ratios, adequate/approved space and permit restrictions were observed in compliance at the time of my observations. Children in all classrooms were sleeping. The one infant present was being cared for in a temporary space that was part of the toddler classroom but separated by shelving. After naptime, children ate chips and salsa and water for snack and transitioned to indoor and outdoor free play. Investigation: The allegations were shared with the administrator, owner, and four staff members. I also received information about the allegations from collaborative partners. Allegation #1: There is a concern that effective measures are not being taken to prevent uncontained insects from being in the classrooms. Your Responses: The administrator and owner stated that staff reported seeing some bugs in the infant room about two weeks ago. The administrator saw them and started killing them manually. When it appeared that the manual method of smashing the bugs was not preventing new ones, she applied Zevo and a Raid powder (later said it was a Hot Shot product with boric acid) around the baseboards in the infant room to kill them. Looking back, she said she should have contacted a professional pest control company. After the first sanitation visit on 11/14/2024 where more live bugs were observed, the owner contacted a local pest control company. The owner of the company and a licensed pest control specialist met her over the on 11/16/2024 to complete an inspection and a first treatment. She said he felt that it was not an infestation but was isolated to the infant classroom and was caught early. He left a monitoring trap in the cabinet in the infant room to measure the effectiveness of the first treatment. The owner removed the small refrigerator from the infant classroom and cleaned and disinfected the center over the weekend. She instructed staff to report any bugs observed to the administrator. Since the initial treatment, staff have been reporting dead bugs and fewer live bugs. The pest control is scheduled to treat the center again the weekend of November 23rd plus perform a bug clean-out service using a non-residual flushing agent and a Hepa vacuum to remove live specimens and expedite the process of elimination. Most staff expressed that while they were concerned about the bugs, they felt that the administrator and owner were handling it and working to eliminate the bugs. One staff member felt that the center should have been closed for a deep clean but was not aware that the owner completed a deep clean over the weekend. My Observations: Today I checked the areas where bugs were observed during the sanitation visits listed below. I observed a few dead bugs in the cabinet in the infant room. I also observed the monitoring trap. I did not observe any live bugs. I also observed emails from the pest control company to the owner explaining the planned treatment for pest control and the contract. Prior to the visit I reviewed sanitation visits made by Dare County Environmental Health. A Sanitation Inspection was completed on 11/24/2024. Twenty-five demerits were documented, resulting in a Provisional classification. The following items related to pests were cited: 12. 15A NCAC 18A .2810, .2812 … the back of the fridge in the baby room has debris present in the back mechanical portion along with live and dead bugs present. 48. 15A NCAC 18A .2831 Live bugs found in the baby room in the back of the fridge storing milk, and around the diaper changing station. Live bugs found in the kitchen behind the fridge. Establishment shall be free of conditions that harbor pests. The sink in the kitchen is leaking water and there are food crumbs under equipment in the kitchen. A Sanitation Inspection was completed on 11/19/2024. Twenty-seven demerits were documented, resulting in an Approved Classification. The following item related to pests was cited: 31 15A NCAC 18A. 2820 …bugs found in the bottom of the changing table in the cabinets around children’s clothing and diapers. These areas shall be maintained clean. 48 15A NCAC 18A .2831 Live and dead bugs found in the toddler area (beside where the cots are stored on the floor), in the baby room (behind the cabinet drawer and multiple bugs seen in the diaper changing storage area). The owner stated that the building had been treated and is working with a pest control operator. Requested documentation from the pest control operator in regards to treatment.” Based upon your statements, information provided by collaborative partners and my observations, this allegation is confirmed. Allegation #2: There is a concern that children are being cared for in an unsafe environment. Your Responses: The owner, administrator, and staff members stated that a home remedy treatment of a Hot Shot, a white Boric acid powder, was initially sprinkled around the baseboards in the infant classroom. The administrator also stated that she tried Zevo, an all-natural insect killer. They all expressed regret not immediately contacting a professional pest control company. When neither seemed to work, they contacted the professional pest control company. They stated that no parents have reported any medical issues due to the application of the Hot Shot powder. They reported that the powder has been removed and the floor and baseboards have been cleaned. My Observations: Today, I did not observe any residue from the Raid Roach Killer. Prior to the visit I reviewed sanitation visits made by Dare County Environmental Health. A Sanitation Inspection was completed on 11/14/2024. Twenty-five demerits were documented, resulting in a Provisional classification. The following items related to safe environment were cited: 17 15A NCAC 18A .2815 (e) Water in the kitchen at the 3 compartment sink was temped at 137 degrees, at the beginning of the inspection the door to the kitchen was unlocked and no one was present in the kitchen. the half door to the hallway to the kitchen was unlocked. 29 15A NCAC 18A . 2820 Bulk bottles of bleach and sanitizer were stored under the sink in the kitchen, the cabinet was unlocked and the door to the kitchen was unlocked. Lysol spray, biofreeze roll on and salonpas patches were stored in the toddler room in a cabinet that was not locked. These items shall be stored in a locked cabinet when not in use. 37 15A NCAC 18A .2824(e) … the floor in the baby room next to the walls had chemical powder present at the beginning of the inspection, the PIC (Person in Charge) wiped up as much as they could but there is still a residue present. Needs to be addressed ASAP. The administrator applied Hot Shot Maxatraxx Roach Killing Powder with Boric Acid along the baseboards in the room used to care for infants. A Sanitation Inspection was completed on 11/19/2024. Twenty-seven demerits were documented, resulting in an Approved Classification. The following item related to safe environment were cited: 49 15A NCAC 18A .2832 Standing water present in the large toy structure. The large toy structure has two red rails on the cross walk between ends, one of the rails is not connected to an end structure on the top. Toy structures shall be maintained in good repair, areas that will allow for standing water shall be properly drained/emptied. Based upon your statements and information provided by collaborative partners, this allegation is confirmed. The following items were documented as violations during today’s visit: Violation Number Comment Rule 721 All equipment and furnishings were not in good repair. A Sanitation Inspection with an Approved Classification dated November 19, 2024 documented that a horizontal support beam connecting the two ends of the large portable play structure was not connected at one end, compromising the integrity of the equipment. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. A Provisional Sanitation Inspection dated November 14, 2024 stated that a chemical powder was observed on the floor next to the walls in the baby room (Space 1). The administrator stated she had applied Hot Shot Maxatraxx Roach Killing Powder with Boric Acid along the baseboards in the room used to care for infants. 10A NCAC 09 .0601(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. A Sanitation Inspection with a Provisional Classification dated November 14, 2024 reflected that bulk bottles of disinfectant and sanitizer, and Lysol spray were not maintained in locked storage. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A Sanitation Inspection with a Provisional Classification dated November 14, 2024 reflected that Bio Freeze Roll-on and Salonpas patches were not maintained in locked storage. 15A NCAC 18A .2820(d) 9995 A violation was found for which there is no item number. A Sanitation Inspection with a Provisional Classification dated 11/14/2024 stated that the water temperature in the sink in the kitchen was 137 degrees, and the kitchen was unlocked, making the hot water accessible to children. Environmental Health Rule 15A NCAC 18A .2815 (3) states “Hot water that exceeds 120 degrees Fahrenheit is a burn hazard and shall not be provided in areas accessible to children.” 9996 A violation was found for which there is no item number. A Sanitation Inspection with a Provisional Classification dated November 14, 2024 and a Sanitation Inspection with an Approved Classification dated November 19, 2024 documented the presence of live and dead bugs in the back mechanical portion of the small refrigerator in Space 1 (room used for infants), around and inside the diaper changing station in Space 1, behind the cabinet drawer in Space 1, beside the cots in Space 2 (room used for toddlers) and behind the refrigerator in the kitchen. Environmental Health Rule 15A NCAC 18A .2831(b) states “Pests shall be excluded from the child care center.” * 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, D. Titus-Johnson, Administrator. We reviewed the visit summary and violation(s) documented during today’s visit. All violations have been corrected and you have shared your plan to maintain compliance to prevent further bug problems and to provide a safe environment. 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 or Jennifer.Linhardt@dhhs.nc.gov. Technical Assistance with Documented Violations: Outdoor Play Equipment – Outdoor play equipment takes a beating from the sun and elements and the children. Inspecting play equipment and removing it from the playground or making it accessible when broken keeps children safe. A Sanitation Inspection with an Approved Classification dated 11/19/2024 documented that a horizontal support beam connecting the two ends of the large portable play structure was not connected at one end, compromising the integrity of the equipment. You stated that the crack in the support beam was not reported to you, but when made aware of that, you informed staff to not to allow children to play on it. While outdoor inspections are completed and documented monthly, staff are also required to check the outdoor area daily to ensure that the playground is clean, any standing water is dumped, and equipment is safe for children. Staff need to inform the administrator when items are broken so that they can be removed or made inaccessible, repaired or replaced. I observed that the play structure was still broken, but a sign designated it and the entire “mulch area” as off-limits for use by the children. I did not see any children playing on the structure. The administrator stated that the owner is planning to have it repaired or removed and replaced and has reminded staff to check the playground daily for trash, standing water, and broken equipment and report any issues that need to be addressed. Safe Indoor and Outdoor Environment – Keeping children and staff healthy and safe is a primary responsibility of any child care facility. Using pesticides in a manner not consistent with pesticide label can harm children and staff who may come in contact with the pesticide or residue from a pesticide. A Provisional Sanitation Inspection dated 11/14/2024 stated that a chemical powder was observed on the floor next to the walls in the baby room (Space 1). The baseboards are accessible to the children in various parts of the classroom. The administrator stated she had applied Hot Shot Maxatraxx Roach Killing Powder with Boric Acid and an all-natural insect killer called Zevo along the baseboards in the room used to care for infants. Looking back, she would have asked the owner to contact a pest control sooner. The EPA Pesticide Label for Hot Shot Maxatraxx states, “CAUTION: KEEP OUT OF REACH OF CHILDREN. Hazards to Humans and Domestic Animals CAUTION: Harmful if swallowed, inhaled, or absorbed through the skin. Causes moderate eye irritation. Avoid contact with skin, eyes or clothing. Wash thoroughly with soap and water after handling. Avoid breathing dust.” While pests create conditions that are hazardous to health, removing and preventing them requires pest control measures that protect the health and safety of children and staff. Applying a pesticide that leaves a dust or residue that can come in contact with children through physical contact or become airborne as air moves throughout the center creates an unsafe environment. See information from Caring for Our Children below. You have removed the insect powder and cleaned the floor and baseboards and have obtained the services of a pest control company to treat the current bug problem and continue on-going pest control prevention. Storage of Hazardous Materials and Medications - There are over two million human poison exposures reported to poison centers every year. Children under six years of age account for over half of those potential poisonings. The substances most involved in poison exposures of children are cosmetics and personal care products, cleaning substances, and medications. A Sanitation Inspection with a Provisional Classification dated 11/14/2024 reflected that bulk bottles of disinfectant and sanitizer, Lysol spray, Bio Freeze Roll-on and Salonpas patches were not maintained in locked storage. The administrator stated that cabinet used to store cleaning products is usually locked but she was using them in the kitchen when the health inspector arrived and accidentally left the cabinet unlocked and the door to the kitchen unlocked. She stated that the teacher in Space 2 told her that the salonpas and biofreeze were hers and she had originally stored them in a lock box, but the lock box was not there that day. Staff need to remain vigilant about storage of hazardous items and making areas used to store hazardous items locked inaccessible to children. Review rules related to hazardous items storage at staff meetings. Check spaces and cabinets to ensure that cleaning supplies are returned to locked storage after use even if the cabinets are out of reach of children. This was not documented on the Sanitation Inspection dated 11/19/2024 and was not observed today. All medications and cleaning supplies were stored appropriately. The administrator stated that she will continue to remind staff about hazardous items storage and routinely check cabinets to ensure hazardous products are not accessible to children. Hot Water – Hot water exceeding 120 degrees Fahrenheit can cause second-degree burns (partial thickness burns) with the possibility of developing into third-degree burns (full thickness burns) especially for vulnerable populations like young children and the elderly with thinner skin. A Sanitation Inspection with a Provisional Classification dated 11/14/2024 stated that the water temperature in the sink in the kitchen was 137 degrees, and the kitchen was unlocked, making the hot water accessible to children. The administrator stated that she was in the kitchen when the health inspector arrived and rushed out and forgot to lock the door behind her. Environmental Health Rule 15A NCAC 18A .2815 (3) states “Hot water that exceeds 120 degrees Fahrenheit is a burn hazard and shall not be provided in areas accessible to children.” Remind staff that kitchen must remain locked at all times when a staff member is not in the kitchen. Locking the half door to the hallway that leads to the kitchen provides an additional layer of security to prevent access to the kitchen, office, and staff bathroom and to prevent children from accessing the playground unattended. This was not documented on the Sanitation Inspection dated 11/19/2024 and was not observed today. The owner and administrator stated that they will not leave the kitchen door unlocked and will remind other staff to lock it behind them. Pests – Pests can carry and spread diseases, pathogens, bacteria, and germs that can make people sick. They can also trigger allergic reactions and asthma symptoms. A Sanitation Inspection with a Provisional Classification dated 11/14/2024 and a Sanitation Inspection with an Approved Classification dated 11/19/2024 documented the presence of live and dead bugs in the back mechanical portion of the small refrigerator in Space 1 (room used for infants), around and inside the diaper changing station in Space 1, behind the cabinet drawer in Space 1, beside the cots in Space 2 (room used for toddlers) and behind the refrigerator in the kitchen. Environmental Health Rule 15A NCAC 18A .2831(b) states “Pests shall be excluded from the child care center.” The owner and administrator stated that they regret trying the home pest control remedy and not contacting a professional pest control when they realized it as more than a random bug. They have obtained the services of a pest control company to treat the current bug problem and continue on-going pest control prevention. Consultation: Integrated Pest Management – “Caring for Our Children 4th Edition” recommends a program of integrated pest management to control and prevent pests in child care facilities. “Facilities should adopt an integrated pest management program (IPM) to ensure long-term, environmentally sound pest suppression through a range of practices including pest exclusion, sanitation and clutter control, and elimination of conditions that are conducive to pest infestations. IPM is a simple, common-sense approach to pest management that eliminates the root causes of pest problems, providing safe and effective control of insects, weeds, rodents, and other pests while minimizing risks to human health and the environment.” This includes maintaining the physical premises to prevent pest breeding areas by ensuring sanitary conditions, filling cracks and crevices, holes, repairing water damage, and removing clutter and trash. Facilities should keep records of pest sightings and sightings of indicators of the presence of pests and always using a pesticide applicator who has the licenses or certifications required by state and local laws, ensuring that pesticides are never applied when children are present and that re-entry periods are adhered to. Records of all pesticides applications (including type and amount of pesticide used), timing and location of treatment, and results should be maintained either on-line or in a manner that permits access by facility managers and staff, state inspectors and regulatory personnel, parents/guardians, and others who may inquire about pesticide usage at the facility. For more information on an integrated pest management program, review Caring for Our Children 4th Edition Chapter 5.2.8 at https://nrckids.org/CFOC. Reminders: Annual License Fees - Check your facility email for the 2024 annual license fee invoice. Invoices will be emailed to the facility addresses on file by November 30, 2024. Online payments will be due by December 31, 2024. Compliance History: I reviewed the facility’s compliance history with the administrator. The 18-month compliance history from 5/19/23 – 11/18/24 = 87%. Please be aware that any information received during this investigation and any violations documented may be included in any future administrative actions. Violations of child care requirements, particularly repeated violations, could result in a civil penalty and/or administrative action that could jeopardize the status of the license for the child care facility. Please also refer to sections labeled Technical Assistance, Consultation, and Reminders for a refresher of our discussions today. If you have any questions, do not hesitate to contact 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. 110-91 · Violation

Name of Operation: EAST COAST EARLY LEARNING ACADEMY Facility ID: 28000275 Consultant: MARJORIE WHITE Operation Type: Center Case Number: 1124-156L Visit Date: 11/21/2024 Number Present: 27 Completed Date: 11/21/2024 Age: From 0 To 5 Total Minutes: 270 Time In: 01:30 PM Time Out: 06:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced * The purpose of today's unannounced visit was to obtain information regarding alleged violations of child care requirements. The allegations are as follows: 1. There is a concern that effective measures are not being taken to prevent uncontained insects from being in the classrooms. 2. There is a concern that children are being cared for in an unsafe environment. D. Titus-Johnson, Administrator, and H. Riden, Owner, assisted me with the visit. I completed a walk-through of the center and completed limited monitoring of child care requirements during the visit. Supervision of children, staff/child ratios, adequate/approved space and permit restrictions were observed in compliance at the time of my observations. Children in all classrooms were sleeping. The one infant present was being cared for in a temporary space that was part of the toddler classroom but separated by shelving. After naptime, children ate chips and salsa and water for snack and transitioned to indoor and outdoor free play. Investigation: The allegations were shared with the administrator, owner, and four staff members. I also received information about the allegations from collaborative partners. Allegation #1: There is a concern that effective measures are not being taken to prevent uncontained insects from being in the classrooms. Your Responses: The administrator and owner stated that staff reported seeing some bugs in the infant room about two weeks ago. The administrator saw them and started killing them manually. When it appeared that the manual method of smashing the bugs was not preventing new ones, she applied Zevo and a Raid powder (later said it was a Hot Shot product with boric acid) around the baseboards in the infant room to kill them. Looking back, she said she should have contacted a professional pest control company. After the first sanitation visit on 11/14/2024 where more live bugs were observed, the owner contacted a local pest control company. The owner of the company and a licensed pest control specialist met her over the on 11/16/2024 to complete an inspection and a first treatment. She said he felt that it was not an infestation but was isolated to the infant classroom and was caught early. He left a monitoring trap in the cabinet in the infant room to measure the effectiveness of the first treatment. The owner removed the small refrigerator from the infant classroom and cleaned and disinfected the center over the weekend. She instructed staff to report any bugs observed to the administrator. Since the initial treatment, staff have been reporting dead bugs and fewer live bugs. The pest control is scheduled to treat the center again the weekend of November 23rd plus perform a bug clean-out service using a non-residual flushing agent and a Hepa vacuum to remove live specimens and expedite the process of elimination. Most staff expressed that while they were concerned about the bugs, they felt that the administrator and owner were handling it and working to eliminate the bugs. One staff member felt that the center should have been closed for a deep clean but was not aware that the owner completed a deep clean over the weekend. My Observations: Today I checked the areas where bugs were observed during the sanitation visits listed below. I observed a few dead bugs in the cabinet in the infant room. I also observed the monitoring trap. I did not observe any live bugs. I also observed emails from the pest control company to the owner explaining the planned treatment for pest control and the contract. Prior to the visit I reviewed sanitation visits made by Dare County Environmental Health. A Sanitation Inspection was completed on 11/24/2024. Twenty-five demerits were documented, resulting in a Provisional classification. The following items related to pests were cited: 12. 15A NCAC 18A .2810, .2812 … the back of the fridge in the baby room has debris present in the back mechanical portion along with live and dead bugs present. 48. 15A NCAC 18A .2831 Live bugs found in the baby room in the back of the fridge storing milk, and around the diaper changing station. Live bugs found in the kitchen behind the fridge. Establishment shall be free of conditions that harbor pests. The sink in the kitchen is leaking water and there are food crumbs under equipment in the kitchen. A Sanitation Inspection was completed on 11/19/2024. Twenty-seven demerits were documented, resulting in an Approved Classification. The following item related to pests was cited: 31 15A NCAC 18A. 2820 …bugs found in the bottom of the changing table in the cabinets around children’s clothing and diapers. These areas shall be maintained clean. 48 15A NCAC 18A .2831 Live and dead bugs found in the toddler area (beside where the cots are stored on the floor), in the baby room (behind the cabinet drawer and multiple bugs seen in the diaper changing storage area). The owner stated that the building had been treated and is working with a pest control operator. Requested documentation from the pest control operator in regards to treatment.” Based upon your statements, information provided by collaborative partners and my observations, this allegation is confirmed. Allegation #2: There is a concern that children are being cared for in an unsafe environment. Your Responses: The owner, administrator, and staff members stated that a home remedy treatment of a Hot Shot, a white Boric acid powder, was initially sprinkled around the baseboards in the infant classroom. The administrator also stated that she tried Zevo, an all-natural insect killer. They all expressed regret not immediately contacting a professional pest control company. When neither seemed to work, they contacted the professional pest control company. They stated that no parents have reported any medical issues due to the application of the Hot Shot powder. They reported that the powder has been removed and the floor and baseboards have been cleaned. My Observations: Today, I did not observe any residue from the Raid Roach Killer. Prior to the visit I reviewed sanitation visits made by Dare County Environmental Health. A Sanitation Inspection was completed on 11/14/2024. Twenty-five demerits were documented, resulting in a Provisional classification. The following items related to safe environment were cited: 17 15A NCAC 18A .2815 (e) Water in the kitchen at the 3 compartment sink was temped at 137 degrees, at the beginning of the inspection the door to the kitchen was unlocked and no one was present in the kitchen. the half door to the hallway to the kitchen was unlocked. 29 15A NCAC 18A . 2820 Bulk bottles of bleach and sanitizer were stored under the sink in the kitchen, the cabinet was unlocked and the door to the kitchen was unlocked. Lysol spray, biofreeze roll on and salonpas patches were stored in the toddler room in a cabinet that was not locked. These items shall be stored in a locked cabinet when not in use. 37 15A NCAC 18A .2824(e) … the floor in the baby room next to the walls had chemical powder present at the beginning of the inspection, the PIC (Person in Charge) wiped up as much as they could but there is still a residue present. Needs to be addressed ASAP. The administrator applied Hot Shot Maxatraxx Roach Killing Powder with Boric Acid along the baseboards in the room used to care for infants. A Sanitation Inspection was completed on 11/19/2024. Twenty-seven demerits were documented, resulting in an Approved Classification. The following item related to safe environment were cited: 49 15A NCAC 18A .2832 Standing water present in the large toy structure. The large toy structure has two red rails on the cross walk between ends, one of the rails is not connected to an end structure on the top. Toy structures shall be maintained in good repair, areas that will allow for standing water shall be properly drained/emptied. Based upon your statements and information provided by collaborative partners, this allegation is confirmed. The following items were documented as violations during today’s visit: Violation Number Comment Rule 721 All equipment and furnishings were not in good repair. A Sanitation Inspection with an Approved Classification dated November 19, 2024 documented that a horizontal support beam connecting the two ends of the large portable play structure was not connected at one end, compromising the integrity of the equipment. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. A Provisional Sanitation Inspection dated November 14, 2024 stated that a chemical powder was observed on the floor next to the walls in the baby room (Space 1). The administrator stated she had applied Hot Shot Maxatraxx Roach Killing Powder with Boric Acid along the baseboards in the room used to care for infants. 10A NCAC 09 .0601(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. A Sanitation Inspection with a Provisional Classification dated November 14, 2024 reflected that bulk bottles of disinfectant and sanitizer, and Lysol spray were not maintained in locked storage. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A Sanitation Inspection with a Provisional Classification dated November 14, 2024 reflected that Bio Freeze Roll-on and Salonpas patches were not maintained in locked storage. 15A NCAC 18A .2820(d) 9995 A violation was found for which there is no item number. A Sanitation Inspection with a Provisional Classification dated 11/14/2024 stated that the water temperature in the sink in the kitchen was 137 degrees, and the kitchen was unlocked, making the hot water accessible to children. Environmental Health Rule 15A NCAC 18A .2815 (3) states “Hot water that exceeds 120 degrees Fahrenheit is a burn hazard and shall not be provided in areas accessible to children.” 9996 A violation was found for which there is no item number. A Sanitation Inspection with a Provisional Classification dated November 14, 2024 and a Sanitation Inspection with an Approved Classification dated November 19, 2024 documented the presence of live and dead bugs in the back mechanical portion of the small refrigerator in Space 1 (room used for infants), around and inside the diaper changing station in Space 1, behind the cabinet drawer in Space 1, beside the cots in Space 2 (room used for toddlers) and behind the refrigerator in the kitchen. Environmental Health Rule 15A NCAC 18A .2831(b) states “Pests shall be excluded from the child care center.” * 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, D. Titus-Johnson, Administrator. We reviewed the visit summary and violation(s) documented during today’s visit. All violations have been corrected and you have shared your plan to maintain compliance to prevent further bug problems and to provide a safe environment. 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 or Jennifer.Linhardt@dhhs.nc.gov. Technical Assistance with Documented Violations: Outdoor Play Equipment – Outdoor play equipment takes a beating from the sun and elements and the children. Inspecting play equipment and removing it from the playground or making it accessible when broken keeps children safe. A Sanitation Inspection with an Approved Classification dated 11/19/2024 documented that a horizontal support beam connecting the two ends of the large portable play structure was not connected at one end, compromising the integrity of the equipment. You stated that the crack in the support beam was not reported to you, but when made aware of that, you informed staff to not to allow children to play on it. While outdoor inspections are completed and documented monthly, staff are also required to check the outdoor area daily to ensure that the playground is clean, any standing water is dumped, and equipment is safe for children. Staff need to inform the administrator when items are broken so that they can be removed or made inaccessible, repaired or replaced. I observed that the play structure was still broken, but a sign designated it and the entire “mulch area” as off-limits for use by the children. I did not see any children playing on the structure. The administrator stated that the owner is planning to have it repaired or removed and replaced and has reminded staff to check the playground daily for trash, standing water, and broken equipment and report any issues that need to be addressed. Safe Indoor and Outdoor Environment – Keeping children and staff healthy and safe is a primary responsibility of any child care facility. Using pesticides in a manner not consistent with pesticide label can harm children and staff who may come in contact with the pesticide or residue from a pesticide. A Provisional Sanitation Inspection dated 11/14/2024 stated that a chemical powder was observed on the floor next to the walls in the baby room (Space 1). The baseboards are accessible to the children in various parts of the classroom. The administrator stated she had applied Hot Shot Maxatraxx Roach Killing Powder with Boric Acid and an all-natural insect killer called Zevo along the baseboards in the room used to care for infants. Looking back, she would have asked the owner to contact a pest control sooner. The EPA Pesticide Label for Hot Shot Maxatraxx states, “CAUTION: KEEP OUT OF REACH OF CHILDREN. Hazards to Humans and Domestic Animals CAUTION: Harmful if swallowed, inhaled, or absorbed through the skin. Causes moderate eye irritation. Avoid contact with skin, eyes or clothing. Wash thoroughly with soap and water after handling. Avoid breathing dust.” While pests create conditions that are hazardous to health, removing and preventing them requires pest control measures that protect the health and safety of children and staff. Applying a pesticide that leaves a dust or residue that can come in contact with children through physical contact or become airborne as air moves throughout the center creates an unsafe environment. See information from Caring for Our Children below. You have removed the insect powder and cleaned the floor and baseboards and have obtained the services of a pest control company to treat the current bug problem and continue on-going pest control prevention. Storage of Hazardous Materials and Medications - There are over two million human poison exposures reported to poison centers every year. Children under six years of age account for over half of those potential poisonings. The substances most involved in poison exposures of children are cosmetics and personal care products, cleaning substances, and medications. A Sanitation Inspection with a Provisional Classification dated 11/14/2024 reflected that bulk bottles of disinfectant and sanitizer, Lysol spray, Bio Freeze Roll-on and Salonpas patches were not maintained in locked storage. The administrator stated that cabinet used to store cleaning products is usually locked but she was using them in the kitchen when the health inspector arrived and accidentally left the cabinet unlocked and the door to the kitchen unlocked. She stated that the teacher in Space 2 told her that the salonpas and biofreeze were hers and she had originally stored them in a lock box, but the lock box was not there that day. Staff need to remain vigilant about storage of hazardous items and making areas used to store hazardous items locked inaccessible to children. Review rules related to hazardous items storage at staff meetings. Check spaces and cabinets to ensure that cleaning supplies are returned to locked storage after use even if the cabinets are out of reach of children. This was not documented on the Sanitation Inspection dated 11/19/2024 and was not observed today. All medications and cleaning supplies were stored appropriately. The administrator stated that she will continue to remind staff about hazardous items storage and routinely check cabinets to ensure hazardous products are not accessible to children. Hot Water – Hot water exceeding 120 degrees Fahrenheit can cause second-degree burns (partial thickness burns) with the possibility of developing into third-degree burns (full thickness burns) especially for vulnerable populations like young children and the elderly with thinner skin. A Sanitation Inspection with a Provisional Classification dated 11/14/2024 stated that the water temperature in the sink in the kitchen was 137 degrees, and the kitchen was unlocked, making the hot water accessible to children. The administrator stated that she was in the kitchen when the health inspector arrived and rushed out and forgot to lock the door behind her. Environmental Health Rule 15A NCAC 18A .2815 (3) states “Hot water that exceeds 120 degrees Fahrenheit is a burn hazard and shall not be provided in areas accessible to children.” Remind staff that kitchen must remain locked at all times when a staff member is not in the kitchen. Locking the half door to the hallway that leads to the kitchen provides an additional layer of security to prevent access to the kitchen, office, and staff bathroom and to prevent children from accessing the playground unattended. This was not documented on the Sanitation Inspection dated 11/19/2024 and was not observed today. The owner and administrator stated that they will not leave the kitchen door unlocked and will remind other staff to lock it behind them. Pests – Pests can carry and spread diseases, pathogens, bacteria, and germs that can make people sick. They can also trigger allergic reactions and asthma symptoms. A Sanitation Inspection with a Provisional Classification dated 11/14/2024 and a Sanitation Inspection with an Approved Classification dated 11/19/2024 documented the presence of live and dead bugs in the back mechanical portion of the small refrigerator in Space 1 (room used for infants), around and inside the diaper changing station in Space 1, behind the cabinet drawer in Space 1, beside the cots in Space 2 (room used for toddlers) and behind the refrigerator in the kitchen. Environmental Health Rule 15A NCAC 18A .2831(b) states “Pests shall be excluded from the child care center.” The owner and administrator stated that they regret trying the home pest control remedy and not contacting a professional pest control when they realized it as more than a random bug. They have obtained the services of a pest control company to treat the current bug problem and continue on-going pest control prevention. Consultation: Integrated Pest Management – “Caring for Our Children 4th Edition” recommends a program of integrated pest management to control and prevent pests in child care facilities. “Facilities should adopt an integrated pest management program (IPM) to ensure long-term, environmentally sound pest suppression through a range of practices including pest exclusion, sanitation and clutter control, and elimination of conditions that are conducive to pest infestations. IPM is a simple, common-sense approach to pest management that eliminates the root causes of pest problems, providing safe and effective control of insects, weeds, rodents, and other pests while minimizing risks to human health and the environment.” This includes maintaining the physical premises to prevent pest breeding areas by ensuring sanitary conditions, filling cracks and crevices, holes, repairing water damage, and removing clutter and trash. Facilities should keep records of pest sightings and sightings of indicators of the presence of pests and always using a pesticide applicator who has the licenses or certifications required by state and local laws, ensuring that pesticides are never applied when children are present and that re-entry periods are adhered to. Records of all pesticides applications (including type and amount of pesticide used), timing and location of treatment, and results should be maintained either on-line or in a manner that permits access by facility managers and staff, state inspectors and regulatory personnel, parents/guardians, and others who may inquire about pesticide usage at the facility. For more information on an integrated pest management program, review Caring for Our Children 4th Edition Chapter 5.2.8 at https://nrckids.org/CFOC. Reminders: Annual License Fees - Check your facility email for the 2024 annual license fee invoice. Invoices will be emailed to the facility addresses on file by November 30, 2024. Online payments will be due by December 31, 2024. Compliance History: I reviewed the facility’s compliance history with the administrator. The 18-month compliance history from 5/19/23 – 11/18/24 = 87%. Please be aware that any information received during this investigation and any violations documented may be included in any future administrative actions. Violations of child care requirements, particularly repeated violations, could result in a civil penalty and/or administrative action that could jeopardize the status of the license for the child care facility. Please also refer to sections labeled Technical Assistance, Consultation, and Reminders for a refresher of our discussions today. If you have any questions, do not hesitate to contact 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: EAST COAST EARLY LEARNING ACADEMY Facility ID: 28000275 Consultant: MARJORIE WHITE Operation Type: Center Case Number: 1124-156L Visit Date: 11/21/2024 Number Present: 27 Completed Date: 11/21/2024 Age: From 0 To 5 Total Minutes: 270 Time In: 01:30 PM Time Out: 06:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced * The purpose of today's unannounced visit was to obtain information regarding alleged violations of child care requirements. The allegations are as follows: 1. There is a concern that effective measures are not being taken to prevent uncontained insects from being in the classrooms. 2. There is a concern that children are being cared for in an unsafe environment. D. Titus-Johnson, Administrator, and H. Riden, Owner, assisted me with the visit. I completed a walk-through of the center and completed limited monitoring of child care requirements during the visit. Supervision of children, staff/child ratios, adequate/approved space and permit restrictions were observed in compliance at the time of my observations. Children in all classrooms were sleeping. The one infant present was being cared for in a temporary space that was part of the toddler classroom but separated by shelving. After naptime, children ate chips and salsa and water for snack and transitioned to indoor and outdoor free play. Investigation: The allegations were shared with the administrator, owner, and four staff members. I also received information about the allegations from collaborative partners. Allegation #1: There is a concern that effective measures are not being taken to prevent uncontained insects from being in the classrooms. Your Responses: The administrator and owner stated that staff reported seeing some bugs in the infant room about two weeks ago. The administrator saw them and started killing them manually. When it appeared that the manual method of smashing the bugs was not preventing new ones, she applied Zevo and a Raid powder (later said it was a Hot Shot product with boric acid) around the baseboards in the infant room to kill them. Looking back, she said she should have contacted a professional pest control company. After the first sanitation visit on 11/14/2024 where more live bugs were observed, the owner contacted a local pest control company. The owner of the company and a licensed pest control specialist met her over the on 11/16/2024 to complete an inspection and a first treatment. She said he felt that it was not an infestation but was isolated to the infant classroom and was caught early. He left a monitoring trap in the cabinet in the infant room to measure the effectiveness of the first treatment. The owner removed the small refrigerator from the infant classroom and cleaned and disinfected the center over the weekend. She instructed staff to report any bugs observed to the administrator. Since the initial treatment, staff have been reporting dead bugs and fewer live bugs. The pest control is scheduled to treat the center again the weekend of November 23rd plus perform a bug clean-out service using a non-residual flushing agent and a Hepa vacuum to remove live specimens and expedite the process of elimination. Most staff expressed that while they were concerned about the bugs, they felt that the administrator and owner were handling it and working to eliminate the bugs. One staff member felt that the center should have been closed for a deep clean but was not aware that the owner completed a deep clean over the weekend. My Observations: Today I checked the areas where bugs were observed during the sanitation visits listed below. I observed a few dead bugs in the cabinet in the infant room. I also observed the monitoring trap. I did not observe any live bugs. I also observed emails from the pest control company to the owner explaining the planned treatment for pest control and the contract. Prior to the visit I reviewed sanitation visits made by Dare County Environmental Health. A Sanitation Inspection was completed on 11/24/2024. Twenty-five demerits were documented, resulting in a Provisional classification. The following items related to pests were cited: 12. 15A NCAC 18A .2810, .2812 … the back of the fridge in the baby room has debris present in the back mechanical portion along with live and dead bugs present. 48. 15A NCAC 18A .2831 Live bugs found in the baby room in the back of the fridge storing milk, and around the diaper changing station. Live bugs found in the kitchen behind the fridge. Establishment shall be free of conditions that harbor pests. The sink in the kitchen is leaking water and there are food crumbs under equipment in the kitchen. A Sanitation Inspection was completed on 11/19/2024. Twenty-seven demerits were documented, resulting in an Approved Classification. The following item related to pests was cited: 31 15A NCAC 18A. 2820 …bugs found in the bottom of the changing table in the cabinets around children’s clothing and diapers. These areas shall be maintained clean. 48 15A NCAC 18A .2831 Live and dead bugs found in the toddler area (beside where the cots are stored on the floor), in the baby room (behind the cabinet drawer and multiple bugs seen in the diaper changing storage area). The owner stated that the building had been treated and is working with a pest control operator. Requested documentation from the pest control operator in regards to treatment.” Based upon your statements, information provided by collaborative partners and my observations, this allegation is confirmed. Allegation #2: There is a concern that children are being cared for in an unsafe environment. Your Responses: The owner, administrator, and staff members stated that a home remedy treatment of a Hot Shot, a white Boric acid powder, was initially sprinkled around the baseboards in the infant classroom. The administrator also stated that she tried Zevo, an all-natural insect killer. They all expressed regret not immediately contacting a professional pest control company. When neither seemed to work, they contacted the professional pest control company. They stated that no parents have reported any medical issues due to the application of the Hot Shot powder. They reported that the powder has been removed and the floor and baseboards have been cleaned. My Observations: Today, I did not observe any residue from the Raid Roach Killer. Prior to the visit I reviewed sanitation visits made by Dare County Environmental Health. A Sanitation Inspection was completed on 11/14/2024. Twenty-five demerits were documented, resulting in a Provisional classification. The following items related to safe environment were cited: 17 15A NCAC 18A .2815 (e) Water in the kitchen at the 3 compartment sink was temped at 137 degrees, at the beginning of the inspection the door to the kitchen was unlocked and no one was present in the kitchen. the half door to the hallway to the kitchen was unlocked. 29 15A NCAC 18A . 2820 Bulk bottles of bleach and sanitizer were stored under the sink in the kitchen, the cabinet was unlocked and the door to the kitchen was unlocked. Lysol spray, biofreeze roll on and salonpas patches were stored in the toddler room in a cabinet that was not locked. These items shall be stored in a locked cabinet when not in use. 37 15A NCAC 18A .2824(e) … the floor in the baby room next to the walls had chemical powder present at the beginning of the inspection, the PIC (Person in Charge) wiped up as much as they could but there is still a residue present. Needs to be addressed ASAP. The administrator applied Hot Shot Maxatraxx Roach Killing Powder with Boric Acid along the baseboards in the room used to care for infants. A Sanitation Inspection was completed on 11/19/2024. Twenty-seven demerits were documented, resulting in an Approved Classification. The following item related to safe environment were cited: 49 15A NCAC 18A .2832 Standing water present in the large toy structure. The large toy structure has two red rails on the cross walk between ends, one of the rails is not connected to an end structure on the top. Toy structures shall be maintained in good repair, areas that will allow for standing water shall be properly drained/emptied. Based upon your statements and information provided by collaborative partners, this allegation is confirmed. The following items were documented as violations during today’s visit: Violation Number Comment Rule 721 All equipment and furnishings were not in good repair. A Sanitation Inspection with an Approved Classification dated November 19, 2024 documented that a horizontal support beam connecting the two ends of the large portable play structure was not connected at one end, compromising the integrity of the equipment. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. A Provisional Sanitation Inspection dated November 14, 2024 stated that a chemical powder was observed on the floor next to the walls in the baby room (Space 1). The administrator stated she had applied Hot Shot Maxatraxx Roach Killing Powder with Boric Acid along the baseboards in the room used to care for infants. 10A NCAC 09 .0601(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. A Sanitation Inspection with a Provisional Classification dated November 14, 2024 reflected that bulk bottles of disinfectant and sanitizer, and Lysol spray were not maintained in locked storage. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A Sanitation Inspection with a Provisional Classification dated November 14, 2024 reflected that Bio Freeze Roll-on and Salonpas patches were not maintained in locked storage. 15A NCAC 18A .2820(d) 9995 A violation was found for which there is no item number. A Sanitation Inspection with a Provisional Classification dated 11/14/2024 stated that the water temperature in the sink in the kitchen was 137 degrees, and the kitchen was unlocked, making the hot water accessible to children. Environmental Health Rule 15A NCAC 18A .2815 (3) states “Hot water that exceeds 120 degrees Fahrenheit is a burn hazard and shall not be provided in areas accessible to children.” 9996 A violation was found for which there is no item number. A Sanitation Inspection with a Provisional Classification dated November 14, 2024 and a Sanitation Inspection with an Approved Classification dated November 19, 2024 documented the presence of live and dead bugs in the back mechanical portion of the small refrigerator in Space 1 (room used for infants), around and inside the diaper changing station in Space 1, behind the cabinet drawer in Space 1, beside the cots in Space 2 (room used for toddlers) and behind the refrigerator in the kitchen. Environmental Health Rule 15A NCAC 18A .2831(b) states “Pests shall be excluded from the child care center.” * 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, D. Titus-Johnson, Administrator. We reviewed the visit summary and violation(s) documented during today’s visit. All violations have been corrected and you have shared your plan to maintain compliance to prevent further bug problems and to provide a safe environment. 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 or Jennifer.Linhardt@dhhs.nc.gov. Technical Assistance with Documented Violations: Outdoor Play Equipment – Outdoor play equipment takes a beating from the sun and elements and the children. Inspecting play equipment and removing it from the playground or making it accessible when broken keeps children safe. A Sanitation Inspection with an Approved Classification dated 11/19/2024 documented that a horizontal support beam connecting the two ends of the large portable play structure was not connected at one end, compromising the integrity of the equipment. You stated that the crack in the support beam was not reported to you, but when made aware of that, you informed staff to not to allow children to play on it. While outdoor inspections are completed and documented monthly, staff are also required to check the outdoor area daily to ensure that the playground is clean, any standing water is dumped, and equipment is safe for children. Staff need to inform the administrator when items are broken so that they can be removed or made inaccessible, repaired or replaced. I observed that the play structure was still broken, but a sign designated it and the entire “mulch area” as off-limits for use by the children. I did not see any children playing on the structure. The administrator stated that the owner is planning to have it repaired or removed and replaced and has reminded staff to check the playground daily for trash, standing water, and broken equipment and report any issues that need to be addressed. Safe Indoor and Outdoor Environment – Keeping children and staff healthy and safe is a primary responsibility of any child care facility. Using pesticides in a manner not consistent with pesticide label can harm children and staff who may come in contact with the pesticide or residue from a pesticide. A Provisional Sanitation Inspection dated 11/14/2024 stated that a chemical powder was observed on the floor next to the walls in the baby room (Space 1). The baseboards are accessible to the children in various parts of the classroom. The administrator stated she had applied Hot Shot Maxatraxx Roach Killing Powder with Boric Acid and an all-natural insect killer called Zevo along the baseboards in the room used to care for infants. Looking back, she would have asked the owner to contact a pest control sooner. The EPA Pesticide Label for Hot Shot Maxatraxx states, “CAUTION: KEEP OUT OF REACH OF CHILDREN. Hazards to Humans and Domestic Animals CAUTION: Harmful if swallowed, inhaled, or absorbed through the skin. Causes moderate eye irritation. Avoid contact with skin, eyes or clothing. Wash thoroughly with soap and water after handling. Avoid breathing dust.” While pests create conditions that are hazardous to health, removing and preventing them requires pest control measures that protect the health and safety of children and staff. Applying a pesticide that leaves a dust or residue that can come in contact with children through physical contact or become airborne as air moves throughout the center creates an unsafe environment. See information from Caring for Our Children below. You have removed the insect powder and cleaned the floor and baseboards and have obtained the services of a pest control company to treat the current bug problem and continue on-going pest control prevention. Storage of Hazardous Materials and Medications - There are over two million human poison exposures reported to poison centers every year. Children under six years of age account for over half of those potential poisonings. The substances most involved in poison exposures of children are cosmetics and personal care products, cleaning substances, and medications. A Sanitation Inspection with a Provisional Classification dated 11/14/2024 reflected that bulk bottles of disinfectant and sanitizer, Lysol spray, Bio Freeze Roll-on and Salonpas patches were not maintained in locked storage. The administrator stated that cabinet used to store cleaning products is usually locked but she was using them in the kitchen when the health inspector arrived and accidentally left the cabinet unlocked and the door to the kitchen unlocked. She stated that the teacher in Space 2 told her that the salonpas and biofreeze were hers and she had originally stored them in a lock box, but the lock box was not there that day. Staff need to remain vigilant about storage of hazardous items and making areas used to store hazardous items locked inaccessible to children. Review rules related to hazardous items storage at staff meetings. Check spaces and cabinets to ensure that cleaning supplies are returned to locked storage after use even if the cabinets are out of reach of children. This was not documented on the Sanitation Inspection dated 11/19/2024 and was not observed today. All medications and cleaning supplies were stored appropriately. The administrator stated that she will continue to remind staff about hazardous items storage and routinely check cabinets to ensure hazardous products are not accessible to children. Hot Water – Hot water exceeding 120 degrees Fahrenheit can cause second-degree burns (partial thickness burns) with the possibility of developing into third-degree burns (full thickness burns) especially for vulnerable populations like young children and the elderly with thinner skin. A Sanitation Inspection with a Provisional Classification dated 11/14/2024 stated that the water temperature in the sink in the kitchen was 137 degrees, and the kitchen was unlocked, making the hot water accessible to children. The administrator stated that she was in the kitchen when the health inspector arrived and rushed out and forgot to lock the door behind her. Environmental Health Rule 15A NCAC 18A .2815 (3) states “Hot water that exceeds 120 degrees Fahrenheit is a burn hazard and shall not be provided in areas accessible to children.” Remind staff that kitchen must remain locked at all times when a staff member is not in the kitchen. Locking the half door to the hallway that leads to the kitchen provides an additional layer of security to prevent access to the kitchen, office, and staff bathroom and to prevent children from accessing the playground unattended. This was not documented on the Sanitation Inspection dated 11/19/2024 and was not observed today. The owner and administrator stated that they will not leave the kitchen door unlocked and will remind other staff to lock it behind them. Pests – Pests can carry and spread diseases, pathogens, bacteria, and germs that can make people sick. They can also trigger allergic reactions and asthma symptoms. A Sanitation Inspection with a Provisional Classification dated 11/14/2024 and a Sanitation Inspection with an Approved Classification dated 11/19/2024 documented the presence of live and dead bugs in the back mechanical portion of the small refrigerator in Space 1 (room used for infants), around and inside the diaper changing station in Space 1, behind the cabinet drawer in Space 1, beside the cots in Space 2 (room used for toddlers) and behind the refrigerator in the kitchen. Environmental Health Rule 15A NCAC 18A .2831(b) states “Pests shall be excluded from the child care center.” The owner and administrator stated that they regret trying the home pest control remedy and not contacting a professional pest control when they realized it as more than a random bug. They have obtained the services of a pest control company to treat the current bug problem and continue on-going pest control prevention. Consultation: Integrated Pest Management – “Caring for Our Children 4th Edition” recommends a program of integrated pest management to control and prevent pests in child care facilities. “Facilities should adopt an integrated pest management program (IPM) to ensure long-term, environmentally sound pest suppression through a range of practices including pest exclusion, sanitation and clutter control, and elimination of conditions that are conducive to pest infestations. IPM is a simple, common-sense approach to pest management that eliminates the root causes of pest problems, providing safe and effective control of insects, weeds, rodents, and other pests while minimizing risks to human health and the environment.” This includes maintaining the physical premises to prevent pest breeding areas by ensuring sanitary conditions, filling cracks and crevices, holes, repairing water damage, and removing clutter and trash. Facilities should keep records of pest sightings and sightings of indicators of the presence of pests and always using a pesticide applicator who has the licenses or certifications required by state and local laws, ensuring that pesticides are never applied when children are present and that re-entry periods are adhered to. Records of all pesticides applications (including type and amount of pesticide used), timing and location of treatment, and results should be maintained either on-line or in a manner that permits access by facility managers and staff, state inspectors and regulatory personnel, parents/guardians, and others who may inquire about pesticide usage at the facility. For more information on an integrated pest management program, review Caring for Our Children 4th Edition Chapter 5.2.8 at https://nrckids.org/CFOC. Reminders: Annual License Fees - Check your facility email for the 2024 annual license fee invoice. Invoices will be emailed to the facility addresses on file by November 30, 2024. Online payments will be due by December 31, 2024. Compliance History: I reviewed the facility’s compliance history with the administrator. The 18-month compliance history from 5/19/23 – 11/18/24 = 87%. Please be aware that any information received during this investigation and any violations documented may be included in any future administrative actions. Violations of child care requirements, particularly repeated violations, could result in a civil penalty and/or administrative action that could jeopardize the status of the license for the child care facility. Please also refer to sections labeled Technical Assistance, Consultation, and Reminders for a refresher of our discussions today. If you have any questions, do not hesitate to contact 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 .0803 · Violation

Name of Operation: EAST COAST EARLY LEARNING ACADEMY Facility ID: 28000275 Consultant: MARJORIE WHITE Operation Type: Center Case Number: Visit Date: 8/12/2024 Number Present: 29 Completed Date: 8/12/2024 Age: From 0 To 5 Total Minutes: 390 Time In: 10:00 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced * The purpose of today’s Routine Unannounced visit was to monitor compliance with applicable child care requirements. Last Annual Compliance visit – 3/25/24 18-month compliance history from 2/10/23 – 8/9/24 = 89% Last Sanitation Inspection – 6/5/24 - Superior Last Fire Inspection – 3/14/24 – Satisfactory; approved for daytime 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. The Clean Classrooms for Carolina Kids website reflects the following information about your center’s required three-year water testing, lead paint testing, and asbestos testing: Three-year Water Testing – 7/5/24; due again 7/2027 Lead Paint Testing – exempt per letter 5/24/24 Asbestos Testing –exempt per letter 5/24/24 Maintain any paperwork received by mail or email in your Program Records file. D. Titus-Johnson, Administrator, was present and assisted me with the visit. The facility currently operates with a Five-Star Center License, issued 2/23/2022, earning points in the following components: Program (6 PTS) + Education (6 PTS) + Quality Point (1 PT) = 13 Points = 5 Stars *Quality Point met and remains in effect: Staff benefits and an infrastructure of parent involvement The program was also monitored for compliance with implementing an approved curriculum (Creative Curriculum 5th edition) as required for all four and five star facilities where four-year old children are enrolled. The next rated license assessment is due by 2/23/25, 25, but new legislation (Senate Bill 425) has extended the “hold harmless” period until the new Quality Rating Improvement System (QRIS) is implemented. At this time, you may choose to complete a rated license assessment using the current rated license process or you may wait until the new QRIS is implemented. This facility is owned by East Coast Academies, Inc. According to the NC Secretary of State's website, this corporation is current and active as of 8/9/24. Please contact me prior to any information change regarding the ownership of this facility. License information was current. Contact me to make any changes to address, phone, or email or to request changes to the license. I monitored the classrooms and spaces used for child care, kitchen, and outdoor play area for applicable child care center requirements using the Child Care Center Requirements, effective 1/1/2024 and Item Number Listing, effective 3/2024. I monitored three staff records and all program records. The facility does not offer transportation. Center Observations: Classrooms were bright and clean. Artwork from the previous themes was posted in the preschool classrooms. All classrooms were arranged with toys and learning materials, accessible to children. Three toddlers were resting in cribs in Space 1. The teacher was playing with the infant who had tummy time on the floor. Documentation of safe sleep checks was available for the one infant. Feeding plans were available for the two children younger than fifteen months. The toddlers were busy with free play before going outside later in the morning. The twenty preschool-age children, three through five years of age, from Space 3 were on the playground with two teachers. The teachers supervised and interacted with them to extend their play. Lunch was fish sticks, green beans, pears, and milk. After lunch children rested on linen-covered mats. I observed and documented the following violations during today’s visit. Violation Number Comment Rule 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In Space 1, two bottles of infant Tylenol were stored out of reach of children in a medication box but were not locked. In the bathroom, a tube of Ultra Athletes Antifungal Foot Cream was stored in a medication box but was not locked. 15A NCAC 18A .2820(d) 848 Questionable medication instructions from parents were followed without signed written dosage instructions received from physician or authorized health professional. A parent provided the center with a tube of Ultra Athletes Foot Cream for use on a child, two years of age. The instructions stated the OTC medication is only for children and adults, twelve years of age and older. 10A NCAC 09 .0803(5) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In Space 1, medication permission forms for Aquaphor and Triple M diaper cream expired on July 17, 2024 and were not reauthorized; the topical ointments were not returned to the parent. .0803(12) 851 When medication was administered, documentation was not completed or maintained for 6 months and/or the documentation did not include the required information. Documentation of medication administration was not available for administering Infant Tylenol and Harris Teeter Infant Ibuprofen to two children. .0803(13)(a-e); .2318(3) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). A staff member did not complete a five-year criminal background check that expired on July 29, 2024. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. A staff member did not have a current qualification letter. The most recent qualification letter was dated July 29, 2019 and expired on July 29, 2024. G.S. 110-90.2(b) & (d) & .2703(e) * 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 D. Titus-Johnson, Administrator. We reviewed the visit summary and violation(s) documented during today’s visit. Correct these immediately. Send evidence of correction to me so that I receive it no later than 8/26/2024. The compliance verification letter needs to state the facility name and license number and list each violation by Item # and describe in detail when and how each violation has been corrected. If referring to staff or children in your compliance letter, refer to them by initials or position. Also include the following documents/pictures to verify compliance: Send compliance verification letter in an email from the center’s official email address, heidi.riden@ecelearningacademy.com to my email address, Marjorie.White@dhhs.nc.gov. If sent from another email address, the center’s official address must be Cc’d in the compliance email. You may include the compliance verification as an attachment or in the body of the email. If sufficient information is not received by the due date, a follow-up visit may be conducted. *I will email a sample compliance verification letter to you. *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 or Jennifer.Linhardt@dhhs.nc.gov. Technical Assistance With Documented Violations: You received several violations related to medication permission forms on this visit and your previous visit. Medication permission forms are confusing. Please contact me to arrange for a staff training on medication permission forms. #841: Storage of Medication - Improper storge of medications results in millions of accidental poisonings in children annually. In Space 1, two bottles of infant Tylenol were stored out of reach of children in a medication box but were not locked. In the bathroom, a tube of Ultra Athletes Foot Cream (anti-fungal hydrocortisone) was stored in a medication box out of reach of children but was not locked. The teacher stated that Environmental Health did not require these medications to be locked. 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. The teacher gave them to the administrator who locked them in the office. Consider having a locked box for the medications that need to be locked and a separate basket for diaper creams that need to be stored out of reach but easily accessible when prepping for diaper changes. #848: Questionable Medication Instructions – Over the counter medication for young children can have confusing and questionable instructions or dosage amounts. Not reading the boxes carefully before accepting the medication may result in administering an incorrect dose. In Space 1, a bottle of Infant Tylenol meeting the criteria for the age and weight of the child (MS) was accompanied by a blanket 12-month medication permission form on which the parent did not list the conditions or symptoms for administration of the medication. The teacher stated that the parent would tell her when she wanted her to administer the medication to the child for teething. In the bathroom, a tube of Ultra Athletes Foot Cream (hydrocortisone anti-fungal medication) was present with a signed medication permission form for RH, two years of age, enrolled in Space 2. The instructions on the tube state for use by children and adults, twelve years of age and older. The administrator stated that she had not read the instructions on the tube. Parents need to complete all sections of a medication permission form; staff need to review the instructions before accepting medication. Parents need to bring the box and any packaging information for OTC medications when they bring it in. Review any OTC medication instructions carefully before you accept them into the child care and put them in a classroom. Share this information with your staff so that this type of medication is clearly vetted before accepting it. For your compliance letter state the date the correct medication permission form is completed (including criteria for administration) for the Infant Tylenol for MS and the date the anti-fungal cream is returned to the parent. #849: Expired Medication – Not having current authorization to administer medication, could create medical or liability issues if there are changes to the child’s medication, dosage, or instructions for administration. In Space 1, 12-month medication permission forms for Aquaphor and Triple M for MS were dated 7/17/23 – 7/17/24 and were expired. The topical ointments were not returned to the parent, and the medication permission forms were not reauthorized. Either return the ointments to the parent or have the parent review and update the medication permission form or complete a new form if any of the instructions have changed. For your compliance letter, state the date when the Aquaphor and Triple M are either returned to the parent or an updated medication administration form is on file. #851: Documentation of Medication Administration – Medicines can be crucial to the health and wellness of children. They can also be very dangerous if the wrong type or wrong amount is given to the wrong person or at the wrong time. In Space 1, a bottle of Infant Tylenol (MS) and a bottle of Harris Teeter Infant Ibuprofen (HH) were accompanied by blanket 12-month medication forms with no medication administration log. The teacher said that she had administered each medication a few times for teething but did not document on a medication log that was maintained for at least six months. She did document on the children’s Daily Notes that are shared with the parent at pick-up. She was not aware that these types of medications must be logged and tracked. Over the counter medications, such as acetaminophen and ibuprofen, can be just as dangerous as prescription medications and can result in illness or even death when these products are misused or unintentional poisoning occurs. OTC and prescription medications require the longer medication form and can be authorized for up to six months. They include more information to safeguard the health of the children. They also include a medication administration log so that staff can ensure a child is not accidently overdosed. If the parents of MS and HH want to continue to have these medications on-site, provide them with a six-month medication permission form to complete. Review carefully to verify all required information is included. Print the medication log and document any time the medication is administered. For your compliance letter, state when the correct medication form is completed or if the medications are returned to the parents. #1044 and #1757: Criminal Background Check (CBC) – Criminal Background Checks ensure that staff have not committed any crimes which could potentially make them unsafe to be around children and other staff. Because Abuse and Neglect registries are also checked, it helps to ensure that children are protected from physical, mental, and sexual abuse. Performing diligent background screenings also protects the child care facility against future legal challenges. D. Swain’s five-year Criminal Background Check expired on 7/29/24 and has not been renewed. She did not have a current Qualifying Letter available for review and when I checked ABCMS, she had not yet reapplied for a DHHS Criminal Background Check and Qualifying Letter. Ms. Swain told the administrator that she had already redone her background check for foster care; however, the DHHS Criminal Background Check for child care is a separate process. Ms. Swain needs to complete the on-line application for a CBC immediately, print required documents, and take documents to the sheriff’s offices to have fingerprints completed. If a Qualifying Letter is not received and forwarded to me within fifteen (15) days, by 8/27/24, Ms. Swain may not be on-site until the Qualifying Letter is received. For your compliance letter, state the dates that Ms. Swain 1. completes her on-line CBC application and links her application to the license number (#28000275); 2. has fingerprints completed; 3. has received her Qualifying Letter and provided a copy for her staff file. Also send a copy of the Qualifying Letter with the compliance letter. Multiple instances of failing to complete Criminal Background Checks may result in an Administrative Action. 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. If your email is not the facility email, sign up for email blasts on the What’s New page for general information and communication 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. *Children & Youth Partnership for Dare County: Phone - (252) 441-0614; website - www.darekids.org. *Child Care Health Consultant – S. Rosser - Office: (252) 557-4208 or stacy_rosser@unc.edu *Albemarle Alliance for Children and Families (AACF) and Region 1 Child Care Resource and Referral: Phone (252) 333-1233; website - www.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: 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. *Encourage staff to maintain copies of all initial hire documents, Qualifying Letters, training certificates, etc. in their own professional file maintained at home. *Make it easier on yourself and schedule annual updates for staff evaluations and professional development plans; health questionnaires and emergency information forms; EPR Plan and Emergency Medical Care Plan at the same time to streamline your staff updates. (Example, even if an employee was hired in January , and you update health questionnaires and emergency forms in August, have this employee go ahead and update in August with the rest of the staff to jump into the same cycle!) *When I email staff worksheets to you prior to your Annual Compliance visit, you are expected to update them and return them prior to the date provided in the email. If you cannot open or work with an Excel document, I can send you a list of questions to answer. Use your staff worksheet as a working document and keep it updated as staff information is updated or changes *We reviewed your staff worksheet. I highlighted items that were delinquent and items that are coming due in the next year. **Complete Annual Evaluations and Staff Professional Development Plans for D. Titus-Johnson (was due 5/2024); other staff due in December and February (Get staff on same cycle!) **Update Staff Annual Health Questionnaires and Emergency Information Forms for some staff due in December and February (Get staff on same cycle!) **Staff Medical Report for A. McCauley (hired 8/12/24) is not dated by health care provider; TB test is from 7/25/22 and is more than 12 months old. Have AM get dated medical report from physician and updated TB test or screening. **Staff Medical Report not available for O. Roughton (hired 7/15/24) **Update your EPR Plan and review it and the Emergency Medical Care Plan for all staff in November 2024. Health and Safety Training and Five (5) Year Cycle Tracking Requirements – Review Row 17 on Staff Worksheet for staff members needing initial H&S Training or five-year renewal. New staff are required to complete Health & Safety Training (H&S Training) within one year of hire (CPR/First Aid and Recognizing and Responding to Suspicions of Child Maltreatment within 3 months of hire) and then complete training in all topic areas every five years. 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 3/25/25 (anniversary of last Annual Compliance visit). Staff Education and Works – Help O. Roughton register for Works and submit official, original transcripts to DCDEE Works. Emergency Preparedness and Response (EPR) Requirements, Emergency Medical Care Plan (EMCP) and Ready-to-Go File – *Your EPR Plan was reviewed in November 2023 in the portal, but you did not print the new cover (page 1) and page 28 that reflects the review and update dates. When you review this fall, print out any new pages. *The owner, H. Riden, is not on-site enough to be listed in the EPR Plan or the Emergency Medical care Plan. Update both of them to reflect staff who are consistently on-site. Playground – Sand and repaint rusted spots on metal jeep on playground. Consider adding a sandbox with sand toys (containers to fill and dump, shovels, funnels, sifters, dump trucks, things to bury and find, etc.) to the playground so that children can have sand play daily instead of once per week. Cots – Remind staff to not place or store items on the cots when they are stacked. Cots must be at least 18 inches apart at naptime or separated by a solid barrier to reduce the spread of germs. Staff/Child Ratios – You have 21 children, three through five years of age enrolled in Space 3. Even though it has a maximum capacity of 21 children, enhanced staff/child ratios for groups that include children, three years of age, are 1:10 or 2:20. Because it is summer, you have not had all 21 children attend on the same day but be cognizant of this as you enroll for the fall. Additional Comments: I shared information on the following topics and emailed the information to you after the visit: 1. Webinar - Getting Started in the New Year – 8/20/24 7-8pm 2. Webinar - Child Care 101: Navigating NC Early Childhood System – 8/19/24 6 – 7pm OR 8/20/24 6 - 7pm 3. Summer Tips 4. Criminal Background Check Reminders 5. Moodle Back Up and Running! 6. Rules Changes, effective 1/1/2024 – Review on Moodle! 7. Provider Access to the Background Check Management System 8. Free On-line Teacher Professional Development Memberships 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.

G.S. 110-90 · Violation

Name of Operation: EAST COAST EARLY LEARNING ACADEMY Facility ID: 28000275 Consultant: MARJORIE WHITE Operation Type: Center Case Number: Visit Date: 8/12/2024 Number Present: 29 Completed Date: 8/12/2024 Age: From 0 To 5 Total Minutes: 390 Time In: 10:00 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced * The purpose of today’s Routine Unannounced visit was to monitor compliance with applicable child care requirements. Last Annual Compliance visit – 3/25/24 18-month compliance history from 2/10/23 – 8/9/24 = 89% Last Sanitation Inspection – 6/5/24 - Superior Last Fire Inspection – 3/14/24 – Satisfactory; approved for daytime 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. The Clean Classrooms for Carolina Kids website reflects the following information about your center’s required three-year water testing, lead paint testing, and asbestos testing: Three-year Water Testing – 7/5/24; due again 7/2027 Lead Paint Testing – exempt per letter 5/24/24 Asbestos Testing –exempt per letter 5/24/24 Maintain any paperwork received by mail or email in your Program Records file. D. Titus-Johnson, Administrator, was present and assisted me with the visit. The facility currently operates with a Five-Star Center License, issued 2/23/2022, earning points in the following components: Program (6 PTS) + Education (6 PTS) + Quality Point (1 PT) = 13 Points = 5 Stars *Quality Point met and remains in effect: Staff benefits and an infrastructure of parent involvement The program was also monitored for compliance with implementing an approved curriculum (Creative Curriculum 5th edition) as required for all four and five star facilities where four-year old children are enrolled. The next rated license assessment is due by 2/23/25, 25, but new legislation (Senate Bill 425) has extended the “hold harmless” period until the new Quality Rating Improvement System (QRIS) is implemented. At this time, you may choose to complete a rated license assessment using the current rated license process or you may wait until the new QRIS is implemented. This facility is owned by East Coast Academies, Inc. According to the NC Secretary of State's website, this corporation is current and active as of 8/9/24. Please contact me prior to any information change regarding the ownership of this facility. License information was current. Contact me to make any changes to address, phone, or email or to request changes to the license. I monitored the classrooms and spaces used for child care, kitchen, and outdoor play area for applicable child care center requirements using the Child Care Center Requirements, effective 1/1/2024 and Item Number Listing, effective 3/2024. I monitored three staff records and all program records. The facility does not offer transportation. Center Observations: Classrooms were bright and clean. Artwork from the previous themes was posted in the preschool classrooms. All classrooms were arranged with toys and learning materials, accessible to children. Three toddlers were resting in cribs in Space 1. The teacher was playing with the infant who had tummy time on the floor. Documentation of safe sleep checks was available for the one infant. Feeding plans were available for the two children younger than fifteen months. The toddlers were busy with free play before going outside later in the morning. The twenty preschool-age children, three through five years of age, from Space 3 were on the playground with two teachers. The teachers supervised and interacted with them to extend their play. Lunch was fish sticks, green beans, pears, and milk. After lunch children rested on linen-covered mats. I observed and documented the following violations during today’s visit. Violation Number Comment Rule 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In Space 1, two bottles of infant Tylenol were stored out of reach of children in a medication box but were not locked. In the bathroom, a tube of Ultra Athletes Antifungal Foot Cream was stored in a medication box but was not locked. 15A NCAC 18A .2820(d) 848 Questionable medication instructions from parents were followed without signed written dosage instructions received from physician or authorized health professional. A parent provided the center with a tube of Ultra Athletes Foot Cream for use on a child, two years of age. The instructions stated the OTC medication is only for children and adults, twelve years of age and older. 10A NCAC 09 .0803(5) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In Space 1, medication permission forms for Aquaphor and Triple M diaper cream expired on July 17, 2024 and were not reauthorized; the topical ointments were not returned to the parent. .0803(12) 851 When medication was administered, documentation was not completed or maintained for 6 months and/or the documentation did not include the required information. Documentation of medication administration was not available for administering Infant Tylenol and Harris Teeter Infant Ibuprofen to two children. .0803(13)(a-e); .2318(3) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). A staff member did not complete a five-year criminal background check that expired on July 29, 2024. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. A staff member did not have a current qualification letter. The most recent qualification letter was dated July 29, 2019 and expired on July 29, 2024. G.S. 110-90.2(b) & (d) & .2703(e) * 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 D. Titus-Johnson, Administrator. We reviewed the visit summary and violation(s) documented during today’s visit. Correct these immediately. Send evidence of correction to me so that I receive it no later than 8/26/2024. The compliance verification letter needs to state the facility name and license number and list each violation by Item # and describe in detail when and how each violation has been corrected. If referring to staff or children in your compliance letter, refer to them by initials or position. Also include the following documents/pictures to verify compliance: Send compliance verification letter in an email from the center’s official email address, heidi.riden@ecelearningacademy.com to my email address, Marjorie.White@dhhs.nc.gov. If sent from another email address, the center’s official address must be Cc’d in the compliance email. You may include the compliance verification as an attachment or in the body of the email. If sufficient information is not received by the due date, a follow-up visit may be conducted. *I will email a sample compliance verification letter to you. *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 or Jennifer.Linhardt@dhhs.nc.gov. Technical Assistance With Documented Violations: You received several violations related to medication permission forms on this visit and your previous visit. Medication permission forms are confusing. Please contact me to arrange for a staff training on medication permission forms. #841: Storage of Medication - Improper storge of medications results in millions of accidental poisonings in children annually. In Space 1, two bottles of infant Tylenol were stored out of reach of children in a medication box but were not locked. In the bathroom, a tube of Ultra Athletes Foot Cream (anti-fungal hydrocortisone) was stored in a medication box out of reach of children but was not locked. The teacher stated that Environmental Health did not require these medications to be locked. 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. The teacher gave them to the administrator who locked them in the office. Consider having a locked box for the medications that need to be locked and a separate basket for diaper creams that need to be stored out of reach but easily accessible when prepping for diaper changes. #848: Questionable Medication Instructions – Over the counter medication for young children can have confusing and questionable instructions or dosage amounts. Not reading the boxes carefully before accepting the medication may result in administering an incorrect dose. In Space 1, a bottle of Infant Tylenol meeting the criteria for the age and weight of the child (MS) was accompanied by a blanket 12-month medication permission form on which the parent did not list the conditions or symptoms for administration of the medication. The teacher stated that the parent would tell her when she wanted her to administer the medication to the child for teething. In the bathroom, a tube of Ultra Athletes Foot Cream (hydrocortisone anti-fungal medication) was present with a signed medication permission form for RH, two years of age, enrolled in Space 2. The instructions on the tube state for use by children and adults, twelve years of age and older. The administrator stated that she had not read the instructions on the tube. Parents need to complete all sections of a medication permission form; staff need to review the instructions before accepting medication. Parents need to bring the box and any packaging information for OTC medications when they bring it in. Review any OTC medication instructions carefully before you accept them into the child care and put them in a classroom. Share this information with your staff so that this type of medication is clearly vetted before accepting it. For your compliance letter state the date the correct medication permission form is completed (including criteria for administration) for the Infant Tylenol for MS and the date the anti-fungal cream is returned to the parent. #849: Expired Medication – Not having current authorization to administer medication, could create medical or liability issues if there are changes to the child’s medication, dosage, or instructions for administration. In Space 1, 12-month medication permission forms for Aquaphor and Triple M for MS were dated 7/17/23 – 7/17/24 and were expired. The topical ointments were not returned to the parent, and the medication permission forms were not reauthorized. Either return the ointments to the parent or have the parent review and update the medication permission form or complete a new form if any of the instructions have changed. For your compliance letter, state the date when the Aquaphor and Triple M are either returned to the parent or an updated medication administration form is on file. #851: Documentation of Medication Administration – Medicines can be crucial to the health and wellness of children. They can also be very dangerous if the wrong type or wrong amount is given to the wrong person or at the wrong time. In Space 1, a bottle of Infant Tylenol (MS) and a bottle of Harris Teeter Infant Ibuprofen (HH) were accompanied by blanket 12-month medication forms with no medication administration log. The teacher said that she had administered each medication a few times for teething but did not document on a medication log that was maintained for at least six months. She did document on the children’s Daily Notes that are shared with the parent at pick-up. She was not aware that these types of medications must be logged and tracked. Over the counter medications, such as acetaminophen and ibuprofen, can be just as dangerous as prescription medications and can result in illness or even death when these products are misused or unintentional poisoning occurs. OTC and prescription medications require the longer medication form and can be authorized for up to six months. They include more information to safeguard the health of the children. They also include a medication administration log so that staff can ensure a child is not accidently overdosed. If the parents of MS and HH want to continue to have these medications on-site, provide them with a six-month medication permission form to complete. Review carefully to verify all required information is included. Print the medication log and document any time the medication is administered. For your compliance letter, state when the correct medication form is completed or if the medications are returned to the parents. #1044 and #1757: Criminal Background Check (CBC) – Criminal Background Checks ensure that staff have not committed any crimes which could potentially make them unsafe to be around children and other staff. Because Abuse and Neglect registries are also checked, it helps to ensure that children are protected from physical, mental, and sexual abuse. Performing diligent background screenings also protects the child care facility against future legal challenges. D. Swain’s five-year Criminal Background Check expired on 7/29/24 and has not been renewed. She did not have a current Qualifying Letter available for review and when I checked ABCMS, she had not yet reapplied for a DHHS Criminal Background Check and Qualifying Letter. Ms. Swain told the administrator that she had already redone her background check for foster care; however, the DHHS Criminal Background Check for child care is a separate process. Ms. Swain needs to complete the on-line application for a CBC immediately, print required documents, and take documents to the sheriff’s offices to have fingerprints completed. If a Qualifying Letter is not received and forwarded to me within fifteen (15) days, by 8/27/24, Ms. Swain may not be on-site until the Qualifying Letter is received. For your compliance letter, state the dates that Ms. Swain 1. completes her on-line CBC application and links her application to the license number (#28000275); 2. has fingerprints completed; 3. has received her Qualifying Letter and provided a copy for her staff file. Also send a copy of the Qualifying Letter with the compliance letter. Multiple instances of failing to complete Criminal Background Checks may result in an Administrative Action. 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. If your email is not the facility email, sign up for email blasts on the What’s New page for general information and communication 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. *Children & Youth Partnership for Dare County: Phone - (252) 441-0614; website - www.darekids.org. *Child Care Health Consultant – S. Rosser - Office: (252) 557-4208 or stacy_rosser@unc.edu *Albemarle Alliance for Children and Families (AACF) and Region 1 Child Care Resource and Referral: Phone (252) 333-1233; website - www.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: 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. *Encourage staff to maintain copies of all initial hire documents, Qualifying Letters, training certificates, etc. in their own professional file maintained at home. *Make it easier on yourself and schedule annual updates for staff evaluations and professional development plans; health questionnaires and emergency information forms; EPR Plan and Emergency Medical Care Plan at the same time to streamline your staff updates. (Example, even if an employee was hired in January , and you update health questionnaires and emergency forms in August, have this employee go ahead and update in August with the rest of the staff to jump into the same cycle!) *When I email staff worksheets to you prior to your Annual Compliance visit, you are expected to update them and return them prior to the date provided in the email. If you cannot open or work with an Excel document, I can send you a list of questions to answer. Use your staff worksheet as a working document and keep it updated as staff information is updated or changes *We reviewed your staff worksheet. I highlighted items that were delinquent and items that are coming due in the next year. **Complete Annual Evaluations and Staff Professional Development Plans for D. Titus-Johnson (was due 5/2024); other staff due in December and February (Get staff on same cycle!) **Update Staff Annual Health Questionnaires and Emergency Information Forms for some staff due in December and February (Get staff on same cycle!) **Staff Medical Report for A. McCauley (hired 8/12/24) is not dated by health care provider; TB test is from 7/25/22 and is more than 12 months old. Have AM get dated medical report from physician and updated TB test or screening. **Staff Medical Report not available for O. Roughton (hired 7/15/24) **Update your EPR Plan and review it and the Emergency Medical Care Plan for all staff in November 2024. Health and Safety Training and Five (5) Year Cycle Tracking Requirements – Review Row 17 on Staff Worksheet for staff members needing initial H&S Training or five-year renewal. New staff are required to complete Health & Safety Training (H&S Training) within one year of hire (CPR/First Aid and Recognizing and Responding to Suspicions of Child Maltreatment within 3 months of hire) and then complete training in all topic areas every five years. 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 3/25/25 (anniversary of last Annual Compliance visit). Staff Education and Works – Help O. Roughton register for Works and submit official, original transcripts to DCDEE Works. Emergency Preparedness and Response (EPR) Requirements, Emergency Medical Care Plan (EMCP) and Ready-to-Go File – *Your EPR Plan was reviewed in November 2023 in the portal, but you did not print the new cover (page 1) and page 28 that reflects the review and update dates. When you review this fall, print out any new pages. *The owner, H. Riden, is not on-site enough to be listed in the EPR Plan or the Emergency Medical care Plan. Update both of them to reflect staff who are consistently on-site. Playground – Sand and repaint rusted spots on metal jeep on playground. Consider adding a sandbox with sand toys (containers to fill and dump, shovels, funnels, sifters, dump trucks, things to bury and find, etc.) to the playground so that children can have sand play daily instead of once per week. Cots – Remind staff to not place or store items on the cots when they are stacked. Cots must be at least 18 inches apart at naptime or separated by a solid barrier to reduce the spread of germs. Staff/Child Ratios – You have 21 children, three through five years of age enrolled in Space 3. Even though it has a maximum capacity of 21 children, enhanced staff/child ratios for groups that include children, three years of age, are 1:10 or 2:20. Because it is summer, you have not had all 21 children attend on the same day but be cognizant of this as you enroll for the fall. Additional Comments: I shared information on the following topics and emailed the information to you after the visit: 1. Webinar - Getting Started in the New Year – 8/20/24 7-8pm 2. Webinar - Child Care 101: Navigating NC Early Childhood System – 8/19/24 6 – 7pm OR 8/20/24 6 - 7pm 3. Summer Tips 4. Criminal Background Check Reminders 5. Moodle Back Up and Running! 6. Rules Changes, effective 1/1/2024 – Review on Moodle! 7. Provider Access to the Background Check Management System 8. Free On-line Teacher Professional Development Memberships 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: EAST COAST EARLY LEARNING ACADEMY Facility ID: 28000275 Consultant: MARJORIE WHITE Operation Type: Center Case Number: Visit Date: 8/12/2024 Number Present: 29 Completed Date: 8/12/2024 Age: From 0 To 5 Total Minutes: 390 Time In: 10:00 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced * The purpose of today’s Routine Unannounced visit was to monitor compliance with applicable child care requirements. Last Annual Compliance visit – 3/25/24 18-month compliance history from 2/10/23 – 8/9/24 = 89% Last Sanitation Inspection – 6/5/24 - Superior Last Fire Inspection – 3/14/24 – Satisfactory; approved for daytime 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. The Clean Classrooms for Carolina Kids website reflects the following information about your center’s required three-year water testing, lead paint testing, and asbestos testing: Three-year Water Testing – 7/5/24; due again 7/2027 Lead Paint Testing – exempt per letter 5/24/24 Asbestos Testing –exempt per letter 5/24/24 Maintain any paperwork received by mail or email in your Program Records file. D. Titus-Johnson, Administrator, was present and assisted me with the visit. The facility currently operates with a Five-Star Center License, issued 2/23/2022, earning points in the following components: Program (6 PTS) + Education (6 PTS) + Quality Point (1 PT) = 13 Points = 5 Stars *Quality Point met and remains in effect: Staff benefits and an infrastructure of parent involvement The program was also monitored for compliance with implementing an approved curriculum (Creative Curriculum 5th edition) as required for all four and five star facilities where four-year old children are enrolled. The next rated license assessment is due by 2/23/25, 25, but new legislation (Senate Bill 425) has extended the “hold harmless” period until the new Quality Rating Improvement System (QRIS) is implemented. At this time, you may choose to complete a rated license assessment using the current rated license process or you may wait until the new QRIS is implemented. This facility is owned by East Coast Academies, Inc. According to the NC Secretary of State's website, this corporation is current and active as of 8/9/24. Please contact me prior to any information change regarding the ownership of this facility. License information was current. Contact me to make any changes to address, phone, or email or to request changes to the license. I monitored the classrooms and spaces used for child care, kitchen, and outdoor play area for applicable child care center requirements using the Child Care Center Requirements, effective 1/1/2024 and Item Number Listing, effective 3/2024. I monitored three staff records and all program records. The facility does not offer transportation. Center Observations: Classrooms were bright and clean. Artwork from the previous themes was posted in the preschool classrooms. All classrooms were arranged with toys and learning materials, accessible to children. Three toddlers were resting in cribs in Space 1. The teacher was playing with the infant who had tummy time on the floor. Documentation of safe sleep checks was available for the one infant. Feeding plans were available for the two children younger than fifteen months. The toddlers were busy with free play before going outside later in the morning. The twenty preschool-age children, three through five years of age, from Space 3 were on the playground with two teachers. The teachers supervised and interacted with them to extend their play. Lunch was fish sticks, green beans, pears, and milk. After lunch children rested on linen-covered mats. I observed and documented the following violations during today’s visit. Violation Number Comment Rule 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In Space 1, two bottles of infant Tylenol were stored out of reach of children in a medication box but were not locked. In the bathroom, a tube of Ultra Athletes Antifungal Foot Cream was stored in a medication box but was not locked. 15A NCAC 18A .2820(d) 848 Questionable medication instructions from parents were followed without signed written dosage instructions received from physician or authorized health professional. A parent provided the center with a tube of Ultra Athletes Foot Cream for use on a child, two years of age. The instructions stated the OTC medication is only for children and adults, twelve years of age and older. 10A NCAC 09 .0803(5) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In Space 1, medication permission forms for Aquaphor and Triple M diaper cream expired on July 17, 2024 and were not reauthorized; the topical ointments were not returned to the parent. .0803(12) 851 When medication was administered, documentation was not completed or maintained for 6 months and/or the documentation did not include the required information. Documentation of medication administration was not available for administering Infant Tylenol and Harris Teeter Infant Ibuprofen to two children. .0803(13)(a-e); .2318(3) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). A staff member did not complete a five-year criminal background check that expired on July 29, 2024. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. A staff member did not have a current qualification letter. The most recent qualification letter was dated July 29, 2019 and expired on July 29, 2024. G.S. 110-90.2(b) & (d) & .2703(e) * 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 D. Titus-Johnson, Administrator. We reviewed the visit summary and violation(s) documented during today’s visit. Correct these immediately. Send evidence of correction to me so that I receive it no later than 8/26/2024. The compliance verification letter needs to state the facility name and license number and list each violation by Item # and describe in detail when and how each violation has been corrected. If referring to staff or children in your compliance letter, refer to them by initials or position. Also include the following documents/pictures to verify compliance: Send compliance verification letter in an email from the center’s official email address, heidi.riden@ecelearningacademy.com to my email address, Marjorie.White@dhhs.nc.gov. If sent from another email address, the center’s official address must be Cc’d in the compliance email. You may include the compliance verification as an attachment or in the body of the email. If sufficient information is not received by the due date, a follow-up visit may be conducted. *I will email a sample compliance verification letter to you. *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 or Jennifer.Linhardt@dhhs.nc.gov. Technical Assistance With Documented Violations: You received several violations related to medication permission forms on this visit and your previous visit. Medication permission forms are confusing. Please contact me to arrange for a staff training on medication permission forms. #841: Storage of Medication - Improper storge of medications results in millions of accidental poisonings in children annually. In Space 1, two bottles of infant Tylenol were stored out of reach of children in a medication box but were not locked. In the bathroom, a tube of Ultra Athletes Foot Cream (anti-fungal hydrocortisone) was stored in a medication box out of reach of children but was not locked. The teacher stated that Environmental Health did not require these medications to be locked. 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. The teacher gave them to the administrator who locked them in the office. Consider having a locked box for the medications that need to be locked and a separate basket for diaper creams that need to be stored out of reach but easily accessible when prepping for diaper changes. #848: Questionable Medication Instructions – Over the counter medication for young children can have confusing and questionable instructions or dosage amounts. Not reading the boxes carefully before accepting the medication may result in administering an incorrect dose. In Space 1, a bottle of Infant Tylenol meeting the criteria for the age and weight of the child (MS) was accompanied by a blanket 12-month medication permission form on which the parent did not list the conditions or symptoms for administration of the medication. The teacher stated that the parent would tell her when she wanted her to administer the medication to the child for teething. In the bathroom, a tube of Ultra Athletes Foot Cream (hydrocortisone anti-fungal medication) was present with a signed medication permission form for RH, two years of age, enrolled in Space 2. The instructions on the tube state for use by children and adults, twelve years of age and older. The administrator stated that she had not read the instructions on the tube. Parents need to complete all sections of a medication permission form; staff need to review the instructions before accepting medication. Parents need to bring the box and any packaging information for OTC medications when they bring it in. Review any OTC medication instructions carefully before you accept them into the child care and put them in a classroom. Share this information with your staff so that this type of medication is clearly vetted before accepting it. For your compliance letter state the date the correct medication permission form is completed (including criteria for administration) for the Infant Tylenol for MS and the date the anti-fungal cream is returned to the parent. #849: Expired Medication – Not having current authorization to administer medication, could create medical or liability issues if there are changes to the child’s medication, dosage, or instructions for administration. In Space 1, 12-month medication permission forms for Aquaphor and Triple M for MS were dated 7/17/23 – 7/17/24 and were expired. The topical ointments were not returned to the parent, and the medication permission forms were not reauthorized. Either return the ointments to the parent or have the parent review and update the medication permission form or complete a new form if any of the instructions have changed. For your compliance letter, state the date when the Aquaphor and Triple M are either returned to the parent or an updated medication administration form is on file. #851: Documentation of Medication Administration – Medicines can be crucial to the health and wellness of children. They can also be very dangerous if the wrong type or wrong amount is given to the wrong person or at the wrong time. In Space 1, a bottle of Infant Tylenol (MS) and a bottle of Harris Teeter Infant Ibuprofen (HH) were accompanied by blanket 12-month medication forms with no medication administration log. The teacher said that she had administered each medication a few times for teething but did not document on a medication log that was maintained for at least six months. She did document on the children’s Daily Notes that are shared with the parent at pick-up. She was not aware that these types of medications must be logged and tracked. Over the counter medications, such as acetaminophen and ibuprofen, can be just as dangerous as prescription medications and can result in illness or even death when these products are misused or unintentional poisoning occurs. OTC and prescription medications require the longer medication form and can be authorized for up to six months. They include more information to safeguard the health of the children. They also include a medication administration log so that staff can ensure a child is not accidently overdosed. If the parents of MS and HH want to continue to have these medications on-site, provide them with a six-month medication permission form to complete. Review carefully to verify all required information is included. Print the medication log and document any time the medication is administered. For your compliance letter, state when the correct medication form is completed or if the medications are returned to the parents. #1044 and #1757: Criminal Background Check (CBC) – Criminal Background Checks ensure that staff have not committed any crimes which could potentially make them unsafe to be around children and other staff. Because Abuse and Neglect registries are also checked, it helps to ensure that children are protected from physical, mental, and sexual abuse. Performing diligent background screenings also protects the child care facility against future legal challenges. D. Swain’s five-year Criminal Background Check expired on 7/29/24 and has not been renewed. She did not have a current Qualifying Letter available for review and when I checked ABCMS, she had not yet reapplied for a DHHS Criminal Background Check and Qualifying Letter. Ms. Swain told the administrator that she had already redone her background check for foster care; however, the DHHS Criminal Background Check for child care is a separate process. Ms. Swain needs to complete the on-line application for a CBC immediately, print required documents, and take documents to the sheriff’s offices to have fingerprints completed. If a Qualifying Letter is not received and forwarded to me within fifteen (15) days, by 8/27/24, Ms. Swain may not be on-site until the Qualifying Letter is received. For your compliance letter, state the dates that Ms. Swain 1. completes her on-line CBC application and links her application to the license number (#28000275); 2. has fingerprints completed; 3. has received her Qualifying Letter and provided a copy for her staff file. Also send a copy of the Qualifying Letter with the compliance letter. Multiple instances of failing to complete Criminal Background Checks may result in an Administrative Action. 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. If your email is not the facility email, sign up for email blasts on the What’s New page for general information and communication 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. *Children & Youth Partnership for Dare County: Phone - (252) 441-0614; website - www.darekids.org. *Child Care Health Consultant – S. Rosser - Office: (252) 557-4208 or stacy_rosser@unc.edu *Albemarle Alliance for Children and Families (AACF) and Region 1 Child Care Resource and Referral: Phone (252) 333-1233; website - www.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: 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. *Encourage staff to maintain copies of all initial hire documents, Qualifying Letters, training certificates, etc. in their own professional file maintained at home. *Make it easier on yourself and schedule annual updates for staff evaluations and professional development plans; health questionnaires and emergency information forms; EPR Plan and Emergency Medical Care Plan at the same time to streamline your staff updates. (Example, even if an employee was hired in January , and you update health questionnaires and emergency forms in August, have this employee go ahead and update in August with the rest of the staff to jump into the same cycle!) *When I email staff worksheets to you prior to your Annual Compliance visit, you are expected to update them and return them prior to the date provided in the email. If you cannot open or work with an Excel document, I can send you a list of questions to answer. Use your staff worksheet as a working document and keep it updated as staff information is updated or changes *We reviewed your staff worksheet. I highlighted items that were delinquent and items that are coming due in the next year. **Complete Annual Evaluations and Staff Professional Development Plans for D. Titus-Johnson (was due 5/2024); other staff due in December and February (Get staff on same cycle!) **Update Staff Annual Health Questionnaires and Emergency Information Forms for some staff due in December and February (Get staff on same cycle!) **Staff Medical Report for A. McCauley (hired 8/12/24) is not dated by health care provider; TB test is from 7/25/22 and is more than 12 months old. Have AM get dated medical report from physician and updated TB test or screening. **Staff Medical Report not available for O. Roughton (hired 7/15/24) **Update your EPR Plan and review it and the Emergency Medical Care Plan for all staff in November 2024. Health and Safety Training and Five (5) Year Cycle Tracking Requirements – Review Row 17 on Staff Worksheet for staff members needing initial H&S Training or five-year renewal. New staff are required to complete Health & Safety Training (H&S Training) within one year of hire (CPR/First Aid and Recognizing and Responding to Suspicions of Child Maltreatment within 3 months of hire) and then complete training in all topic areas every five years. 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 3/25/25 (anniversary of last Annual Compliance visit). Staff Education and Works – Help O. Roughton register for Works and submit official, original transcripts to DCDEE Works. Emergency Preparedness and Response (EPR) Requirements, Emergency Medical Care Plan (EMCP) and Ready-to-Go File – *Your EPR Plan was reviewed in November 2023 in the portal, but you did not print the new cover (page 1) and page 28 that reflects the review and update dates. When you review this fall, print out any new pages. *The owner, H. Riden, is not on-site enough to be listed in the EPR Plan or the Emergency Medical care Plan. Update both of them to reflect staff who are consistently on-site. Playground – Sand and repaint rusted spots on metal jeep on playground. Consider adding a sandbox with sand toys (containers to fill and dump, shovels, funnels, sifters, dump trucks, things to bury and find, etc.) to the playground so that children can have sand play daily instead of once per week. Cots – Remind staff to not place or store items on the cots when they are stacked. Cots must be at least 18 inches apart at naptime or separated by a solid barrier to reduce the spread of germs. Staff/Child Ratios – You have 21 children, three through five years of age enrolled in Space 3. Even though it has a maximum capacity of 21 children, enhanced staff/child ratios for groups that include children, three years of age, are 1:10 or 2:20. Because it is summer, you have not had all 21 children attend on the same day but be cognizant of this as you enroll for the fall. Additional Comments: I shared information on the following topics and emailed the information to you after the visit: 1. Webinar - Getting Started in the New Year – 8/20/24 7-8pm 2. Webinar - Child Care 101: Navigating NC Early Childhood System – 8/19/24 6 – 7pm OR 8/20/24 6 - 7pm 3. Summer Tips 4. Criminal Background Check Reminders 5. Moodle Back Up and Running! 6. Rules Changes, effective 1/1/2024 – Review on Moodle! 7. Provider Access to the Background Check Management System 8. Free On-line Teacher Professional Development Memberships 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 .0803 · Violation

Name of Operation: EAST COAST EARLY LEARNING ACADEMY Facility ID: 28000275 Consultant: MARJORIE WHITE Operation Type: Center Case Number: Visit Date: 3/25/2024 Number Present: 25 Completed Date: 3/25/2024 Age: From 0 To 5 Total Minutes: 420 Time In: 10:00 AM Time Out: 05:00 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. Last Annual Compliance visit – 5/24/23 Last Sanitation Inspection – 12/18/233 with a Superior Rating Last Fire Inspection – 3/14/23 with Satisfactory rating; approved for daytime 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. 18-month compliance history from 9/22/22 – 3/21/24 = 93% D. Titus-Johnson, Administrator, was present and assisted me with the visit. The facility currently operates with a Five-Star Center License, issued 2/23/2022, earning points in the following components: Program (6 PTS) + Education (6 PTS) + Quality Point (1 PT) = 13 Points = 5 Stars *Quality Point met and remains in effect: Staff benefits and an infrastructure of parent involvement The program was also monitored for compliance with implementing an approved curriculum (Creative Curriculum 5th edition) as required for all four and five star facilities where four-year old children are enrolled. The next rated license assessment was due by 2/23/25, but DCDEE has developed a two-year cohort system to return all facilities back to rated license reassessments. Your center has been assigned to Cohort 3. The Cohort 3 Rated License Preparation Year is from 7/1/2025 – 6/30/2026. You may complete your ECERS-R during the Preparation Year and choose to use your scores and complete the rated license reassessment if education is where you want it to be. If you would like to complete the ECERS-R again to improve your scores, you may do this during your Assessment Year from 7/1/2026 – 6/30/2027 at no cost to you which will also give you additional time to work on education, if needed. We will discuss more details at next year’s annual compliance visit. This facility is owned by East Coast Academies, Inc. According to the NC Secretary of State's website, this corporation is current and active as of 3/21/24. Please contact me prior to any information change regarding the ownership of this facility. License information was current. Contact me to make any changes to address, phone, or email or to request changes to the license. I monitored the classrooms and spaces used for child care, kitchen, and outdoor play area for applicable child care center requirements using the Child Care Center Requirements, effective 1/1/2024 and Item Number Listing, effective 8/2023. I monitored five children’s records, two staff records and all program records. The facility does not offer transportation. Center Observations: The center was busy with activities to prepare for Easter. Twenty-five children were present in three classrooms with four teachers. The children, two years of age, in Space 2 were in the middle of bathroom routines before putting on coats and going outdoors. They played on several portable climbers, in playhouses and with riding toys. The infants were cared for on their own schedules. Feeding plans were posted. Documentation of safe sleep checks was available and current. Infants and toddlers had a variety of toys to choose from when on the floor. The preschool group was decorating the class for Easter. Pastels, bunnies, chicks and Easter eggs brightened the walls. Lunch was hot dogs with beans, peas and carrots, pears, and milk. Children were offered seconds. After lunch they rested on linen-covered cots. I observed and documented the following violations during today’s visit. Violation Number Comment Rule 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A bottle of Parent's Choice Infant Pain and Fever Relief was stored in an unlocked medication box out of reach of children but not locked. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. Two medication permissions forms for Albuterol and an Epi-pen did not include the six-month authorization time frame and were not dated by the parent. 10A NCAC 09 .0803(4)(6-9) 848 Questionable medication instructions from parents were followed without signed written dosage instructions received from physician or authorized health professional. A bottle of Parent's Choice Infant Pain Reliever (2-3 years) was observed with a medication permission form completed by a parent of a child, eleven months of age. Dosage instructions stated to consult a physician for children younger than two years of age. A physician's note was not available. The medication had not been administered to the infant. 10A NCAC 09 .0803(5) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. A medication permission form for Eucerin Eczema Relief was dated October 24, 2022 - October 24, 2023 and was expired. An empty tube of Desitin was not discarded or returned to the parent. .0803(12) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report documented on the center incident log for December 5, 2023 was not available in a child's file. .0802 (e) 1320 Children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care was not on file for each child. In one of three children's records reviewed, a Children's Medical Report or health assessment was not available for a child enrolled on March 8. 2022. GS 110-91(1);.0302(d)(2); .0304(g) 1329 Application for enrollment did not include all required information. In two of the three children's records reviewed, the parent did not complete parts of the Health Care Needs section on the Child's Application. .0801(a)(1-7) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. Medical action plans were available with the mediation for a child with two chronic medical conditions, but copies were not attached to the Child's Application in the child's file. .0801(b) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A staff person hired on July 31, 2023 did not complete Recognizing and Responding to Suspicions of Child Maltreatment until December 10, 2023. .1102(g) * 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 D. Titus-Johnson, Administrator. We reviewed the visit summary and the nine violations documented during today’s visit. You corrected five of them during the visit. Correct the four remaining violations immediately. Send evidence of correction to me so that I receive it no later than 4/8/2024. The compliance verification letter needs to state the facility name and license number and list each violation by Item # and describe in detail when and how each violation has been corrected. If referring to staff or children in your compliance letter, refer to them by initials or position. Send compliance verification letter in an email from the center’s official email address, heidi.riden@ecelearningacademy.com to my email address, Marjorie.White@dhhs.nc.gov. If sent from another email address, the center’s official address must be Cc’d in the compliance email. You may include the compliance verification as an attachment or in the body of the email. If sufficient information is not received by the due date, a follow-up visit may be conducted. *I will email a sample compliance verification letter to you. *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 or Jennifer.Linhardt@dhhs.nc.gov. Technical Assistance With Documented Violations: #841: Storage of Medication - Improper storge of medications results in millions of accidental poisonings in children annually. In Space 1, Parents Choice Infant Pain and Fever Relief was stored out of reach of children in an unlocked medication box but was not locked. The teacher stated that she did not realize it had to be locked even though it’s an over the counter medication. 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. Emergency medications such as asthma inhalers, Epi-Pens, Diastat, and glucagon may be stored out of reach but easily accessible to a teacher in the event of a medical emergency. OTC and non-emergency prescription medications must be locked. This was corrected during the visit today. #847: Medication Permission Forms - All medications for children present at the center must have a current, completed medication permission form so that staff have the required information to administer any type of medication per the parent’s or physician’s instructions. Two medication permission forms for an Epi-pen and an Albuterol Inhaler for JC (DOE 12/4/23) were not dated by the parent and did not include six-month authorization time frame (12/4/23 – 6/4/24). The administrator stated that this was overlooked when accepting the medication. Assist parents with completing these forms when bringing in any type of medication to the center. Don’t accept medication until the medication forms and medication have been reviewed closely to ensure that they meet the requirements and include all information that could be critical when administering medicine. For your compliance letter, state the date when the medication forms are completed. Add a reminder to your tracker that the parent needs to update these in June 2024 for another six months. (The medical action plans also need to be updated in June.) #848: Questionable Medication Instructions – Over the counter medication for young children can have confusing and questionable instructions or dosage amounts. Not reading the boxes carefully before accepting the medication may result in administering an incorrect dose. A bottle of Parent’s Choice Infant Pain and Fever Relief was observed in the medication box in Space 1 for a child, eleven months of age. The medication permission form stated that the medication was to be used for teething pain. The parent indicated that a dose of 2.5 ml was to be administered. Even though the label called the medication “Infant Pain Relief”, it also stated that it was for children, two – three years of age. The dosage information on the box stated to “consultant a physician” for children younger than two years of age, but a physician note was not available. The teacher stated that she had not administered the medication for any reason to the infant. Review any OTC medication instructions carefully before you accept them into the child care and put them in a classroom. Many OTC pain relievers, decongestants, cough suppressants, etc. appear to be for young children because they say “infant” or “child” and have pictures of cute babies on them, but when you read the dosage instructions, it is clear that they should not be given to young children without a physician’s consent. You corrected this by removing the medication from the classroom and returning it to the parent. Share this information with your staff so that this type of medication is clearly vetted before accepting it. #849: Expired Medication – When medications or medication permission forms expire or child leaves center, return the medication to the parent within 72 hours unless the medication is still needed and the permission form needs to be updated. A tube of Eucerin Eczema Relief for PW (Space 2) was observed in the medication box stored out of reach in the bathroom. The accompanying medication permission form was dated 10/24/22 – 10/24/23 and was expired. Have parent update or complete a new form valid for one year. An empty tube of Desitin was observed for BW, along with a full tube of Butt-paste. Discard or return the empty tube of Desitin. Check medication boxes or cabinets monthly to review medications and medication permission forms. Update or return as needed. This was corrected during the visit. #852 Incident Report – Incident Reports keep parents informed of injuries their child has at your facility and provide an opportunity for you and your staff to review your own safety and supervision practices to prevent similar injuries in the future. Your incident log had documentation of an incident that occurred on 12/5/23 for JC (enrolled 12/4/23); however, a copy of the incident report was not available in the child’s file. You stated that the teacher may have accidentally given the parent the copy without making a copy for the child’s file. If a child is injured while attending child care and the injury requires minor on-site first aid (band-aid, ice pack, tweezers, etc.) or professional medical care (doctor, hospital, EMS, etc.), complete an Incident Report (updated 3/2021) with help from the staff members who witnessed the accident and provided first aid. Review with the parent and have her/him sign. The parent must be offered a copy but may choose to decline a copy by checking and initially the box at the bottom. The original copy is maintained in the child’s file and documented on the Incident Log. If the injury requires professional medical attention, mail a copy of the Incident Report to the child care consultant within seven days. Review 10A NCAC 09 .0802 (e-g) Emergency Medical Care for more information on incident reports and the incident log. For your compliance letter, state when you reviewed incident report requirements with staff so that incident reports are maintained in children’s files. Children’s Files Maintaining accurate records on the children in your care helps to ensure their health and safety, informs families of rules you are required to follow and your center’s policies, and provides a certain transfer of knowledge so that you can provide the best care possible for their children. I monitored three children’s files. The following children’s documents were not available. #1320: Children’s Medical Report – missing for LY (Space 2 – DOE 3/8/22) – For your compliance letter state that date when you have received a child’s medical report for JY and it is available in her file for review. Do not send a copy of the medical report. #1329: Child’s Application – Health Care Needs Section – not fully completed for MA (Space 1) and JC (Space 3) – Parents need to complete all information in the Health Care Needs section or write “N/A” or something similar. – For your compliance letter state the date when the parents of MA and JC have completed the health care needs information on the child’s application. Use Children’s File Checklist to verify you have received all required enrollment documents. Build in time to review enrollment documents with families explaining that they need to be fully completed, signed and dated. Check them before the parent leaves their children with you the first time. The empty blank might be the signature you need to seek emergency medical care if the child is injured. Have parents review and update the Child’s Application annually to ensure information is still current. #1834: Medical Action Plan – Medical Action Plans include medical information that is crucial in the event of a medical emergency that requires medication such as an Epi-pen or Asthma Inhaler. A child enrolled on 12/3/23 (JC) has two chronic medical conditions that require emergency medications; medical action plans for both medications were included with the medication but copies were not attached to the child’s application in the file. You stated you were not aware that they needed to be included in the child’s file and corrected it immediately by making copies and stapling them to the child’s application. The medical action plan must be completed by the child’s physician or parent and updated annually. (These medical action plans were dated for June 2023 and must be updated in June 2024.) Another copy needs to be attached to the application in the Ready to Go File. It is also best practice to have a copy in the classroom with the medication and the required medication permission form. #1897: Recognizing and Responding to Suspicions of Child Maltreatment – Recognizing and Responding to Suspicions of Child Maltreatment staff the signs and symptoms to look out for with child abuse and neglect, what to do when they suspect it is happening, NC’s reporting law, and what happens after a report is made. ED (DOH 7/31/23) was required to complete the training by 10/31/23 but did not complete it until 12/10/23. You stated that both of you forgot about the deadline. This has been corrected. I will email a list of required trainings/tasks that need to be completed at hire and throughout a new employee’s first year. Use a tracker (handwritten or electronic) to track due dates for staff documents and task. General Visit Information: Be knowledgeable of the child care laws and rules and environmental health rules; review them with your staff and assist them with understanding and implementing them to maintain compliance and keep children safe and healthy. The most recent versions of child care laws and rules (updated 1/1/24) and environmental health rules (updated 7/1/23) in North Carolina, the Items Number Listing (can be used as a detailed checklist of required items) and What’s New information are available on the DCDEE website, www.ncchildcare.ncdhhs.gov. Check the designated facility email at least weekly to stay current with communication and email blasts from DCDEE. If your email is not the facility email, sign up for email blasts on the What’s New page for general information and communication from DCDEE. Your local and regional Smart Start Partnerships and Child Care Resource and Referral Agencies are available to assist you with technical assistance and training on a multitude of topics including but not limited to: Environment Rating Scales, infant/toddler practices, healthy behaviors and classroom management, developmentally appropriate practice, EPR plans, activity plans, NC Foundations for Early Learning (developmental domains), etc. 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. *Children & Youth Partnership for Dare County: Phone - (252) 441-0614; website - www.darekids.org. *Child Care Health Consultant – S. Rosser - Office: (252) 557-4208 or stacy_rosser@unc.edu Reminders: 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. *Make it easier on yourself and schedule annual updates for staff evaluations and professional development plans; health questionnaires and emergency information forms; EPR Plan and Emergency Medical Care Plan at the same time to streamline your staff updates. (Example, even if an employee was hired in January , and you update health questionnaires and emergency forms in August, have this employee go ahead and update in August with the rest of the staff to jump into the same cycle!) *We reviewed your staff worksheet. I highlighted items that were delinquent and items that are coming due in the next year. *D. Titus-Johnson – ITS/SIDS due 4/20/24 *E. Dosaeva – CPR/FA due 6/30/24 *D. Swain – due for 5-year CBC by 7/29/24 Health and Safety Training and Five (5) Year Cycle Tracking Requirements – Review Row 17 on Staff Worksheet for staff members needing initial H&S Training or five-year renewal. New staff are required to complete Health & Safety Training (H&S Training) within one year of hire (CPR/First Aid and Recognizing and Responding to Suspicions of Child Maltreatment within 3 months of hire) and then complete training in all topic areas every five years. *E. Dosaeva – Initial H&S due 7/31/24 *L. Clark – Initial H&S due 11/3/24 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 3/258/25 (anniversary of today’s Annual Compliance visit). New staff will complete Health & Safety in their first year and then will complete on-going training annually based upon their level of education posted in DCDEE Works. Activity Plans – Activity Plans must be current, dated and posted where they are easily visible. Additional Comments: Required Water, Lead Paint, and Asbestos Testing - New child care rules require child care facilities to test for lead in drinking water, lead paint, and asbestos. Testing is required by 1/1/2025. Check out the FAQ in the updated Clean Classrooms for Carolina Kids. Currently there is funding to pay for the testing and to mitigate lead paint or asbestos hazards. Depending on the age of your home or building and the information you provide in the enrollment process, testing for lead paint and asbestos may not be required. Water testing will be required every three years. For more information go to https://www.cleanwaterforuskids.org/en/carolina/ or contact your Environmental Health Specialist. Medicaid Expansion – Share with your staff! - Studies show that at least 25% of people working in child care in North Carolina do not have health insurance. Starting 12/1/2023, more North Carolinians can now get health coverage through Medicaid even if they haven’t qualified before. Medicaid pays for doctor visits, yearly check-ups, emergency care, mental health services and more – at little or no cost to beneficiaries. Most people can get health care coverage through Medicaid if they meet the criteria below. • Live in North Carolina • Age 19 through 64 • Are a citizen. Some non-U.S. citizens can get health care coverage through Medicaid. • Have a household income that is below 138% of the federal poverty level. That’s about $20,000 for a single adult or about $34,000 for a family of three. If you were eligible for Medicaid prior to Dec 1, 2023, you still are. To learn more, go to Medicaid.nc.gov. I shared information on the following topics and emailed the information to you after the visit: 1. Clean Classrooms for Carolina Kids – required testing for lead in water, lead paint, asbestos 2. Moodle Back Up and Running! 3. Love Them Through It: Understanding Trauma in Young Children – 6 month training opportunity 4. Rules Changes, effective 1/1/2024 – Review on Moodle! 5. Provider Access to the Background Check Management System 6. Free On-line Teacher Professional Development Memberships 7. Unpacking ITERS-R: An Overview of the Infant/Toddler Environment Rating Scale 8. Resources from Health and Safety Resource Center! 9. Environmental Health Rules Update 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 .0802 · Violation

Name of Operation: EAST COAST EARLY LEARNING ACADEMY Facility ID: 28000275 Consultant: MARJORIE WHITE Operation Type: Center Case Number: Visit Date: 3/25/2024 Number Present: 25 Completed Date: 3/25/2024 Age: From 0 To 5 Total Minutes: 420 Time In: 10:00 AM Time Out: 05:00 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. Last Annual Compliance visit – 5/24/23 Last Sanitation Inspection – 12/18/233 with a Superior Rating Last Fire Inspection – 3/14/23 with Satisfactory rating; approved for daytime 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. 18-month compliance history from 9/22/22 – 3/21/24 = 93% D. Titus-Johnson, Administrator, was present and assisted me with the visit. The facility currently operates with a Five-Star Center License, issued 2/23/2022, earning points in the following components: Program (6 PTS) + Education (6 PTS) + Quality Point (1 PT) = 13 Points = 5 Stars *Quality Point met and remains in effect: Staff benefits and an infrastructure of parent involvement The program was also monitored for compliance with implementing an approved curriculum (Creative Curriculum 5th edition) as required for all four and five star facilities where four-year old children are enrolled. The next rated license assessment was due by 2/23/25, but DCDEE has developed a two-year cohort system to return all facilities back to rated license reassessments. Your center has been assigned to Cohort 3. The Cohort 3 Rated License Preparation Year is from 7/1/2025 – 6/30/2026. You may complete your ECERS-R during the Preparation Year and choose to use your scores and complete the rated license reassessment if education is where you want it to be. If you would like to complete the ECERS-R again to improve your scores, you may do this during your Assessment Year from 7/1/2026 – 6/30/2027 at no cost to you which will also give you additional time to work on education, if needed. We will discuss more details at next year’s annual compliance visit. This facility is owned by East Coast Academies, Inc. According to the NC Secretary of State's website, this corporation is current and active as of 3/21/24. Please contact me prior to any information change regarding the ownership of this facility. License information was current. Contact me to make any changes to address, phone, or email or to request changes to the license. I monitored the classrooms and spaces used for child care, kitchen, and outdoor play area for applicable child care center requirements using the Child Care Center Requirements, effective 1/1/2024 and Item Number Listing, effective 8/2023. I monitored five children’s records, two staff records and all program records. The facility does not offer transportation. Center Observations: The center was busy with activities to prepare for Easter. Twenty-five children were present in three classrooms with four teachers. The children, two years of age, in Space 2 were in the middle of bathroom routines before putting on coats and going outdoors. They played on several portable climbers, in playhouses and with riding toys. The infants were cared for on their own schedules. Feeding plans were posted. Documentation of safe sleep checks was available and current. Infants and toddlers had a variety of toys to choose from when on the floor. The preschool group was decorating the class for Easter. Pastels, bunnies, chicks and Easter eggs brightened the walls. Lunch was hot dogs with beans, peas and carrots, pears, and milk. Children were offered seconds. After lunch they rested on linen-covered cots. I observed and documented the following violations during today’s visit. Violation Number Comment Rule 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A bottle of Parent's Choice Infant Pain and Fever Relief was stored in an unlocked medication box out of reach of children but not locked. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. Two medication permissions forms for Albuterol and an Epi-pen did not include the six-month authorization time frame and were not dated by the parent. 10A NCAC 09 .0803(4)(6-9) 848 Questionable medication instructions from parents were followed without signed written dosage instructions received from physician or authorized health professional. A bottle of Parent's Choice Infant Pain Reliever (2-3 years) was observed with a medication permission form completed by a parent of a child, eleven months of age. Dosage instructions stated to consult a physician for children younger than two years of age. A physician's note was not available. The medication had not been administered to the infant. 10A NCAC 09 .0803(5) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. A medication permission form for Eucerin Eczema Relief was dated October 24, 2022 - October 24, 2023 and was expired. An empty tube of Desitin was not discarded or returned to the parent. .0803(12) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report documented on the center incident log for December 5, 2023 was not available in a child's file. .0802 (e) 1320 Children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care was not on file for each child. In one of three children's records reviewed, a Children's Medical Report or health assessment was not available for a child enrolled on March 8. 2022. GS 110-91(1);.0302(d)(2); .0304(g) 1329 Application for enrollment did not include all required information. In two of the three children's records reviewed, the parent did not complete parts of the Health Care Needs section on the Child's Application. .0801(a)(1-7) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. Medical action plans were available with the mediation for a child with two chronic medical conditions, but copies were not attached to the Child's Application in the child's file. .0801(b) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A staff person hired on July 31, 2023 did not complete Recognizing and Responding to Suspicions of Child Maltreatment until December 10, 2023. .1102(g) * 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 D. Titus-Johnson, Administrator. We reviewed the visit summary and the nine violations documented during today’s visit. You corrected five of them during the visit. Correct the four remaining violations immediately. Send evidence of correction to me so that I receive it no later than 4/8/2024. The compliance verification letter needs to state the facility name and license number and list each violation by Item # and describe in detail when and how each violation has been corrected. If referring to staff or children in your compliance letter, refer to them by initials or position. Send compliance verification letter in an email from the center’s official email address, heidi.riden@ecelearningacademy.com to my email address, Marjorie.White@dhhs.nc.gov. If sent from another email address, the center’s official address must be Cc’d in the compliance email. You may include the compliance verification as an attachment or in the body of the email. If sufficient information is not received by the due date, a follow-up visit may be conducted. *I will email a sample compliance verification letter to you. *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 or Jennifer.Linhardt@dhhs.nc.gov. Technical Assistance With Documented Violations: #841: Storage of Medication - Improper storge of medications results in millions of accidental poisonings in children annually. In Space 1, Parents Choice Infant Pain and Fever Relief was stored out of reach of children in an unlocked medication box but was not locked. The teacher stated that she did not realize it had to be locked even though it’s an over the counter medication. 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. Emergency medications such as asthma inhalers, Epi-Pens, Diastat, and glucagon may be stored out of reach but easily accessible to a teacher in the event of a medical emergency. OTC and non-emergency prescription medications must be locked. This was corrected during the visit today. #847: Medication Permission Forms - All medications for children present at the center must have a current, completed medication permission form so that staff have the required information to administer any type of medication per the parent’s or physician’s instructions. Two medication permission forms for an Epi-pen and an Albuterol Inhaler for JC (DOE 12/4/23) were not dated by the parent and did not include six-month authorization time frame (12/4/23 – 6/4/24). The administrator stated that this was overlooked when accepting the medication. Assist parents with completing these forms when bringing in any type of medication to the center. Don’t accept medication until the medication forms and medication have been reviewed closely to ensure that they meet the requirements and include all information that could be critical when administering medicine. For your compliance letter, state the date when the medication forms are completed. Add a reminder to your tracker that the parent needs to update these in June 2024 for another six months. (The medical action plans also need to be updated in June.) #848: Questionable Medication Instructions – Over the counter medication for young children can have confusing and questionable instructions or dosage amounts. Not reading the boxes carefully before accepting the medication may result in administering an incorrect dose. A bottle of Parent’s Choice Infant Pain and Fever Relief was observed in the medication box in Space 1 for a child, eleven months of age. The medication permission form stated that the medication was to be used for teething pain. The parent indicated that a dose of 2.5 ml was to be administered. Even though the label called the medication “Infant Pain Relief”, it also stated that it was for children, two – three years of age. The dosage information on the box stated to “consultant a physician” for children younger than two years of age, but a physician note was not available. The teacher stated that she had not administered the medication for any reason to the infant. Review any OTC medication instructions carefully before you accept them into the child care and put them in a classroom. Many OTC pain relievers, decongestants, cough suppressants, etc. appear to be for young children because they say “infant” or “child” and have pictures of cute babies on them, but when you read the dosage instructions, it is clear that they should not be given to young children without a physician’s consent. You corrected this by removing the medication from the classroom and returning it to the parent. Share this information with your staff so that this type of medication is clearly vetted before accepting it. #849: Expired Medication – When medications or medication permission forms expire or child leaves center, return the medication to the parent within 72 hours unless the medication is still needed and the permission form needs to be updated. A tube of Eucerin Eczema Relief for PW (Space 2) was observed in the medication box stored out of reach in the bathroom. The accompanying medication permission form was dated 10/24/22 – 10/24/23 and was expired. Have parent update or complete a new form valid for one year. An empty tube of Desitin was observed for BW, along with a full tube of Butt-paste. Discard or return the empty tube of Desitin. Check medication boxes or cabinets monthly to review medications and medication permission forms. Update or return as needed. This was corrected during the visit. #852 Incident Report – Incident Reports keep parents informed of injuries their child has at your facility and provide an opportunity for you and your staff to review your own safety and supervision practices to prevent similar injuries in the future. Your incident log had documentation of an incident that occurred on 12/5/23 for JC (enrolled 12/4/23); however, a copy of the incident report was not available in the child’s file. You stated that the teacher may have accidentally given the parent the copy without making a copy for the child’s file. If a child is injured while attending child care and the injury requires minor on-site first aid (band-aid, ice pack, tweezers, etc.) or professional medical care (doctor, hospital, EMS, etc.), complete an Incident Report (updated 3/2021) with help from the staff members who witnessed the accident and provided first aid. Review with the parent and have her/him sign. The parent must be offered a copy but may choose to decline a copy by checking and initially the box at the bottom. The original copy is maintained in the child’s file and documented on the Incident Log. If the injury requires professional medical attention, mail a copy of the Incident Report to the child care consultant within seven days. Review 10A NCAC 09 .0802 (e-g) Emergency Medical Care for more information on incident reports and the incident log. For your compliance letter, state when you reviewed incident report requirements with staff so that incident reports are maintained in children’s files. Children’s Files Maintaining accurate records on the children in your care helps to ensure their health and safety, informs families of rules you are required to follow and your center’s policies, and provides a certain transfer of knowledge so that you can provide the best care possible for their children. I monitored three children’s files. The following children’s documents were not available. #1320: Children’s Medical Report – missing for LY (Space 2 – DOE 3/8/22) – For your compliance letter state that date when you have received a child’s medical report for JY and it is available in her file for review. Do not send a copy of the medical report. #1329: Child’s Application – Health Care Needs Section – not fully completed for MA (Space 1) and JC (Space 3) – Parents need to complete all information in the Health Care Needs section or write “N/A” or something similar. – For your compliance letter state the date when the parents of MA and JC have completed the health care needs information on the child’s application. Use Children’s File Checklist to verify you have received all required enrollment documents. Build in time to review enrollment documents with families explaining that they need to be fully completed, signed and dated. Check them before the parent leaves their children with you the first time. The empty blank might be the signature you need to seek emergency medical care if the child is injured. Have parents review and update the Child’s Application annually to ensure information is still current. #1834: Medical Action Plan – Medical Action Plans include medical information that is crucial in the event of a medical emergency that requires medication such as an Epi-pen or Asthma Inhaler. A child enrolled on 12/3/23 (JC) has two chronic medical conditions that require emergency medications; medical action plans for both medications were included with the medication but copies were not attached to the child’s application in the file. You stated you were not aware that they needed to be included in the child’s file and corrected it immediately by making copies and stapling them to the child’s application. The medical action plan must be completed by the child’s physician or parent and updated annually. (These medical action plans were dated for June 2023 and must be updated in June 2024.) Another copy needs to be attached to the application in the Ready to Go File. It is also best practice to have a copy in the classroom with the medication and the required medication permission form. #1897: Recognizing and Responding to Suspicions of Child Maltreatment – Recognizing and Responding to Suspicions of Child Maltreatment staff the signs and symptoms to look out for with child abuse and neglect, what to do when they suspect it is happening, NC’s reporting law, and what happens after a report is made. ED (DOH 7/31/23) was required to complete the training by 10/31/23 but did not complete it until 12/10/23. You stated that both of you forgot about the deadline. This has been corrected. I will email a list of required trainings/tasks that need to be completed at hire and throughout a new employee’s first year. Use a tracker (handwritten or electronic) to track due dates for staff documents and task. General Visit Information: Be knowledgeable of the child care laws and rules and environmental health rules; review them with your staff and assist them with understanding and implementing them to maintain compliance and keep children safe and healthy. The most recent versions of child care laws and rules (updated 1/1/24) and environmental health rules (updated 7/1/23) in North Carolina, the Items Number Listing (can be used as a detailed checklist of required items) and What’s New information are available on the DCDEE website, www.ncchildcare.ncdhhs.gov. Check the designated facility email at least weekly to stay current with communication and email blasts from DCDEE. If your email is not the facility email, sign up for email blasts on the What’s New page for general information and communication from DCDEE. Your local and regional Smart Start Partnerships and Child Care Resource and Referral Agencies are available to assist you with technical assistance and training on a multitude of topics including but not limited to: Environment Rating Scales, infant/toddler practices, healthy behaviors and classroom management, developmentally appropriate practice, EPR plans, activity plans, NC Foundations for Early Learning (developmental domains), etc. 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. *Children & Youth Partnership for Dare County: Phone - (252) 441-0614; website - www.darekids.org. *Child Care Health Consultant – S. Rosser - Office: (252) 557-4208 or stacy_rosser@unc.edu Reminders: 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. *Make it easier on yourself and schedule annual updates for staff evaluations and professional development plans; health questionnaires and emergency information forms; EPR Plan and Emergency Medical Care Plan at the same time to streamline your staff updates. (Example, even if an employee was hired in January , and you update health questionnaires and emergency forms in August, have this employee go ahead and update in August with the rest of the staff to jump into the same cycle!) *We reviewed your staff worksheet. I highlighted items that were delinquent and items that are coming due in the next year. *D. Titus-Johnson – ITS/SIDS due 4/20/24 *E. Dosaeva – CPR/FA due 6/30/24 *D. Swain – due for 5-year CBC by 7/29/24 Health and Safety Training and Five (5) Year Cycle Tracking Requirements – Review Row 17 on Staff Worksheet for staff members needing initial H&S Training or five-year renewal. New staff are required to complete Health & Safety Training (H&S Training) within one year of hire (CPR/First Aid and Recognizing and Responding to Suspicions of Child Maltreatment within 3 months of hire) and then complete training in all topic areas every five years. *E. Dosaeva – Initial H&S due 7/31/24 *L. Clark – Initial H&S due 11/3/24 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 3/258/25 (anniversary of today’s Annual Compliance visit). New staff will complete Health & Safety in their first year and then will complete on-going training annually based upon their level of education posted in DCDEE Works. Activity Plans – Activity Plans must be current, dated and posted where they are easily visible. Additional Comments: Required Water, Lead Paint, and Asbestos Testing - New child care rules require child care facilities to test for lead in drinking water, lead paint, and asbestos. Testing is required by 1/1/2025. Check out the FAQ in the updated Clean Classrooms for Carolina Kids. Currently there is funding to pay for the testing and to mitigate lead paint or asbestos hazards. Depending on the age of your home or building and the information you provide in the enrollment process, testing for lead paint and asbestos may not be required. Water testing will be required every three years. For more information go to https://www.cleanwaterforuskids.org/en/carolina/ or contact your Environmental Health Specialist. Medicaid Expansion – Share with your staff! - Studies show that at least 25% of people working in child care in North Carolina do not have health insurance. Starting 12/1/2023, more North Carolinians can now get health coverage through Medicaid even if they haven’t qualified before. Medicaid pays for doctor visits, yearly check-ups, emergency care, mental health services and more – at little or no cost to beneficiaries. Most people can get health care coverage through Medicaid if they meet the criteria below. • Live in North Carolina • Age 19 through 64 • Are a citizen. Some non-U.S. citizens can get health care coverage through Medicaid. • Have a household income that is below 138% of the federal poverty level. That’s about $20,000 for a single adult or about $34,000 for a family of three. If you were eligible for Medicaid prior to Dec 1, 2023, you still are. To learn more, go to Medicaid.nc.gov. I shared information on the following topics and emailed the information to you after the visit: 1. Clean Classrooms for Carolina Kids – required testing for lead in water, lead paint, asbestos 2. Moodle Back Up and Running! 3. Love Them Through It: Understanding Trauma in Young Children – 6 month training opportunity 4. Rules Changes, effective 1/1/2024 – Review on Moodle! 5. Provider Access to the Background Check Management System 6. Free On-line Teacher Professional Development Memberships 7. Unpacking ITERS-R: An Overview of the Infant/Toddler Environment Rating Scale 8. Resources from Health and Safety Resource Center! 9. Environmental Health Rules Update 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 .0803 · Violation

Name of Operation: EAST COAST EARLY LEARNING ACADEMY Facility ID: 28000275 Consultant: MARJORIE WHITE Operation Type: Center Case Number: Visit Date: 3/25/2024 Number Present: 25 Completed Date: 3/25/2024 Age: From 0 To 5 Total Minutes: 420 Time In: 10:00 AM Time Out: 05:00 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. Last Annual Compliance visit – 5/24/23 Last Sanitation Inspection – 12/18/233 with a Superior Rating Last Fire Inspection – 3/14/23 with Satisfactory rating; approved for daytime 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. 18-month compliance history from 9/22/22 – 3/21/24 = 93% D. Titus-Johnson, Administrator, was present and assisted me with the visit. The facility currently operates with a Five-Star Center License, issued 2/23/2022, earning points in the following components: Program (6 PTS) + Education (6 PTS) + Quality Point (1 PT) = 13 Points = 5 Stars *Quality Point met and remains in effect: Staff benefits and an infrastructure of parent involvement The program was also monitored for compliance with implementing an approved curriculum (Creative Curriculum 5th edition) as required for all four and five star facilities where four-year old children are enrolled. The next rated license assessment was due by 2/23/25, but DCDEE has developed a two-year cohort system to return all facilities back to rated license reassessments. Your center has been assigned to Cohort 3. The Cohort 3 Rated License Preparation Year is from 7/1/2025 – 6/30/2026. You may complete your ECERS-R during the Preparation Year and choose to use your scores and complete the rated license reassessment if education is where you want it to be. If you would like to complete the ECERS-R again to improve your scores, you may do this during your Assessment Year from 7/1/2026 – 6/30/2027 at no cost to you which will also give you additional time to work on education, if needed. We will discuss more details at next year’s annual compliance visit. This facility is owned by East Coast Academies, Inc. According to the NC Secretary of State's website, this corporation is current and active as of 3/21/24. Please contact me prior to any information change regarding the ownership of this facility. License information was current. Contact me to make any changes to address, phone, or email or to request changes to the license. I monitored the classrooms and spaces used for child care, kitchen, and outdoor play area for applicable child care center requirements using the Child Care Center Requirements, effective 1/1/2024 and Item Number Listing, effective 8/2023. I monitored five children’s records, two staff records and all program records. The facility does not offer transportation. Center Observations: The center was busy with activities to prepare for Easter. Twenty-five children were present in three classrooms with four teachers. The children, two years of age, in Space 2 were in the middle of bathroom routines before putting on coats and going outdoors. They played on several portable climbers, in playhouses and with riding toys. The infants were cared for on their own schedules. Feeding plans were posted. Documentation of safe sleep checks was available and current. Infants and toddlers had a variety of toys to choose from when on the floor. The preschool group was decorating the class for Easter. Pastels, bunnies, chicks and Easter eggs brightened the walls. Lunch was hot dogs with beans, peas and carrots, pears, and milk. Children were offered seconds. After lunch they rested on linen-covered cots. I observed and documented the following violations during today’s visit. Violation Number Comment Rule 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A bottle of Parent's Choice Infant Pain and Fever Relief was stored in an unlocked medication box out of reach of children but not locked. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. Two medication permissions forms for Albuterol and an Epi-pen did not include the six-month authorization time frame and were not dated by the parent. 10A NCAC 09 .0803(4)(6-9) 848 Questionable medication instructions from parents were followed without signed written dosage instructions received from physician or authorized health professional. A bottle of Parent's Choice Infant Pain Reliever (2-3 years) was observed with a medication permission form completed by a parent of a child, eleven months of age. Dosage instructions stated to consult a physician for children younger than two years of age. A physician's note was not available. The medication had not been administered to the infant. 10A NCAC 09 .0803(5) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. A medication permission form for Eucerin Eczema Relief was dated October 24, 2022 - October 24, 2023 and was expired. An empty tube of Desitin was not discarded or returned to the parent. .0803(12) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report documented on the center incident log for December 5, 2023 was not available in a child's file. .0802 (e) 1320 Children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care was not on file for each child. In one of three children's records reviewed, a Children's Medical Report or health assessment was not available for a child enrolled on March 8. 2022. GS 110-91(1);.0302(d)(2); .0304(g) 1329 Application for enrollment did not include all required information. In two of the three children's records reviewed, the parent did not complete parts of the Health Care Needs section on the Child's Application. .0801(a)(1-7) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. Medical action plans were available with the mediation for a child with two chronic medical conditions, but copies were not attached to the Child's Application in the child's file. .0801(b) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A staff person hired on July 31, 2023 did not complete Recognizing and Responding to Suspicions of Child Maltreatment until December 10, 2023. .1102(g) * 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 D. Titus-Johnson, Administrator. We reviewed the visit summary and the nine violations documented during today’s visit. You corrected five of them during the visit. Correct the four remaining violations immediately. Send evidence of correction to me so that I receive it no later than 4/8/2024. The compliance verification letter needs to state the facility name and license number and list each violation by Item # and describe in detail when and how each violation has been corrected. If referring to staff or children in your compliance letter, refer to them by initials or position. Send compliance verification letter in an email from the center’s official email address, heidi.riden@ecelearningacademy.com to my email address, Marjorie.White@dhhs.nc.gov. If sent from another email address, the center’s official address must be Cc’d in the compliance email. You may include the compliance verification as an attachment or in the body of the email. If sufficient information is not received by the due date, a follow-up visit may be conducted. *I will email a sample compliance verification letter to you. *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 or Jennifer.Linhardt@dhhs.nc.gov. Technical Assistance With Documented Violations: #841: Storage of Medication - Improper storge of medications results in millions of accidental poisonings in children annually. In Space 1, Parents Choice Infant Pain and Fever Relief was stored out of reach of children in an unlocked medication box but was not locked. The teacher stated that she did not realize it had to be locked even though it’s an over the counter medication. 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. Emergency medications such as asthma inhalers, Epi-Pens, Diastat, and glucagon may be stored out of reach but easily accessible to a teacher in the event of a medical emergency. OTC and non-emergency prescription medications must be locked. This was corrected during the visit today. #847: Medication Permission Forms - All medications for children present at the center must have a current, completed medication permission form so that staff have the required information to administer any type of medication per the parent’s or physician’s instructions. Two medication permission forms for an Epi-pen and an Albuterol Inhaler for JC (DOE 12/4/23) were not dated by the parent and did not include six-month authorization time frame (12/4/23 – 6/4/24). The administrator stated that this was overlooked when accepting the medication. Assist parents with completing these forms when bringing in any type of medication to the center. Don’t accept medication until the medication forms and medication have been reviewed closely to ensure that they meet the requirements and include all information that could be critical when administering medicine. For your compliance letter, state the date when the medication forms are completed. Add a reminder to your tracker that the parent needs to update these in June 2024 for another six months. (The medical action plans also need to be updated in June.) #848: Questionable Medication Instructions – Over the counter medication for young children can have confusing and questionable instructions or dosage amounts. Not reading the boxes carefully before accepting the medication may result in administering an incorrect dose. A bottle of Parent’s Choice Infant Pain and Fever Relief was observed in the medication box in Space 1 for a child, eleven months of age. The medication permission form stated that the medication was to be used for teething pain. The parent indicated that a dose of 2.5 ml was to be administered. Even though the label called the medication “Infant Pain Relief”, it also stated that it was for children, two – three years of age. The dosage information on the box stated to “consultant a physician” for children younger than two years of age, but a physician note was not available. The teacher stated that she had not administered the medication for any reason to the infant. Review any OTC medication instructions carefully before you accept them into the child care and put them in a classroom. Many OTC pain relievers, decongestants, cough suppressants, etc. appear to be for young children because they say “infant” or “child” and have pictures of cute babies on them, but when you read the dosage instructions, it is clear that they should not be given to young children without a physician’s consent. You corrected this by removing the medication from the classroom and returning it to the parent. Share this information with your staff so that this type of medication is clearly vetted before accepting it. #849: Expired Medication – When medications or medication permission forms expire or child leaves center, return the medication to the parent within 72 hours unless the medication is still needed and the permission form needs to be updated. A tube of Eucerin Eczema Relief for PW (Space 2) was observed in the medication box stored out of reach in the bathroom. The accompanying medication permission form was dated 10/24/22 – 10/24/23 and was expired. Have parent update or complete a new form valid for one year. An empty tube of Desitin was observed for BW, along with a full tube of Butt-paste. Discard or return the empty tube of Desitin. Check medication boxes or cabinets monthly to review medications and medication permission forms. Update or return as needed. This was corrected during the visit. #852 Incident Report – Incident Reports keep parents informed of injuries their child has at your facility and provide an opportunity for you and your staff to review your own safety and supervision practices to prevent similar injuries in the future. Your incident log had documentation of an incident that occurred on 12/5/23 for JC (enrolled 12/4/23); however, a copy of the incident report was not available in the child’s file. You stated that the teacher may have accidentally given the parent the copy without making a copy for the child’s file. If a child is injured while attending child care and the injury requires minor on-site first aid (band-aid, ice pack, tweezers, etc.) or professional medical care (doctor, hospital, EMS, etc.), complete an Incident Report (updated 3/2021) with help from the staff members who witnessed the accident and provided first aid. Review with the parent and have her/him sign. The parent must be offered a copy but may choose to decline a copy by checking and initially the box at the bottom. The original copy is maintained in the child’s file and documented on the Incident Log. If the injury requires professional medical attention, mail a copy of the Incident Report to the child care consultant within seven days. Review 10A NCAC 09 .0802 (e-g) Emergency Medical Care for more information on incident reports and the incident log. For your compliance letter, state when you reviewed incident report requirements with staff so that incident reports are maintained in children’s files. Children’s Files Maintaining accurate records on the children in your care helps to ensure their health and safety, informs families of rules you are required to follow and your center’s policies, and provides a certain transfer of knowledge so that you can provide the best care possible for their children. I monitored three children’s files. The following children’s documents were not available. #1320: Children’s Medical Report – missing for LY (Space 2 – DOE 3/8/22) – For your compliance letter state that date when you have received a child’s medical report for JY and it is available in her file for review. Do not send a copy of the medical report. #1329: Child’s Application – Health Care Needs Section – not fully completed for MA (Space 1) and JC (Space 3) – Parents need to complete all information in the Health Care Needs section or write “N/A” or something similar. – For your compliance letter state the date when the parents of MA and JC have completed the health care needs information on the child’s application. Use Children’s File Checklist to verify you have received all required enrollment documents. Build in time to review enrollment documents with families explaining that they need to be fully completed, signed and dated. Check them before the parent leaves their children with you the first time. The empty blank might be the signature you need to seek emergency medical care if the child is injured. Have parents review and update the Child’s Application annually to ensure information is still current. #1834: Medical Action Plan – Medical Action Plans include medical information that is crucial in the event of a medical emergency that requires medication such as an Epi-pen or Asthma Inhaler. A child enrolled on 12/3/23 (JC) has two chronic medical conditions that require emergency medications; medical action plans for both medications were included with the medication but copies were not attached to the child’s application in the file. You stated you were not aware that they needed to be included in the child’s file and corrected it immediately by making copies and stapling them to the child’s application. The medical action plan must be completed by the child’s physician or parent and updated annually. (These medical action plans were dated for June 2023 and must be updated in June 2024.) Another copy needs to be attached to the application in the Ready to Go File. It is also best practice to have a copy in the classroom with the medication and the required medication permission form. #1897: Recognizing and Responding to Suspicions of Child Maltreatment – Recognizing and Responding to Suspicions of Child Maltreatment staff the signs and symptoms to look out for with child abuse and neglect, what to do when they suspect it is happening, NC’s reporting law, and what happens after a report is made. ED (DOH 7/31/23) was required to complete the training by 10/31/23 but did not complete it until 12/10/23. You stated that both of you forgot about the deadline. This has been corrected. I will email a list of required trainings/tasks that need to be completed at hire and throughout a new employee’s first year. Use a tracker (handwritten or electronic) to track due dates for staff documents and task. General Visit Information: Be knowledgeable of the child care laws and rules and environmental health rules; review them with your staff and assist them with understanding and implementing them to maintain compliance and keep children safe and healthy. The most recent versions of child care laws and rules (updated 1/1/24) and environmental health rules (updated 7/1/23) in North Carolina, the Items Number Listing (can be used as a detailed checklist of required items) and What’s New information are available on the DCDEE website, www.ncchildcare.ncdhhs.gov. Check the designated facility email at least weekly to stay current with communication and email blasts from DCDEE. If your email is not the facility email, sign up for email blasts on the What’s New page for general information and communication from DCDEE. Your local and regional Smart Start Partnerships and Child Care Resource and Referral Agencies are available to assist you with technical assistance and training on a multitude of topics including but not limited to: Environment Rating Scales, infant/toddler practices, healthy behaviors and classroom management, developmentally appropriate practice, EPR plans, activity plans, NC Foundations for Early Learning (developmental domains), etc. 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. *Children & Youth Partnership for Dare County: Phone - (252) 441-0614; website - www.darekids.org. *Child Care Health Consultant – S. Rosser - Office: (252) 557-4208 or stacy_rosser@unc.edu Reminders: 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. *Make it easier on yourself and schedule annual updates for staff evaluations and professional development plans; health questionnaires and emergency information forms; EPR Plan and Emergency Medical Care Plan at the same time to streamline your staff updates. (Example, even if an employee was hired in January , and you update health questionnaires and emergency forms in August, have this employee go ahead and update in August with the rest of the staff to jump into the same cycle!) *We reviewed your staff worksheet. I highlighted items that were delinquent and items that are coming due in the next year. *D. Titus-Johnson – ITS/SIDS due 4/20/24 *E. Dosaeva – CPR/FA due 6/30/24 *D. Swain – due for 5-year CBC by 7/29/24 Health and Safety Training and Five (5) Year Cycle Tracking Requirements – Review Row 17 on Staff Worksheet for staff members needing initial H&S Training or five-year renewal. New staff are required to complete Health & Safety Training (H&S Training) within one year of hire (CPR/First Aid and Recognizing and Responding to Suspicions of Child Maltreatment within 3 months of hire) and then complete training in all topic areas every five years. *E. Dosaeva – Initial H&S due 7/31/24 *L. Clark – Initial H&S due 11/3/24 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 3/258/25 (anniversary of today’s Annual Compliance visit). New staff will complete Health & Safety in their first year and then will complete on-going training annually based upon their level of education posted in DCDEE Works. Activity Plans – Activity Plans must be current, dated and posted where they are easily visible. Additional Comments: Required Water, Lead Paint, and Asbestos Testing - New child care rules require child care facilities to test for lead in drinking water, lead paint, and asbestos. Testing is required by 1/1/2025. Check out the FAQ in the updated Clean Classrooms for Carolina Kids. Currently there is funding to pay for the testing and to mitigate lead paint or asbestos hazards. Depending on the age of your home or building and the information you provide in the enrollment process, testing for lead paint and asbestos may not be required. Water testing will be required every three years. For more information go to https://www.cleanwaterforuskids.org/en/carolina/ or contact your Environmental Health Specialist. Medicaid Expansion – Share with your staff! - Studies show that at least 25% of people working in child care in North Carolina do not have health insurance. Starting 12/1/2023, more North Carolinians can now get health coverage through Medicaid even if they haven’t qualified before. Medicaid pays for doctor visits, yearly check-ups, emergency care, mental health services and more – at little or no cost to beneficiaries. Most people can get health care coverage through Medicaid if they meet the criteria below. • Live in North Carolina • Age 19 through 64 • Are a citizen. Some non-U.S. citizens can get health care coverage through Medicaid. • Have a household income that is below 138% of the federal poverty level. That’s about $20,000 for a single adult or about $34,000 for a family of three. If you were eligible for Medicaid prior to Dec 1, 2023, you still are. To learn more, go to Medicaid.nc.gov. I shared information on the following topics and emailed the information to you after the visit: 1. Clean Classrooms for Carolina Kids – required testing for lead in water, lead paint, asbestos 2. Moodle Back Up and Running! 3. Love Them Through It: Understanding Trauma in Young Children – 6 month training opportunity 4. Rules Changes, effective 1/1/2024 – Review on Moodle! 5. Provider Access to the Background Check Management System 6. Free On-line Teacher Professional Development Memberships 7. Unpacking ITERS-R: An Overview of the Infant/Toddler Environment Rating Scale 8. Resources from Health and Safety Resource Center! 9. Environmental Health Rules Update 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

GS 110-91 · Violation

Name of Operation: EAST COAST EARLY LEARNING ACADEMY Facility ID: 28000275 Consultant: MARJORIE WHITE Operation Type: Center Case Number: Visit Date: 3/25/2024 Number Present: 25 Completed Date: 3/25/2024 Age: From 0 To 5 Total Minutes: 420 Time In: 10:00 AM Time Out: 05:00 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. Last Annual Compliance visit – 5/24/23 Last Sanitation Inspection – 12/18/233 with a Superior Rating Last Fire Inspection – 3/14/23 with Satisfactory rating; approved for daytime 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. 18-month compliance history from 9/22/22 – 3/21/24 = 93% D. Titus-Johnson, Administrator, was present and assisted me with the visit. The facility currently operates with a Five-Star Center License, issued 2/23/2022, earning points in the following components: Program (6 PTS) + Education (6 PTS) + Quality Point (1 PT) = 13 Points = 5 Stars *Quality Point met and remains in effect: Staff benefits and an infrastructure of parent involvement The program was also monitored for compliance with implementing an approved curriculum (Creative Curriculum 5th edition) as required for all four and five star facilities where four-year old children are enrolled. The next rated license assessment was due by 2/23/25, but DCDEE has developed a two-year cohort system to return all facilities back to rated license reassessments. Your center has been assigned to Cohort 3. The Cohort 3 Rated License Preparation Year is from 7/1/2025 – 6/30/2026. You may complete your ECERS-R during the Preparation Year and choose to use your scores and complete the rated license reassessment if education is where you want it to be. If you would like to complete the ECERS-R again to improve your scores, you may do this during your Assessment Year from 7/1/2026 – 6/30/2027 at no cost to you which will also give you additional time to work on education, if needed. We will discuss more details at next year’s annual compliance visit. This facility is owned by East Coast Academies, Inc. According to the NC Secretary of State's website, this corporation is current and active as of 3/21/24. Please contact me prior to any information change regarding the ownership of this facility. License information was current. Contact me to make any changes to address, phone, or email or to request changes to the license. I monitored the classrooms and spaces used for child care, kitchen, and outdoor play area for applicable child care center requirements using the Child Care Center Requirements, effective 1/1/2024 and Item Number Listing, effective 8/2023. I monitored five children’s records, two staff records and all program records. The facility does not offer transportation. Center Observations: The center was busy with activities to prepare for Easter. Twenty-five children were present in three classrooms with four teachers. The children, two years of age, in Space 2 were in the middle of bathroom routines before putting on coats and going outdoors. They played on several portable climbers, in playhouses and with riding toys. The infants were cared for on their own schedules. Feeding plans were posted. Documentation of safe sleep checks was available and current. Infants and toddlers had a variety of toys to choose from when on the floor. The preschool group was decorating the class for Easter. Pastels, bunnies, chicks and Easter eggs brightened the walls. Lunch was hot dogs with beans, peas and carrots, pears, and milk. Children were offered seconds. After lunch they rested on linen-covered cots. I observed and documented the following violations during today’s visit. Violation Number Comment Rule 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A bottle of Parent's Choice Infant Pain and Fever Relief was stored in an unlocked medication box out of reach of children but not locked. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. Two medication permissions forms for Albuterol and an Epi-pen did not include the six-month authorization time frame and were not dated by the parent. 10A NCAC 09 .0803(4)(6-9) 848 Questionable medication instructions from parents were followed without signed written dosage instructions received from physician or authorized health professional. A bottle of Parent's Choice Infant Pain Reliever (2-3 years) was observed with a medication permission form completed by a parent of a child, eleven months of age. Dosage instructions stated to consult a physician for children younger than two years of age. A physician's note was not available. The medication had not been administered to the infant. 10A NCAC 09 .0803(5) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. A medication permission form for Eucerin Eczema Relief was dated October 24, 2022 - October 24, 2023 and was expired. An empty tube of Desitin was not discarded or returned to the parent. .0803(12) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report documented on the center incident log for December 5, 2023 was not available in a child's file. .0802 (e) 1320 Children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care was not on file for each child. In one of three children's records reviewed, a Children's Medical Report or health assessment was not available for a child enrolled on March 8. 2022. GS 110-91(1);.0302(d)(2); .0304(g) 1329 Application for enrollment did not include all required information. In two of the three children's records reviewed, the parent did not complete parts of the Health Care Needs section on the Child's Application. .0801(a)(1-7) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. Medical action plans were available with the mediation for a child with two chronic medical conditions, but copies were not attached to the Child's Application in the child's file. .0801(b) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A staff person hired on July 31, 2023 did not complete Recognizing and Responding to Suspicions of Child Maltreatment until December 10, 2023. .1102(g) * 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 D. Titus-Johnson, Administrator. We reviewed the visit summary and the nine violations documented during today’s visit. You corrected five of them during the visit. Correct the four remaining violations immediately. Send evidence of correction to me so that I receive it no later than 4/8/2024. The compliance verification letter needs to state the facility name and license number and list each violation by Item # and describe in detail when and how each violation has been corrected. If referring to staff or children in your compliance letter, refer to them by initials or position. Send compliance verification letter in an email from the center’s official email address, heidi.riden@ecelearningacademy.com to my email address, Marjorie.White@dhhs.nc.gov. If sent from another email address, the center’s official address must be Cc’d in the compliance email. You may include the compliance verification as an attachment or in the body of the email. If sufficient information is not received by the due date, a follow-up visit may be conducted. *I will email a sample compliance verification letter to you. *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 or Jennifer.Linhardt@dhhs.nc.gov. Technical Assistance With Documented Violations: #841: Storage of Medication - Improper storge of medications results in millions of accidental poisonings in children annually. In Space 1, Parents Choice Infant Pain and Fever Relief was stored out of reach of children in an unlocked medication box but was not locked. The teacher stated that she did not realize it had to be locked even though it’s an over the counter medication. 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. Emergency medications such as asthma inhalers, Epi-Pens, Diastat, and glucagon may be stored out of reach but easily accessible to a teacher in the event of a medical emergency. OTC and non-emergency prescription medications must be locked. This was corrected during the visit today. #847: Medication Permission Forms - All medications for children present at the center must have a current, completed medication permission form so that staff have the required information to administer any type of medication per the parent’s or physician’s instructions. Two medication permission forms for an Epi-pen and an Albuterol Inhaler for JC (DOE 12/4/23) were not dated by the parent and did not include six-month authorization time frame (12/4/23 – 6/4/24). The administrator stated that this was overlooked when accepting the medication. Assist parents with completing these forms when bringing in any type of medication to the center. Don’t accept medication until the medication forms and medication have been reviewed closely to ensure that they meet the requirements and include all information that could be critical when administering medicine. For your compliance letter, state the date when the medication forms are completed. Add a reminder to your tracker that the parent needs to update these in June 2024 for another six months. (The medical action plans also need to be updated in June.) #848: Questionable Medication Instructions – Over the counter medication for young children can have confusing and questionable instructions or dosage amounts. Not reading the boxes carefully before accepting the medication may result in administering an incorrect dose. A bottle of Parent’s Choice Infant Pain and Fever Relief was observed in the medication box in Space 1 for a child, eleven months of age. The medication permission form stated that the medication was to be used for teething pain. The parent indicated that a dose of 2.5 ml was to be administered. Even though the label called the medication “Infant Pain Relief”, it also stated that it was for children, two – three years of age. The dosage information on the box stated to “consultant a physician” for children younger than two years of age, but a physician note was not available. The teacher stated that she had not administered the medication for any reason to the infant. Review any OTC medication instructions carefully before you accept them into the child care and put them in a classroom. Many OTC pain relievers, decongestants, cough suppressants, etc. appear to be for young children because they say “infant” or “child” and have pictures of cute babies on them, but when you read the dosage instructions, it is clear that they should not be given to young children without a physician’s consent. You corrected this by removing the medication from the classroom and returning it to the parent. Share this information with your staff so that this type of medication is clearly vetted before accepting it. #849: Expired Medication – When medications or medication permission forms expire or child leaves center, return the medication to the parent within 72 hours unless the medication is still needed and the permission form needs to be updated. A tube of Eucerin Eczema Relief for PW (Space 2) was observed in the medication box stored out of reach in the bathroom. The accompanying medication permission form was dated 10/24/22 – 10/24/23 and was expired. Have parent update or complete a new form valid for one year. An empty tube of Desitin was observed for BW, along with a full tube of Butt-paste. Discard or return the empty tube of Desitin. Check medication boxes or cabinets monthly to review medications and medication permission forms. Update or return as needed. This was corrected during the visit. #852 Incident Report – Incident Reports keep parents informed of injuries their child has at your facility and provide an opportunity for you and your staff to review your own safety and supervision practices to prevent similar injuries in the future. Your incident log had documentation of an incident that occurred on 12/5/23 for JC (enrolled 12/4/23); however, a copy of the incident report was not available in the child’s file. You stated that the teacher may have accidentally given the parent the copy without making a copy for the child’s file. If a child is injured while attending child care and the injury requires minor on-site first aid (band-aid, ice pack, tweezers, etc.) or professional medical care (doctor, hospital, EMS, etc.), complete an Incident Report (updated 3/2021) with help from the staff members who witnessed the accident and provided first aid. Review with the parent and have her/him sign. The parent must be offered a copy but may choose to decline a copy by checking and initially the box at the bottom. The original copy is maintained in the child’s file and documented on the Incident Log. If the injury requires professional medical attention, mail a copy of the Incident Report to the child care consultant within seven days. Review 10A NCAC 09 .0802 (e-g) Emergency Medical Care for more information on incident reports and the incident log. For your compliance letter, state when you reviewed incident report requirements with staff so that incident reports are maintained in children’s files. Children’s Files Maintaining accurate records on the children in your care helps to ensure their health and safety, informs families of rules you are required to follow and your center’s policies, and provides a certain transfer of knowledge so that you can provide the best care possible for their children. I monitored three children’s files. The following children’s documents were not available. #1320: Children’s Medical Report – missing for LY (Space 2 – DOE 3/8/22) – For your compliance letter state that date when you have received a child’s medical report for JY and it is available in her file for review. Do not send a copy of the medical report. #1329: Child’s Application – Health Care Needs Section – not fully completed for MA (Space 1) and JC (Space 3) – Parents need to complete all information in the Health Care Needs section or write “N/A” or something similar. – For your compliance letter state the date when the parents of MA and JC have completed the health care needs information on the child’s application. Use Children’s File Checklist to verify you have received all required enrollment documents. Build in time to review enrollment documents with families explaining that they need to be fully completed, signed and dated. Check them before the parent leaves their children with you the first time. The empty blank might be the signature you need to seek emergency medical care if the child is injured. Have parents review and update the Child’s Application annually to ensure information is still current. #1834: Medical Action Plan – Medical Action Plans include medical information that is crucial in the event of a medical emergency that requires medication such as an Epi-pen or Asthma Inhaler. A child enrolled on 12/3/23 (JC) has two chronic medical conditions that require emergency medications; medical action plans for both medications were included with the medication but copies were not attached to the child’s application in the file. You stated you were not aware that they needed to be included in the child’s file and corrected it immediately by making copies and stapling them to the child’s application. The medical action plan must be completed by the child’s physician or parent and updated annually. (These medical action plans were dated for June 2023 and must be updated in June 2024.) Another copy needs to be attached to the application in the Ready to Go File. It is also best practice to have a copy in the classroom with the medication and the required medication permission form. #1897: Recognizing and Responding to Suspicions of Child Maltreatment – Recognizing and Responding to Suspicions of Child Maltreatment staff the signs and symptoms to look out for with child abuse and neglect, what to do when they suspect it is happening, NC’s reporting law, and what happens after a report is made. ED (DOH 7/31/23) was required to complete the training by 10/31/23 but did not complete it until 12/10/23. You stated that both of you forgot about the deadline. This has been corrected. I will email a list of required trainings/tasks that need to be completed at hire and throughout a new employee’s first year. Use a tracker (handwritten or electronic) to track due dates for staff documents and task. General Visit Information: Be knowledgeable of the child care laws and rules and environmental health rules; review them with your staff and assist them with understanding and implementing them to maintain compliance and keep children safe and healthy. The most recent versions of child care laws and rules (updated 1/1/24) and environmental health rules (updated 7/1/23) in North Carolina, the Items Number Listing (can be used as a detailed checklist of required items) and What’s New information are available on the DCDEE website, www.ncchildcare.ncdhhs.gov. Check the designated facility email at least weekly to stay current with communication and email blasts from DCDEE. If your email is not the facility email, sign up for email blasts on the What’s New page for general information and communication from DCDEE. Your local and regional Smart Start Partnerships and Child Care Resource and Referral Agencies are available to assist you with technical assistance and training on a multitude of topics including but not limited to: Environment Rating Scales, infant/toddler practices, healthy behaviors and classroom management, developmentally appropriate practice, EPR plans, activity plans, NC Foundations for Early Learning (developmental domains), etc. 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. *Children & Youth Partnership for Dare County: Phone - (252) 441-0614; website - www.darekids.org. *Child Care Health Consultant – S. Rosser - Office: (252) 557-4208 or stacy_rosser@unc.edu Reminders: 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. *Make it easier on yourself and schedule annual updates for staff evaluations and professional development plans; health questionnaires and emergency information forms; EPR Plan and Emergency Medical Care Plan at the same time to streamline your staff updates. (Example, even if an employee was hired in January , and you update health questionnaires and emergency forms in August, have this employee go ahead and update in August with the rest of the staff to jump into the same cycle!) *We reviewed your staff worksheet. I highlighted items that were delinquent and items that are coming due in the next year. *D. Titus-Johnson – ITS/SIDS due 4/20/24 *E. Dosaeva – CPR/FA due 6/30/24 *D. Swain – due for 5-year CBC by 7/29/24 Health and Safety Training and Five (5) Year Cycle Tracking Requirements – Review Row 17 on Staff Worksheet for staff members needing initial H&S Training or five-year renewal. New staff are required to complete Health & Safety Training (H&S Training) within one year of hire (CPR/First Aid and Recognizing and Responding to Suspicions of Child Maltreatment within 3 months of hire) and then complete training in all topic areas every five years. *E. Dosaeva – Initial H&S due 7/31/24 *L. Clark – Initial H&S due 11/3/24 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 3/258/25 (anniversary of today’s Annual Compliance visit). New staff will complete Health & Safety in their first year and then will complete on-going training annually based upon their level of education posted in DCDEE Works. Activity Plans – Activity Plans must be current, dated and posted where they are easily visible. Additional Comments: Required Water, Lead Paint, and Asbestos Testing - New child care rules require child care facilities to test for lead in drinking water, lead paint, and asbestos. Testing is required by 1/1/2025. Check out the FAQ in the updated Clean Classrooms for Carolina Kids. Currently there is funding to pay for the testing and to mitigate lead paint or asbestos hazards. Depending on the age of your home or building and the information you provide in the enrollment process, testing for lead paint and asbestos may not be required. Water testing will be required every three years. For more information go to https://www.cleanwaterforuskids.org/en/carolina/ or contact your Environmental Health Specialist. Medicaid Expansion – Share with your staff! - Studies show that at least 25% of people working in child care in North Carolina do not have health insurance. Starting 12/1/2023, more North Carolinians can now get health coverage through Medicaid even if they haven’t qualified before. Medicaid pays for doctor visits, yearly check-ups, emergency care, mental health services and more – at little or no cost to beneficiaries. Most people can get health care coverage through Medicaid if they meet the criteria below. • Live in North Carolina • Age 19 through 64 • Are a citizen. Some non-U.S. citizens can get health care coverage through Medicaid. • Have a household income that is below 138% of the federal poverty level. That’s about $20,000 for a single adult or about $34,000 for a family of three. If you were eligible for Medicaid prior to Dec 1, 2023, you still are. To learn more, go to Medicaid.nc.gov. I shared information on the following topics and emailed the information to you after the visit: 1. Clean Classrooms for Carolina Kids – required testing for lead in water, lead paint, asbestos 2. Moodle Back Up and Running! 3. Love Them Through It: Understanding Trauma in Young Children – 6 month training opportunity 4. Rules Changes, effective 1/1/2024 – Review on Moodle! 5. Provider Access to the Background Check Management System 6. Free On-line Teacher Professional Development Memberships 7. Unpacking ITERS-R: An Overview of the Infant/Toddler Environment Rating Scale 8. Resources from Health and Safety Resource Center! 9. Environmental Health Rules Update 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: EAST COAST EARLY LEARNING ACADEMY Facility ID: 28000275 Consultant: MARJORIE WHITE Operation Type: Center Case Number: Visit Date: 3/25/2024 Number Present: 25 Completed Date: 3/25/2024 Age: From 0 To 5 Total Minutes: 420 Time In: 10:00 AM Time Out: 05:00 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. Last Annual Compliance visit – 5/24/23 Last Sanitation Inspection – 12/18/233 with a Superior Rating Last Fire Inspection – 3/14/23 with Satisfactory rating; approved for daytime 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. 18-month compliance history from 9/22/22 – 3/21/24 = 93% D. Titus-Johnson, Administrator, was present and assisted me with the visit. The facility currently operates with a Five-Star Center License, issued 2/23/2022, earning points in the following components: Program (6 PTS) + Education (6 PTS) + Quality Point (1 PT) = 13 Points = 5 Stars *Quality Point met and remains in effect: Staff benefits and an infrastructure of parent involvement The program was also monitored for compliance with implementing an approved curriculum (Creative Curriculum 5th edition) as required for all four and five star facilities where four-year old children are enrolled. The next rated license assessment was due by 2/23/25, but DCDEE has developed a two-year cohort system to return all facilities back to rated license reassessments. Your center has been assigned to Cohort 3. The Cohort 3 Rated License Preparation Year is from 7/1/2025 – 6/30/2026. You may complete your ECERS-R during the Preparation Year and choose to use your scores and complete the rated license reassessment if education is where you want it to be. If you would like to complete the ECERS-R again to improve your scores, you may do this during your Assessment Year from 7/1/2026 – 6/30/2027 at no cost to you which will also give you additional time to work on education, if needed. We will discuss more details at next year’s annual compliance visit. This facility is owned by East Coast Academies, Inc. According to the NC Secretary of State's website, this corporation is current and active as of 3/21/24. Please contact me prior to any information change regarding the ownership of this facility. License information was current. Contact me to make any changes to address, phone, or email or to request changes to the license. I monitored the classrooms and spaces used for child care, kitchen, and outdoor play area for applicable child care center requirements using the Child Care Center Requirements, effective 1/1/2024 and Item Number Listing, effective 8/2023. I monitored five children’s records, two staff records and all program records. The facility does not offer transportation. Center Observations: The center was busy with activities to prepare for Easter. Twenty-five children were present in three classrooms with four teachers. The children, two years of age, in Space 2 were in the middle of bathroom routines before putting on coats and going outdoors. They played on several portable climbers, in playhouses and with riding toys. The infants were cared for on their own schedules. Feeding plans were posted. Documentation of safe sleep checks was available and current. Infants and toddlers had a variety of toys to choose from when on the floor. The preschool group was decorating the class for Easter. Pastels, bunnies, chicks and Easter eggs brightened the walls. Lunch was hot dogs with beans, peas and carrots, pears, and milk. Children were offered seconds. After lunch they rested on linen-covered cots. I observed and documented the following violations during today’s visit. Violation Number Comment Rule 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A bottle of Parent's Choice Infant Pain and Fever Relief was stored in an unlocked medication box out of reach of children but not locked. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. Two medication permissions forms for Albuterol and an Epi-pen did not include the six-month authorization time frame and were not dated by the parent. 10A NCAC 09 .0803(4)(6-9) 848 Questionable medication instructions from parents were followed without signed written dosage instructions received from physician or authorized health professional. A bottle of Parent's Choice Infant Pain Reliever (2-3 years) was observed with a medication permission form completed by a parent of a child, eleven months of age. Dosage instructions stated to consult a physician for children younger than two years of age. A physician's note was not available. The medication had not been administered to the infant. 10A NCAC 09 .0803(5) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. A medication permission form for Eucerin Eczema Relief was dated October 24, 2022 - October 24, 2023 and was expired. An empty tube of Desitin was not discarded or returned to the parent. .0803(12) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report documented on the center incident log for December 5, 2023 was not available in a child's file. .0802 (e) 1320 Children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care was not on file for each child. In one of three children's records reviewed, a Children's Medical Report or health assessment was not available for a child enrolled on March 8. 2022. GS 110-91(1);.0302(d)(2); .0304(g) 1329 Application for enrollment did not include all required information. In two of the three children's records reviewed, the parent did not complete parts of the Health Care Needs section on the Child's Application. .0801(a)(1-7) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. Medical action plans were available with the mediation for a child with two chronic medical conditions, but copies were not attached to the Child's Application in the child's file. .0801(b) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A staff person hired on July 31, 2023 did not complete Recognizing and Responding to Suspicions of Child Maltreatment until December 10, 2023. .1102(g) * 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 D. Titus-Johnson, Administrator. We reviewed the visit summary and the nine violations documented during today’s visit. You corrected five of them during the visit. Correct the four remaining violations immediately. Send evidence of correction to me so that I receive it no later than 4/8/2024. The compliance verification letter needs to state the facility name and license number and list each violation by Item # and describe in detail when and how each violation has been corrected. If referring to staff or children in your compliance letter, refer to them by initials or position. Send compliance verification letter in an email from the center’s official email address, heidi.riden@ecelearningacademy.com to my email address, Marjorie.White@dhhs.nc.gov. If sent from another email address, the center’s official address must be Cc’d in the compliance email. You may include the compliance verification as an attachment or in the body of the email. If sufficient information is not received by the due date, a follow-up visit may be conducted. *I will email a sample compliance verification letter to you. *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 or Jennifer.Linhardt@dhhs.nc.gov. Technical Assistance With Documented Violations: #841: Storage of Medication - Improper storge of medications results in millions of accidental poisonings in children annually. In Space 1, Parents Choice Infant Pain and Fever Relief was stored out of reach of children in an unlocked medication box but was not locked. The teacher stated that she did not realize it had to be locked even though it’s an over the counter medication. 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. Emergency medications such as asthma inhalers, Epi-Pens, Diastat, and glucagon may be stored out of reach but easily accessible to a teacher in the event of a medical emergency. OTC and non-emergency prescription medications must be locked. This was corrected during the visit today. #847: Medication Permission Forms - All medications for children present at the center must have a current, completed medication permission form so that staff have the required information to administer any type of medication per the parent’s or physician’s instructions. Two medication permission forms for an Epi-pen and an Albuterol Inhaler for JC (DOE 12/4/23) were not dated by the parent and did not include six-month authorization time frame (12/4/23 – 6/4/24). The administrator stated that this was overlooked when accepting the medication. Assist parents with completing these forms when bringing in any type of medication to the center. Don’t accept medication until the medication forms and medication have been reviewed closely to ensure that they meet the requirements and include all information that could be critical when administering medicine. For your compliance letter, state the date when the medication forms are completed. Add a reminder to your tracker that the parent needs to update these in June 2024 for another six months. (The medical action plans also need to be updated in June.) #848: Questionable Medication Instructions – Over the counter medication for young children can have confusing and questionable instructions or dosage amounts. Not reading the boxes carefully before accepting the medication may result in administering an incorrect dose. A bottle of Parent’s Choice Infant Pain and Fever Relief was observed in the medication box in Space 1 for a child, eleven months of age. The medication permission form stated that the medication was to be used for teething pain. The parent indicated that a dose of 2.5 ml was to be administered. Even though the label called the medication “Infant Pain Relief”, it also stated that it was for children, two – three years of age. The dosage information on the box stated to “consultant a physician” for children younger than two years of age, but a physician note was not available. The teacher stated that she had not administered the medication for any reason to the infant. Review any OTC medication instructions carefully before you accept them into the child care and put them in a classroom. Many OTC pain relievers, decongestants, cough suppressants, etc. appear to be for young children because they say “infant” or “child” and have pictures of cute babies on them, but when you read the dosage instructions, it is clear that they should not be given to young children without a physician’s consent. You corrected this by removing the medication from the classroom and returning it to the parent. Share this information with your staff so that this type of medication is clearly vetted before accepting it. #849: Expired Medication – When medications or medication permission forms expire or child leaves center, return the medication to the parent within 72 hours unless the medication is still needed and the permission form needs to be updated. A tube of Eucerin Eczema Relief for PW (Space 2) was observed in the medication box stored out of reach in the bathroom. The accompanying medication permission form was dated 10/24/22 – 10/24/23 and was expired. Have parent update or complete a new form valid for one year. An empty tube of Desitin was observed for BW, along with a full tube of Butt-paste. Discard or return the empty tube of Desitin. Check medication boxes or cabinets monthly to review medications and medication permission forms. Update or return as needed. This was corrected during the visit. #852 Incident Report – Incident Reports keep parents informed of injuries their child has at your facility and provide an opportunity for you and your staff to review your own safety and supervision practices to prevent similar injuries in the future. Your incident log had documentation of an incident that occurred on 12/5/23 for JC (enrolled 12/4/23); however, a copy of the incident report was not available in the child’s file. You stated that the teacher may have accidentally given the parent the copy without making a copy for the child’s file. If a child is injured while attending child care and the injury requires minor on-site first aid (band-aid, ice pack, tweezers, etc.) or professional medical care (doctor, hospital, EMS, etc.), complete an Incident Report (updated 3/2021) with help from the staff members who witnessed the accident and provided first aid. Review with the parent and have her/him sign. The parent must be offered a copy but may choose to decline a copy by checking and initially the box at the bottom. The original copy is maintained in the child’s file and documented on the Incident Log. If the injury requires professional medical attention, mail a copy of the Incident Report to the child care consultant within seven days. Review 10A NCAC 09 .0802 (e-g) Emergency Medical Care for more information on incident reports and the incident log. For your compliance letter, state when you reviewed incident report requirements with staff so that incident reports are maintained in children’s files. Children’s Files Maintaining accurate records on the children in your care helps to ensure their health and safety, informs families of rules you are required to follow and your center’s policies, and provides a certain transfer of knowledge so that you can provide the best care possible for their children. I monitored three children’s files. The following children’s documents were not available. #1320: Children’s Medical Report – missing for LY (Space 2 – DOE 3/8/22) – For your compliance letter state that date when you have received a child’s medical report for JY and it is available in her file for review. Do not send a copy of the medical report. #1329: Child’s Application – Health Care Needs Section – not fully completed for MA (Space 1) and JC (Space 3) – Parents need to complete all information in the Health Care Needs section or write “N/A” or something similar. – For your compliance letter state the date when the parents of MA and JC have completed the health care needs information on the child’s application. Use Children’s File Checklist to verify you have received all required enrollment documents. Build in time to review enrollment documents with families explaining that they need to be fully completed, signed and dated. Check them before the parent leaves their children with you the first time. The empty blank might be the signature you need to seek emergency medical care if the child is injured. Have parents review and update the Child’s Application annually to ensure information is still current. #1834: Medical Action Plan – Medical Action Plans include medical information that is crucial in the event of a medical emergency that requires medication such as an Epi-pen or Asthma Inhaler. A child enrolled on 12/3/23 (JC) has two chronic medical conditions that require emergency medications; medical action plans for both medications were included with the medication but copies were not attached to the child’s application in the file. You stated you were not aware that they needed to be included in the child’s file and corrected it immediately by making copies and stapling them to the child’s application. The medical action plan must be completed by the child’s physician or parent and updated annually. (These medical action plans were dated for June 2023 and must be updated in June 2024.) Another copy needs to be attached to the application in the Ready to Go File. It is also best practice to have a copy in the classroom with the medication and the required medication permission form. #1897: Recognizing and Responding to Suspicions of Child Maltreatment – Recognizing and Responding to Suspicions of Child Maltreatment staff the signs and symptoms to look out for with child abuse and neglect, what to do when they suspect it is happening, NC’s reporting law, and what happens after a report is made. ED (DOH 7/31/23) was required to complete the training by 10/31/23 but did not complete it until 12/10/23. You stated that both of you forgot about the deadline. This has been corrected. I will email a list of required trainings/tasks that need to be completed at hire and throughout a new employee’s first year. Use a tracker (handwritten or electronic) to track due dates for staff documents and task. General Visit Information: Be knowledgeable of the child care laws and rules and environmental health rules; review them with your staff and assist them with understanding and implementing them to maintain compliance and keep children safe and healthy. The most recent versions of child care laws and rules (updated 1/1/24) and environmental health rules (updated 7/1/23) in North Carolina, the Items Number Listing (can be used as a detailed checklist of required items) and What’s New information are available on the DCDEE website, www.ncchildcare.ncdhhs.gov. Check the designated facility email at least weekly to stay current with communication and email blasts from DCDEE. If your email is not the facility email, sign up for email blasts on the What’s New page for general information and communication from DCDEE. Your local and regional Smart Start Partnerships and Child Care Resource and Referral Agencies are available to assist you with technical assistance and training on a multitude of topics including but not limited to: Environment Rating Scales, infant/toddler practices, healthy behaviors and classroom management, developmentally appropriate practice, EPR plans, activity plans, NC Foundations for Early Learning (developmental domains), etc. 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. *Children & Youth Partnership for Dare County: Phone - (252) 441-0614; website - www.darekids.org. *Child Care Health Consultant – S. Rosser - Office: (252) 557-4208 or stacy_rosser@unc.edu Reminders: 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. *Make it easier on yourself and schedule annual updates for staff evaluations and professional development plans; health questionnaires and emergency information forms; EPR Plan and Emergency Medical Care Plan at the same time to streamline your staff updates. (Example, even if an employee was hired in January , and you update health questionnaires and emergency forms in August, have this employee go ahead and update in August with the rest of the staff to jump into the same cycle!) *We reviewed your staff worksheet. I highlighted items that were delinquent and items that are coming due in the next year. *D. Titus-Johnson – ITS/SIDS due 4/20/24 *E. Dosaeva – CPR/FA due 6/30/24 *D. Swain – due for 5-year CBC by 7/29/24 Health and Safety Training and Five (5) Year Cycle Tracking Requirements – Review Row 17 on Staff Worksheet for staff members needing initial H&S Training or five-year renewal. New staff are required to complete Health & Safety Training (H&S Training) within one year of hire (CPR/First Aid and Recognizing and Responding to Suspicions of Child Maltreatment within 3 months of hire) and then complete training in all topic areas every five years. *E. Dosaeva – Initial H&S due 7/31/24 *L. Clark – Initial H&S due 11/3/24 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 3/258/25 (anniversary of today’s Annual Compliance visit). New staff will complete Health & Safety in their first year and then will complete on-going training annually based upon their level of education posted in DCDEE Works. Activity Plans – Activity Plans must be current, dated and posted where they are easily visible. Additional Comments: Required Water, Lead Paint, and Asbestos Testing - New child care rules require child care facilities to test for lead in drinking water, lead paint, and asbestos. Testing is required by 1/1/2025. Check out the FAQ in the updated Clean Classrooms for Carolina Kids. Currently there is funding to pay for the testing and to mitigate lead paint or asbestos hazards. Depending on the age of your home or building and the information you provide in the enrollment process, testing for lead paint and asbestos may not be required. Water testing will be required every three years. For more information go to https://www.cleanwaterforuskids.org/en/carolina/ or contact your Environmental Health Specialist. Medicaid Expansion – Share with your staff! - Studies show that at least 25% of people working in child care in North Carolina do not have health insurance. Starting 12/1/2023, more North Carolinians can now get health coverage through Medicaid even if they haven’t qualified before. Medicaid pays for doctor visits, yearly check-ups, emergency care, mental health services and more – at little or no cost to beneficiaries. Most people can get health care coverage through Medicaid if they meet the criteria below. • Live in North Carolina • Age 19 through 64 • Are a citizen. Some non-U.S. citizens can get health care coverage through Medicaid. • Have a household income that is below 138% of the federal poverty level. That’s about $20,000 for a single adult or about $34,000 for a family of three. If you were eligible for Medicaid prior to Dec 1, 2023, you still are. To learn more, go to Medicaid.nc.gov. I shared information on the following topics and emailed the information to you after the visit: 1. Clean Classrooms for Carolina Kids – required testing for lead in water, lead paint, asbestos 2. Moodle Back Up and Running! 3. Love Them Through It: Understanding Trauma in Young Children – 6 month training opportunity 4. Rules Changes, effective 1/1/2024 – Review on Moodle! 5. Provider Access to the Background Check Management System 6. Free On-line Teacher Professional Development Memberships 7. Unpacking ITERS-R: An Overview of the Infant/Toddler Environment Rating Scale 8. Resources from Health and Safety Resource Center! 9. Environmental Health Rules Update 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 .0713 · Violation

Name of Operation: EAST COAST EARLY LEARNING ACADEMY Facility ID: 28000275 Consultant: MARJORIE WHITE Operation Type: Center Case Number: Visit Date: 8/21/2023 Number Present: 27 Completed Date: 8/21/2023 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced * The purpose of today’s Routine Unannounced visit was to monitor compliance with applicable child care requirements. Last Annual Compliance visit – 5/24/2023 Last Sanitation Inspection – 12/14/2022 with Superior Rating; expires 12/14/2023 Last Fire Inspection – 2/4/2023 with Satisfactory rating; approved for daytime only; expires 2/4/2024 *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. 18-month compliance history from 2/19/2022 – 8/18/2023 = 97% D. Titus-Johnson, Administrator, was present and assisted me with the visit. The facility currently operates with a Five-Star Center License, issued 2/23/2022, earning points in the following components: Program (6 PTS) + Education (6 PTS) + Quality Point (1 PT) = 13 Points = 5 Stars *Quality Point met and remains in effect: Staff benefits and an infrastructure of parent involvement The program was also monitored for compliance with implementing an approved curriculum (Creative Curriculum 5th edition) as required for all four and five star facilities where four-year old children are enrolled. The next rated license assessment is due by 2/23/2025. See below for more information about the Division’s plan to return to rated license assessments. This facility is owned by East Coast Academies, Inc. According to the NC Secretary of State's website, this corporation is current and active as of 8/18/2023. Please contact me prior to any information change regarding the ownership of this facility. Facility contact information and license information were current. Contact me to make any changes to address, phone, or email or to request changes to the license. I monitored the classrooms and spaces used for child care, kitchen, and outdoor play area for applicable child care center requirements using the Child Care Center Requirements, effective 7/1/2023 and Item Number Listing, effective 6/2022. I monitored four staff records and all program records. The facility does not offer transportation. Center Observations: Parent information was posted at the entrance. Documentation of arrival and departure was available. Two infants and two toddlers were playing in Space 1. The younger infant was playing with toys in the bouncy seat while the older infant crawled on the mat and played with toys. The teacher later held the smaller infant and played with him. The two toddlers played with the different types of rain sticks while the teacher talked to them about the sounds and the colors. The children, twenty months through from Space 2 and Space 3 were outdoors. It was hot, but the shade structure provided relief from the sun. They played on the portable climber and in the dramatic play houses. When they returned indoors, they used the bathroom and washed their hands. Both groups engaged in indoor free play while the teachers assisted and supervised. Lunch was fish sticks, carrots, mandarin oranges, and milk. After lunch children rested on linen-covered cots. Documentation of safe sleep checks was available for the infants. I observed and documented the following violations during today’s visit. Violation Number Comment Rule 318 Children between 12 and 24 months of age were grouped with children 3 years of age or older. Group 2, that included seven children, twenty months through two years of age, was on the playground at the same time as Group 3, that included sixteen children, three through five years of age. 10A NCAC 09 .0713(a)(6) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In Space 1, Aquaphor was administered to a child without a completed medication permission form. A medication permission form for a diaper cream reflected the incorrect name of the diaper cream, Butt Paste instead of Triple Paste. A medication permission form for Desitin did not include the one year authorization dates or the specific amount to be applied. In Space 2, a medication permission form for Beaudreaux's Buttpaste did not specify the amount of diaper cream to be applied. 10A NCAC 09 .0803(1)(a & b) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. A staff person completed five of eight required on-going training hours by the due date, June 14, 2023 and was short three hours of on-going training. .1103(a) * 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 D. Titus-Johnson, Administrator. We reviewed the visit summary and violation(s) documented during today’s visit. Correct these immediately. Send evidence of correction to me so that I receive it no later than 9/5/2023. The compliance verification letter needs to state the facility name and license number and list each violation by Item # and describe in detail when and how each violation has been corrected. Also include the following documents/pictures to verify compliance: copies of training certificates and on-going training log for D. Swain. Send compliance verification letter in an email from the center’s official email address, heidi.riden@ecelearningacademy.com to my email address, Marjorie.White@dhhs.nc.gov. If sent from another email address, the center’s official address must be Cc’d in the compliance email. You may include the compliance verification as an attachment or in the body of the email. If sufficient information is not received by the due date, a follow-up visit may be conducted. *I will email a sample compliance verification letter to you. *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. A violation was documented that requires a follow-up visit. An unannounced visit will be made soon to verify correction. 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 or Jennifer.Linhardt@dhhs.nc.gov. TECHNICAL ASSISTANCE WITH DOCUMENTED VIOLATIONS: Grouping – Providing separate spaces indoors and outdoors for toddlers, 12 – 24 months, gives them the opportunity to safely explore and engage with their environment without having older, bigger children interfering with their play and possibly harming them due to their size and their higher levels of energy. Today, Group 2 and Group 3 were on the playground at the same time. Group 2 had seven (7) children, twenty months through two years of age, with two staff persons. Group 3 had sixteen children, three through five years of age, with two staff persons. The playground is one large space and does not have a separate space for younger children. You stated that a teacher called out today, causing you to be short-staffed. You thought having both groups go outdoors at the same time would make it easier because there were only 23 children outside. You forgot that one of the children in Group 2 was under two years of age. Except for the first and last operating hour of the day, infants can be routinely grouped with children younger than twenty-four months but may not be grouped with children two years of age and older. Children between twelve months and twenty-four months can be grouped with infants and children two years of age but may not be grouped with children three years of age and older. All children may be grouped during the first and last hour of the operating day if staff/child ratios and group size are maintained for the youngest child present. Today, Group 2 had nine children present, three toddlers and six children, two years of age. You moved two toddlers back to the infant room because there were only two babies present today. You could have also moved a two-year old up to the preschool class (16 children present) and still have been within staff/child ratio for a two-year (1:9 or 2:18). At naptime, you moved the oldest two-year old over to the preschool classroom. I encourage you to review NC Child Care Requirements related to staff/child ratios – 10A NCAC 09 .0718 so that when you are short-staffed, you can regroup children to maintain staff/child ratios and grouping requirements, allowing you as the administrator to float, do administrative duties and cook when needed. While regrouping is not the best option for children who need the stability of their teacher, friends and classroom but it is an option to use occasionally. Also ensure that Groups 1, 2, and 3 all have separate outdoor times scheduled. Medication Permission Forms - Medication permission forms provide information that could be critical to the administration of the medication and the care of the child and verify that the parent has authorized use of the medication for their child. Even topical medications such as diaper cream or sunscreen need to have completed medication forms to ensure that you are applying it how the parent expects you. MS (Space 1) – Has Aquaphor to be applied to his face but no medication permission form available *MS (Space 1) – Name of diaper cream on medication permission form is listed as Butt Paste but name of diaper cream observed is Triple Paste. *LM (Space 1) – Dates to apply Desitin is 7/10/23 with no expiration date; amount to be applied is not listed. *AR (Space 2) - Amount of Boudreaux’s Butt Paste to be applied is not listed. The medication permission forms must include the specific name of the medication. (Coppertone Baby vs. Sunscreen. Cutter Bug Repellant vs. Bug Spray. Albuterol vs. Inhaler). Medication permission forms are valid for a defined length of time and must be updated, if needed. I shared a Medication Flyer with this information. I encourage you to review the section in the NC Child Care Requirements on medication: 10A NCAC 09 .0803 Administering Medication in Child Care Centers and review with your staff. Determine who is responsible for receiving and reviewing medication and medication permission forms and checking them frequently to verify that they are current and complete. On-going Training – On-going training and professional development provides early learning staff opportunities to learn new skills and/or refresh previously learned skills. During your Annual Compliance visit on 5/24/2023, I monitored on-going training for staff. The following staff needed to complete the listed number of on-going training hours by 6/15/2023. D. Swain needed 3 hours K. Ellington needed 3 hours Today, I monitored their on-going training for the additional hours but the required number of hours for one of the staff persons was not available. D. Swain needs 3 hours by 9/5/2023 and 8 hours by 5/24/2024. (Her ITS/SIDS certification expires 10/20/2023 so she may want to complete that training for 1.5 to 2 hours of on-going training.) K. Ellington completed the required number of on-going training hours. All staff need to complete On-going Training Logs and attach their certificates to the log You stated that due to staffing issues, you have not been able to follow up with them to ensure they completed the required number of hours. Planning for on-going training as part of the annual Professional Development Plan helps the administrator and staff person map out completion of on-going training for the upcoming year. On-going training is tracked from Annual Compliance visit to the one year anniversary. Have D. Swain complete the remaining on-going training by 9/5/2023. Send copies of her training certificates and her completed On-going Training Logs with your compliance letter. Review Row 18 (# hours to carry over) on the Staff Worksheets to determine how many on-going training hours other staff will need by 5/24/2024 (anniversary of your last Annual Compliance visit). *The Health and Safety Training available on Moodle on the DCDEE website and other free trainings can also be used to help staff meet on-going training hours. *Also available on Moodle is a training course on Supporting Children and Families Experiencing Homelessness. *NITTO – New Infant Toddler Teacher Orientation – 14 hours on Moodle *Trainings on the environment rating scales that count as on-going training hours are available on the NC Rated License Assessment Project (NCRLAP), www.ncrlap.org *ECE college coursework or coursework leading to an ECE degree counts towards on-going training hours. Each semester credit counts as 16 hours so a 3-credit classes also earns 48 hours of on-going training. *Check with your local Child Care Resource & Referral for available training. *The following offer on-line training opportunities at reasonable prices and accessible at times for your busy schedules: Southwestern Child Development Commission, www.swcdcinc.org – offers individual and group packages also ProSolutions courses are still available for a fee – offers individual and group packages also *Use the On-going Training Log to document training annually. Attach copies of certificates. GENERAL VISIT INFORMATION: Be knowledgeable of the child care laws and rules and environmental health rules; review them with your staff and assist them with understanding and implementing them to maintain compliance and keep children safe and healthy. The most recent versions of child care laws and rules (updated 7/1/23) and environmental health rules (updated 7/1/23) in North Carolina, the Items Number Listing (can be used as a detailed checklist of required items) and What’s New information are available on the DCDEE website, www.ncchildcare.ncdhhs.gov. Check the designated facility email at least weekly to stay current with communication and email blasts from DCDEE. If your email is not the facility email, sign up for email blasts on the What’s New page for general information and communication from DCDEE. Your local and regional Smart Start Partnerships and Child Care Resource and Referral Agencies are available to assist you with technical assistance and training on a multitude of topics including but not limited to: Environment Rating Scales, infant/toddler practices, healthy behaviors and classroom management, developmentally appropriate practice, EPR plans, activity plans, NC Foundations for Early Learning (developmental domains), etc. 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. *Children & Youth Partnership for Dare County: Phone - (252) 441-0614; website - www.darekids.org. *Albemarle Alliance for Children and Families (AACF) and Region 1 Child Care Resource and Referral: Phone (252) 333-1233; website - www.aacfnc.org . REMINDERS: 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. *Encourage staff to maintain copies of all initial hire documents, Qualifying Letters, training certificates, etc. in their own professional file maintained at home. *Make it easier on yourself and schedule annual updates for staff evaluations, professional development plans, health questionnaires, emergency information forms, and EPR plan and Emergency Medical Care Plan at the same time to streamline your staff updates. *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 and Five (5) Year Cycle Tracking Requirements – Review Row 17 on Staff Worksheet for staff members needing initial H&S Training or five-year renewal. New staff are required to complete Health & Safety Training (H&S Training) within one year of hire (CPR/First Aid and Recognizing and Responding to Suspicions of Child Maltreatment within 3 months of hire) and then complete training in all topic areas every five years. *Numerous staff were due for are due for CPR/First Aid Training this year. Look at Row 19 on the Staff Training Worksheet to schedule CPR/First Aid training before it expires. *C. Martin needed to complete Medication Administration to close out H&S Training by 11/14/23 *E. Dosaeva – due 7/31/2024; Recognizing and Responding to Suspicions of Child Maltreatment due 10/31/2024 Moodle Support - 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. Emergency Preparedness and Response (EPR) Requirements, Emergency Medical Care Plan (EMCP) and Ready-to-Go File – Your Emergency Preparedness and Response (EPR) Plan needs to be reviewed and updated annually in the Emergency Management Portal. You have reviewed the hard copy in 2023 but have not updated in the portal since August 2021. *Log into the Emergency Management Portal on the DCDEE website -> Provider tab -> Emergency Preparedness and Response -> Emergency Management Portal -> Log in using NCID used to create or update EPR Plan. Review EPR Plan and update as needed. Document review date on page 28. If changes are needed, print the plan up to page 29. If no changes are needed, print page 28 with the review date reflected. Review annually with staff and during orientation with new staff. Use this time to also review and update Emergency Medical Care Plan and review with staff also. * If you have questions, or need assistance with accessing your EPR Plan contact Amia M. Eaton, Training and Program Development Consultant Amia.Eaton@dhhs.nc.gov *Use this time to also review and update Emergency Medical Care Plan (EMCP) and review with staff also. Ensure that at least one person listed on the EMCP is always on-site. *Also update your Ready-to-Go File to include new students, remove former students, and add updated medication information. (Make sure a copy of the Child’s Application for Enrollment is added to the R2G File when a new child starts, or the application is updated.) ADDITIONAL COMMENTS: I shared information on the following topics: 1. Annual Licensing Fee 2. Environmental Health Rules Update 3. New Rules – July 2023 – enhanced outdoor space, cooperative arrangements, multi-age grouping 4. NC Rated License Assessment Project (NCRLAP) Resources 5. NCID TRANSITION BACK TO RATED LICENSE ASSESSMENTS AND COHORTS To transition back to rated license assessments, the Division has created a two-year Cohort Model. All facilities are assigned to one of three cohorts based on their current rated license assessment due date. Each cohort will have a year for preparation and a year for assessment. (However, you are encouraged to begin preparations now so that you are ready when your cohort group is due!) Your child care center is due for a three-year rated license reassessment by 2/23/2025 and has been assigned to Cohort 3. The Cohort 3 Rated License Preparation Year is from 7/1/2025 – 6/30/2026. During your preparation year, if you are interested in having the Environment Rating Scales completed, review the ITERS-R and ECERS-R by obtaining the manuals for each classroom and looking for assessment related resources at ncrlap.org. Request technical assistance and training for your staff from Children & Youth Partnership for Dare County. You can request and complete an ITERS-R and ECERS-R during your preparation year. If your scores help you meet or exceed your current star rating and you are ready to move forward with your rated license assessment, you may choose to do so during your preparation year. Your preparation year is also the time to continue to work on staff education and ensure that Works accounts are completed and up to date for staff members. Look at options to help staff earn the NC Early Childhood Credential (NCECC): completing EDU 119, applying for Early Educator Certification, completing and passing the new NCECC Equivalency Exam option available on Moodle. Encourage staff with the NCECC to enroll in additional college coursework to increase points in Education. TEACH Scholarships are available to help staff pay for educational expenses. Go to https://www.childcareservices.org/programs/teach-north-carolina/ . The Cohort 3 Rated License Assessment Year is from 7/1/2026 – 6/30/2027. During your assessment year you may choose to complete the ITERS-R and ECERS-R again at no cost even if you completed them during your preparation year. Use the feedback from your preparation year scores to create a plan to improve your scores. During this year, all education needs to be posted in Works. At some point during that year, you will have your rated license assessed. Technical Assistance to Improve ITERS-R Scores The website for the NC Rated License Assessment Project (NCRLAP), www.ncrlap.org , has a wealth of resources and training opportunities to help you intentionally prepare for your upcoming ITERS-R assessment. From the main webpage, you can access self-assessment tools to review each subscale in detail and determine how you can make improvements in each area. See “Thinking More About Space and Furnishing,” “Thinking More About Personal Care Routines,” “Thinking More About Language and Interactions,” “Thinking More About Activities,” and “Thinking More About Program Structure.” Taking the time to work through these activities with your staff and using that self-reflection to purchase materials, rearrange your classrooms, work on interactions, improve daily routines, etc. will help you improve your environment and your scores. Also check out the training options under the training tab. Trainings are both self-guided and live (virtual). You and your staff can earn training credit for participating in these trainings. In December 2021, you completed the modified ECERS-R and ITERS-R and scored lowest on Subscale 4: Activities of the ITERS-R. Review the following and consider ways to improve your scores. Item 14: Using books – Providing children, even toddlers and two’s, with intact books without torn or marked pages helps to promote the message that books are meant for looking at and reading and not for handling roughly. For this age of children, provide sturdy hard books, cloth books, or vinyl books that this age group can handle. Of course, close supervision is important and reading with children one-on-one to model how to enjoy a book without damaging it. Item 16: Active physical play – Accessing the playground from Spaces 1 and 2 involves walking through part of Space 3, through a gate and out the back door to the playground; therefore, the playground is not easily accessible for infants, toddlers, and two’s in Spaces 1 and 2. This item is out of your control. However, even though NC Child Care Requirements only require 30 minutes of outdoor time for infants and toddlers, the ITERS-R at the 5 point level requires at least 60 minutes. Develop a schedule that provides at least 60 minutes of outdoor time. Because you do not have a separate play space for infants and toddlers, remember that grouping requirements do not allow infants to be grouped with children older than one years of age. Children one-year of age may not be grouped with children older than two years of age so separate schedules for playground use will be needed. Item 17: Art – Providing even infants and toddlers with art materials, e.g., chunky crayons and paper, fingerpaints, chunky brushes and paint, gives them an opportunity to make marks on paper with their own hands, experiment with colors, develop hand/eye coordination, etc. Limiting them to coloring pages does not allow for creative expression. Item 18: Music and movement – Music in all classrooms should be used for a purpose and not played all day long. It is appropriate at group time for music and movement or singing songs and fingerplays. Soothing music is appropriate at naptime to help children relax and drift off to sleep. Playing music or the radio all day can be overstimulating for young children, distracts them from their play, and may make it difficult for them to hear the nuances of language and vocabulary as they develop language skills. Item 19: Blocks – Providing infants and toddlers with a space for block play allows them to build structures without other children walking through the space and possibly knocking them down. Your space for infants and toddlers is tight with much space taken up by cribs. Look at other arrangements for the activity areas to provide a dedicated space for block play. Item 20: Dramatic play – When toddlers are grouped with infants, they need to have appropriate dramatic play materials for their developmental age. This includes dress-up clothes, child-sized house furniture, cooking/eating equipment (pots and pans, dishes, spoons), play foods, dolls, doll furnishings, soft animals, small play buildings with accessories, toy telephones. Toddlers need to have at least two examples of at least seven of the nine categories listed. In addition, toddlers should be provided with child-sized furnishings such as a toddler-sized couch and soft chair, toddler size table for kitchen play. This item may be difficult for you to meet because of the small area in Space 1. Item 22: Nature/science – All children need to have daily experiences with nature. The outdoor playground has wood chips for resilient surfacing and artificial grass on the rest of the playground. Consider adding some planters with flowers or even vegetables (non-toxic, of course!). All classes could have the opportunity to plant and care for them. Add some bird feeders and birdhouses to attract wild birds to observe and talk about. Talk about the sun and wind and rain. It doesn’t have to be a weather report at group time; it can be casual discussion about the weather. Item 24: Promoting acceptance of diversity – Add materials, books and pictures that reflect a range of diversity that are easily accessible to the infants and toddlers daily. At least ten examples are required in at least for of the five categories of diversity: race, cultures, ages, abilities, and gender. Since dolls are required in Item 5.2, for materials think of having puppets, foreign play food, foreign dress-up materials, world music, etc. In 2020, you scored second lowest on Subscale 5: Interaction. Look at the following and consider ways to improve your scores: Interaction – Item 25: Supervision of play and learning – Close supervision for infants, toddlers and two’s requires staff to position themselves in the classroom to be able to always see and hear children to prevent injuries and typical toddler/two disputes/biting. When on the floor with children, find a spot where you can view the classroom and see all the children. Circulate throughout the space to provide guidance and assist with play materials. This age group learns about their world by putting things in their mouth. Remain close to children when they are eating and when using art materials. Work with staff to maintain communication so that they are aware of each other’s responsibilities. When one is diapering the other maintains visual supervision of the rest of the classroom. Item 26: Peer interaction – Even with toddlers and two’s, staff need to work with children to develop positive peer interactions. It’s one thing to handle typical disputes that involve pushing or hitting, but it is important to “model” how to play together, learn to share take turns. P. White, Healthy Behaviors Specialist, and W. Dickenson, Birth – Two Quality Initiative Specialist with Albemarle Alliance for Children and Families (AACF) are available at your request to provide training on working with infants, toddlers and two’s. Contact them at (252) 333-3205. Item 27: Staff-child interaction - Children need to be cared for in a nurturing manner based upon their individual needs. If a child is tired and cranky, give them a space to sleep even if it’s not naptime. If a child is hungry and cranky, give them something to eat even if it’s not meal or snack time. Responding to a child’s individual needs gives them a safe space to feel loved and nurtured. Item 28: Discipline – Again, children need to be cared for in a nurturing manner based upon their individual needs. At this age, effective discipline and guidance policies are geared towards setting up your environment to avoid conflict. Have duplicates of popular toys. Allow children time to play with favorite toys so that can interact with it without being disturbed from other children. Respond quickly to problems such as crying, fighting, hitting, pushing. Good lesson planning helps children transition from one activity to another and know what is next. 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 .0718 · Violation

Name of Operation: EAST COAST EARLY LEARNING ACADEMY Facility ID: 28000275 Consultant: MARJORIE WHITE Operation Type: Center Case Number: Visit Date: 8/21/2023 Number Present: 27 Completed Date: 8/21/2023 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced * The purpose of today’s Routine Unannounced visit was to monitor compliance with applicable child care requirements. Last Annual Compliance visit – 5/24/2023 Last Sanitation Inspection – 12/14/2022 with Superior Rating; expires 12/14/2023 Last Fire Inspection – 2/4/2023 with Satisfactory rating; approved for daytime only; expires 2/4/2024 *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. 18-month compliance history from 2/19/2022 – 8/18/2023 = 97% D. Titus-Johnson, Administrator, was present and assisted me with the visit. The facility currently operates with a Five-Star Center License, issued 2/23/2022, earning points in the following components: Program (6 PTS) + Education (6 PTS) + Quality Point (1 PT) = 13 Points = 5 Stars *Quality Point met and remains in effect: Staff benefits and an infrastructure of parent involvement The program was also monitored for compliance with implementing an approved curriculum (Creative Curriculum 5th edition) as required for all four and five star facilities where four-year old children are enrolled. The next rated license assessment is due by 2/23/2025. See below for more information about the Division’s plan to return to rated license assessments. This facility is owned by East Coast Academies, Inc. According to the NC Secretary of State's website, this corporation is current and active as of 8/18/2023. Please contact me prior to any information change regarding the ownership of this facility. Facility contact information and license information were current. Contact me to make any changes to address, phone, or email or to request changes to the license. I monitored the classrooms and spaces used for child care, kitchen, and outdoor play area for applicable child care center requirements using the Child Care Center Requirements, effective 7/1/2023 and Item Number Listing, effective 6/2022. I monitored four staff records and all program records. The facility does not offer transportation. Center Observations: Parent information was posted at the entrance. Documentation of arrival and departure was available. Two infants and two toddlers were playing in Space 1. The younger infant was playing with toys in the bouncy seat while the older infant crawled on the mat and played with toys. The teacher later held the smaller infant and played with him. The two toddlers played with the different types of rain sticks while the teacher talked to them about the sounds and the colors. The children, twenty months through from Space 2 and Space 3 were outdoors. It was hot, but the shade structure provided relief from the sun. They played on the portable climber and in the dramatic play houses. When they returned indoors, they used the bathroom and washed their hands. Both groups engaged in indoor free play while the teachers assisted and supervised. Lunch was fish sticks, carrots, mandarin oranges, and milk. After lunch children rested on linen-covered cots. Documentation of safe sleep checks was available for the infants. I observed and documented the following violations during today’s visit. Violation Number Comment Rule 318 Children between 12 and 24 months of age were grouped with children 3 years of age or older. Group 2, that included seven children, twenty months through two years of age, was on the playground at the same time as Group 3, that included sixteen children, three through five years of age. 10A NCAC 09 .0713(a)(6) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In Space 1, Aquaphor was administered to a child without a completed medication permission form. A medication permission form for a diaper cream reflected the incorrect name of the diaper cream, Butt Paste instead of Triple Paste. A medication permission form for Desitin did not include the one year authorization dates or the specific amount to be applied. In Space 2, a medication permission form for Beaudreaux's Buttpaste did not specify the amount of diaper cream to be applied. 10A NCAC 09 .0803(1)(a & b) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. A staff person completed five of eight required on-going training hours by the due date, June 14, 2023 and was short three hours of on-going training. .1103(a) * 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 D. Titus-Johnson, Administrator. We reviewed the visit summary and violation(s) documented during today’s visit. Correct these immediately. Send evidence of correction to me so that I receive it no later than 9/5/2023. The compliance verification letter needs to state the facility name and license number and list each violation by Item # and describe in detail when and how each violation has been corrected. Also include the following documents/pictures to verify compliance: copies of training certificates and on-going training log for D. Swain. Send compliance verification letter in an email from the center’s official email address, heidi.riden@ecelearningacademy.com to my email address, Marjorie.White@dhhs.nc.gov. If sent from another email address, the center’s official address must be Cc’d in the compliance email. You may include the compliance verification as an attachment or in the body of the email. If sufficient information is not received by the due date, a follow-up visit may be conducted. *I will email a sample compliance verification letter to you. *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. A violation was documented that requires a follow-up visit. An unannounced visit will be made soon to verify correction. 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 or Jennifer.Linhardt@dhhs.nc.gov. TECHNICAL ASSISTANCE WITH DOCUMENTED VIOLATIONS: Grouping – Providing separate spaces indoors and outdoors for toddlers, 12 – 24 months, gives them the opportunity to safely explore and engage with their environment without having older, bigger children interfering with their play and possibly harming them due to their size and their higher levels of energy. Today, Group 2 and Group 3 were on the playground at the same time. Group 2 had seven (7) children, twenty months through two years of age, with two staff persons. Group 3 had sixteen children, three through five years of age, with two staff persons. The playground is one large space and does not have a separate space for younger children. You stated that a teacher called out today, causing you to be short-staffed. You thought having both groups go outdoors at the same time would make it easier because there were only 23 children outside. You forgot that one of the children in Group 2 was under two years of age. Except for the first and last operating hour of the day, infants can be routinely grouped with children younger than twenty-four months but may not be grouped with children two years of age and older. Children between twelve months and twenty-four months can be grouped with infants and children two years of age but may not be grouped with children three years of age and older. All children may be grouped during the first and last hour of the operating day if staff/child ratios and group size are maintained for the youngest child present. Today, Group 2 had nine children present, three toddlers and six children, two years of age. You moved two toddlers back to the infant room because there were only two babies present today. You could have also moved a two-year old up to the preschool class (16 children present) and still have been within staff/child ratio for a two-year (1:9 or 2:18). At naptime, you moved the oldest two-year old over to the preschool classroom. I encourage you to review NC Child Care Requirements related to staff/child ratios – 10A NCAC 09 .0718 so that when you are short-staffed, you can regroup children to maintain staff/child ratios and grouping requirements, allowing you as the administrator to float, do administrative duties and cook when needed. While regrouping is not the best option for children who need the stability of their teacher, friends and classroom but it is an option to use occasionally. Also ensure that Groups 1, 2, and 3 all have separate outdoor times scheduled. Medication Permission Forms - Medication permission forms provide information that could be critical to the administration of the medication and the care of the child and verify that the parent has authorized use of the medication for their child. Even topical medications such as diaper cream or sunscreen need to have completed medication forms to ensure that you are applying it how the parent expects you. MS (Space 1) – Has Aquaphor to be applied to his face but no medication permission form available *MS (Space 1) – Name of diaper cream on medication permission form is listed as Butt Paste but name of diaper cream observed is Triple Paste. *LM (Space 1) – Dates to apply Desitin is 7/10/23 with no expiration date; amount to be applied is not listed. *AR (Space 2) - Amount of Boudreaux’s Butt Paste to be applied is not listed. The medication permission forms must include the specific name of the medication. (Coppertone Baby vs. Sunscreen. Cutter Bug Repellant vs. Bug Spray. Albuterol vs. Inhaler). Medication permission forms are valid for a defined length of time and must be updated, if needed. I shared a Medication Flyer with this information. I encourage you to review the section in the NC Child Care Requirements on medication: 10A NCAC 09 .0803 Administering Medication in Child Care Centers and review with your staff. Determine who is responsible for receiving and reviewing medication and medication permission forms and checking them frequently to verify that they are current and complete. On-going Training – On-going training and professional development provides early learning staff opportunities to learn new skills and/or refresh previously learned skills. During your Annual Compliance visit on 5/24/2023, I monitored on-going training for staff. The following staff needed to complete the listed number of on-going training hours by 6/15/2023. D. Swain needed 3 hours K. Ellington needed 3 hours Today, I monitored their on-going training for the additional hours but the required number of hours for one of the staff persons was not available. D. Swain needs 3 hours by 9/5/2023 and 8 hours by 5/24/2024. (Her ITS/SIDS certification expires 10/20/2023 so she may want to complete that training for 1.5 to 2 hours of on-going training.) K. Ellington completed the required number of on-going training hours. All staff need to complete On-going Training Logs and attach their certificates to the log You stated that due to staffing issues, you have not been able to follow up with them to ensure they completed the required number of hours. Planning for on-going training as part of the annual Professional Development Plan helps the administrator and staff person map out completion of on-going training for the upcoming year. On-going training is tracked from Annual Compliance visit to the one year anniversary. Have D. Swain complete the remaining on-going training by 9/5/2023. Send copies of her training certificates and her completed On-going Training Logs with your compliance letter. Review Row 18 (# hours to carry over) on the Staff Worksheets to determine how many on-going training hours other staff will need by 5/24/2024 (anniversary of your last Annual Compliance visit). *The Health and Safety Training available on Moodle on the DCDEE website and other free trainings can also be used to help staff meet on-going training hours. *Also available on Moodle is a training course on Supporting Children and Families Experiencing Homelessness. *NITTO – New Infant Toddler Teacher Orientation – 14 hours on Moodle *Trainings on the environment rating scales that count as on-going training hours are available on the NC Rated License Assessment Project (NCRLAP), www.ncrlap.org *ECE college coursework or coursework leading to an ECE degree counts towards on-going training hours. Each semester credit counts as 16 hours so a 3-credit classes also earns 48 hours of on-going training. *Check with your local Child Care Resource & Referral for available training. *The following offer on-line training opportunities at reasonable prices and accessible at times for your busy schedules: Southwestern Child Development Commission, www.swcdcinc.org – offers individual and group packages also ProSolutions courses are still available for a fee – offers individual and group packages also *Use the On-going Training Log to document training annually. Attach copies of certificates. GENERAL VISIT INFORMATION: Be knowledgeable of the child care laws and rules and environmental health rules; review them with your staff and assist them with understanding and implementing them to maintain compliance and keep children safe and healthy. The most recent versions of child care laws and rules (updated 7/1/23) and environmental health rules (updated 7/1/23) in North Carolina, the Items Number Listing (can be used as a detailed checklist of required items) and What’s New information are available on the DCDEE website, www.ncchildcare.ncdhhs.gov. Check the designated facility email at least weekly to stay current with communication and email blasts from DCDEE. If your email is not the facility email, sign up for email blasts on the What’s New page for general information and communication from DCDEE. Your local and regional Smart Start Partnerships and Child Care Resource and Referral Agencies are available to assist you with technical assistance and training on a multitude of topics including but not limited to: Environment Rating Scales, infant/toddler practices, healthy behaviors and classroom management, developmentally appropriate practice, EPR plans, activity plans, NC Foundations for Early Learning (developmental domains), etc. 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. *Children & Youth Partnership for Dare County: Phone - (252) 441-0614; website - www.darekids.org. *Albemarle Alliance for Children and Families (AACF) and Region 1 Child Care Resource and Referral: Phone (252) 333-1233; website - www.aacfnc.org . REMINDERS: 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. *Encourage staff to maintain copies of all initial hire documents, Qualifying Letters, training certificates, etc. in their own professional file maintained at home. *Make it easier on yourself and schedule annual updates for staff evaluations, professional development plans, health questionnaires, emergency information forms, and EPR plan and Emergency Medical Care Plan at the same time to streamline your staff updates. *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 and Five (5) Year Cycle Tracking Requirements – Review Row 17 on Staff Worksheet for staff members needing initial H&S Training or five-year renewal. New staff are required to complete Health & Safety Training (H&S Training) within one year of hire (CPR/First Aid and Recognizing and Responding to Suspicions of Child Maltreatment within 3 months of hire) and then complete training in all topic areas every five years. *Numerous staff were due for are due for CPR/First Aid Training this year. Look at Row 19 on the Staff Training Worksheet to schedule CPR/First Aid training before it expires. *C. Martin needed to complete Medication Administration to close out H&S Training by 11/14/23 *E. Dosaeva – due 7/31/2024; Recognizing and Responding to Suspicions of Child Maltreatment due 10/31/2024 Moodle Support - 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. Emergency Preparedness and Response (EPR) Requirements, Emergency Medical Care Plan (EMCP) and Ready-to-Go File – Your Emergency Preparedness and Response (EPR) Plan needs to be reviewed and updated annually in the Emergency Management Portal. You have reviewed the hard copy in 2023 but have not updated in the portal since August 2021. *Log into the Emergency Management Portal on the DCDEE website -> Provider tab -> Emergency Preparedness and Response -> Emergency Management Portal -> Log in using NCID used to create or update EPR Plan. Review EPR Plan and update as needed. Document review date on page 28. If changes are needed, print the plan up to page 29. If no changes are needed, print page 28 with the review date reflected. Review annually with staff and during orientation with new staff. Use this time to also review and update Emergency Medical Care Plan and review with staff also. * If you have questions, or need assistance with accessing your EPR Plan contact Amia M. Eaton, Training and Program Development Consultant Amia.Eaton@dhhs.nc.gov *Use this time to also review and update Emergency Medical Care Plan (EMCP) and review with staff also. Ensure that at least one person listed on the EMCP is always on-site. *Also update your Ready-to-Go File to include new students, remove former students, and add updated medication information. (Make sure a copy of the Child’s Application for Enrollment is added to the R2G File when a new child starts, or the application is updated.) ADDITIONAL COMMENTS: I shared information on the following topics: 1. Annual Licensing Fee 2. Environmental Health Rules Update 3. New Rules – July 2023 – enhanced outdoor space, cooperative arrangements, multi-age grouping 4. NC Rated License Assessment Project (NCRLAP) Resources 5. NCID TRANSITION BACK TO RATED LICENSE ASSESSMENTS AND COHORTS To transition back to rated license assessments, the Division has created a two-year Cohort Model. All facilities are assigned to one of three cohorts based on their current rated license assessment due date. Each cohort will have a year for preparation and a year for assessment. (However, you are encouraged to begin preparations now so that you are ready when your cohort group is due!) Your child care center is due for a three-year rated license reassessment by 2/23/2025 and has been assigned to Cohort 3. The Cohort 3 Rated License Preparation Year is from 7/1/2025 – 6/30/2026. During your preparation year, if you are interested in having the Environment Rating Scales completed, review the ITERS-R and ECERS-R by obtaining the manuals for each classroom and looking for assessment related resources at ncrlap.org. Request technical assistance and training for your staff from Children & Youth Partnership for Dare County. You can request and complete an ITERS-R and ECERS-R during your preparation year. If your scores help you meet or exceed your current star rating and you are ready to move forward with your rated license assessment, you may choose to do so during your preparation year. Your preparation year is also the time to continue to work on staff education and ensure that Works accounts are completed and up to date for staff members. Look at options to help staff earn the NC Early Childhood Credential (NCECC): completing EDU 119, applying for Early Educator Certification, completing and passing the new NCECC Equivalency Exam option available on Moodle. Encourage staff with the NCECC to enroll in additional college coursework to increase points in Education. TEACH Scholarships are available to help staff pay for educational expenses. Go to https://www.childcareservices.org/programs/teach-north-carolina/ . The Cohort 3 Rated License Assessment Year is from 7/1/2026 – 6/30/2027. During your assessment year you may choose to complete the ITERS-R and ECERS-R again at no cost even if you completed them during your preparation year. Use the feedback from your preparation year scores to create a plan to improve your scores. During this year, all education needs to be posted in Works. At some point during that year, you will have your rated license assessed. Technical Assistance to Improve ITERS-R Scores The website for the NC Rated License Assessment Project (NCRLAP), www.ncrlap.org , has a wealth of resources and training opportunities to help you intentionally prepare for your upcoming ITERS-R assessment. From the main webpage, you can access self-assessment tools to review each subscale in detail and determine how you can make improvements in each area. See “Thinking More About Space and Furnishing,” “Thinking More About Personal Care Routines,” “Thinking More About Language and Interactions,” “Thinking More About Activities,” and “Thinking More About Program Structure.” Taking the time to work through these activities with your staff and using that self-reflection to purchase materials, rearrange your classrooms, work on interactions, improve daily routines, etc. will help you improve your environment and your scores. Also check out the training options under the training tab. Trainings are both self-guided and live (virtual). You and your staff can earn training credit for participating in these trainings. In December 2021, you completed the modified ECERS-R and ITERS-R and scored lowest on Subscale 4: Activities of the ITERS-R. Review the following and consider ways to improve your scores. Item 14: Using books – Providing children, even toddlers and two’s, with intact books without torn or marked pages helps to promote the message that books are meant for looking at and reading and not for handling roughly. For this age of children, provide sturdy hard books, cloth books, or vinyl books that this age group can handle. Of course, close supervision is important and reading with children one-on-one to model how to enjoy a book without damaging it. Item 16: Active physical play – Accessing the playground from Spaces 1 and 2 involves walking through part of Space 3, through a gate and out the back door to the playground; therefore, the playground is not easily accessible for infants, toddlers, and two’s in Spaces 1 and 2. This item is out of your control. However, even though NC Child Care Requirements only require 30 minutes of outdoor time for infants and toddlers, the ITERS-R at the 5 point level requires at least 60 minutes. Develop a schedule that provides at least 60 minutes of outdoor time. Because you do not have a separate play space for infants and toddlers, remember that grouping requirements do not allow infants to be grouped with children older than one years of age. Children one-year of age may not be grouped with children older than two years of age so separate schedules for playground use will be needed. Item 17: Art – Providing even infants and toddlers with art materials, e.g., chunky crayons and paper, fingerpaints, chunky brushes and paint, gives them an opportunity to make marks on paper with their own hands, experiment with colors, develop hand/eye coordination, etc. Limiting them to coloring pages does not allow for creative expression. Item 18: Music and movement – Music in all classrooms should be used for a purpose and not played all day long. It is appropriate at group time for music and movement or singing songs and fingerplays. Soothing music is appropriate at naptime to help children relax and drift off to sleep. Playing music or the radio all day can be overstimulating for young children, distracts them from their play, and may make it difficult for them to hear the nuances of language and vocabulary as they develop language skills. Item 19: Blocks – Providing infants and toddlers with a space for block play allows them to build structures without other children walking through the space and possibly knocking them down. Your space for infants and toddlers is tight with much space taken up by cribs. Look at other arrangements for the activity areas to provide a dedicated space for block play. Item 20: Dramatic play – When toddlers are grouped with infants, they need to have appropriate dramatic play materials for their developmental age. This includes dress-up clothes, child-sized house furniture, cooking/eating equipment (pots and pans, dishes, spoons), play foods, dolls, doll furnishings, soft animals, small play buildings with accessories, toy telephones. Toddlers need to have at least two examples of at least seven of the nine categories listed. In addition, toddlers should be provided with child-sized furnishings such as a toddler-sized couch and soft chair, toddler size table for kitchen play. This item may be difficult for you to meet because of the small area in Space 1. Item 22: Nature/science – All children need to have daily experiences with nature. The outdoor playground has wood chips for resilient surfacing and artificial grass on the rest of the playground. Consider adding some planters with flowers or even vegetables (non-toxic, of course!). All classes could have the opportunity to plant and care for them. Add some bird feeders and birdhouses to attract wild birds to observe and talk about. Talk about the sun and wind and rain. It doesn’t have to be a weather report at group time; it can be casual discussion about the weather. Item 24: Promoting acceptance of diversity – Add materials, books and pictures that reflect a range of diversity that are easily accessible to the infants and toddlers daily. At least ten examples are required in at least for of the five categories of diversity: race, cultures, ages, abilities, and gender. Since dolls are required in Item 5.2, for materials think of having puppets, foreign play food, foreign dress-up materials, world music, etc. In 2020, you scored second lowest on Subscale 5: Interaction. Look at the following and consider ways to improve your scores: Interaction – Item 25: Supervision of play and learning – Close supervision for infants, toddlers and two’s requires staff to position themselves in the classroom to be able to always see and hear children to prevent injuries and typical toddler/two disputes/biting. When on the floor with children, find a spot where you can view the classroom and see all the children. Circulate throughout the space to provide guidance and assist with play materials. This age group learns about their world by putting things in their mouth. Remain close to children when they are eating and when using art materials. Work with staff to maintain communication so that they are aware of each other’s responsibilities. When one is diapering the other maintains visual supervision of the rest of the classroom. Item 26: Peer interaction – Even with toddlers and two’s, staff need to work with children to develop positive peer interactions. It’s one thing to handle typical disputes that involve pushing or hitting, but it is important to “model” how to play together, learn to share take turns. P. White, Healthy Behaviors Specialist, and W. Dickenson, Birth – Two Quality Initiative Specialist with Albemarle Alliance for Children and Families (AACF) are available at your request to provide training on working with infants, toddlers and two’s. Contact them at (252) 333-3205. Item 27: Staff-child interaction - Children need to be cared for in a nurturing manner based upon their individual needs. If a child is tired and cranky, give them a space to sleep even if it’s not naptime. If a child is hungry and cranky, give them something to eat even if it’s not meal or snack time. Responding to a child’s individual needs gives them a safe space to feel loved and nurtured. Item 28: Discipline – Again, children need to be cared for in a nurturing manner based upon their individual needs. At this age, effective discipline and guidance policies are geared towards setting up your environment to avoid conflict. Have duplicates of popular toys. Allow children time to play with favorite toys so that can interact with it without being disturbed from other children. Respond quickly to problems such as crying, fighting, hitting, pushing. Good lesson planning helps children transition from one activity to another and know what is next. 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 .0803 · Violation

Name of Operation: EAST COAST EARLY LEARNING ACADEMY Facility ID: 28000275 Consultant: MARJORIE WHITE Operation Type: Center Case Number: Visit Date: 8/21/2023 Number Present: 27 Completed Date: 8/21/2023 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced * The purpose of today’s Routine Unannounced visit was to monitor compliance with applicable child care requirements. Last Annual Compliance visit – 5/24/2023 Last Sanitation Inspection – 12/14/2022 with Superior Rating; expires 12/14/2023 Last Fire Inspection – 2/4/2023 with Satisfactory rating; approved for daytime only; expires 2/4/2024 *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. 18-month compliance history from 2/19/2022 – 8/18/2023 = 97% D. Titus-Johnson, Administrator, was present and assisted me with the visit. The facility currently operates with a Five-Star Center License, issued 2/23/2022, earning points in the following components: Program (6 PTS) + Education (6 PTS) + Quality Point (1 PT) = 13 Points = 5 Stars *Quality Point met and remains in effect: Staff benefits and an infrastructure of parent involvement The program was also monitored for compliance with implementing an approved curriculum (Creative Curriculum 5th edition) as required for all four and five star facilities where four-year old children are enrolled. The next rated license assessment is due by 2/23/2025. See below for more information about the Division’s plan to return to rated license assessments. This facility is owned by East Coast Academies, Inc. According to the NC Secretary of State's website, this corporation is current and active as of 8/18/2023. Please contact me prior to any information change regarding the ownership of this facility. Facility contact information and license information were current. Contact me to make any changes to address, phone, or email or to request changes to the license. I monitored the classrooms and spaces used for child care, kitchen, and outdoor play area for applicable child care center requirements using the Child Care Center Requirements, effective 7/1/2023 and Item Number Listing, effective 6/2022. I monitored four staff records and all program records. The facility does not offer transportation. Center Observations: Parent information was posted at the entrance. Documentation of arrival and departure was available. Two infants and two toddlers were playing in Space 1. The younger infant was playing with toys in the bouncy seat while the older infant crawled on the mat and played with toys. The teacher later held the smaller infant and played with him. The two toddlers played with the different types of rain sticks while the teacher talked to them about the sounds and the colors. The children, twenty months through from Space 2 and Space 3 were outdoors. It was hot, but the shade structure provided relief from the sun. They played on the portable climber and in the dramatic play houses. When they returned indoors, they used the bathroom and washed their hands. Both groups engaged in indoor free play while the teachers assisted and supervised. Lunch was fish sticks, carrots, mandarin oranges, and milk. After lunch children rested on linen-covered cots. Documentation of safe sleep checks was available for the infants. I observed and documented the following violations during today’s visit. Violation Number Comment Rule 318 Children between 12 and 24 months of age were grouped with children 3 years of age or older. Group 2, that included seven children, twenty months through two years of age, was on the playground at the same time as Group 3, that included sixteen children, three through five years of age. 10A NCAC 09 .0713(a)(6) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In Space 1, Aquaphor was administered to a child without a completed medication permission form. A medication permission form for a diaper cream reflected the incorrect name of the diaper cream, Butt Paste instead of Triple Paste. A medication permission form for Desitin did not include the one year authorization dates or the specific amount to be applied. In Space 2, a medication permission form for Beaudreaux's Buttpaste did not specify the amount of diaper cream to be applied. 10A NCAC 09 .0803(1)(a & b) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. A staff person completed five of eight required on-going training hours by the due date, June 14, 2023 and was short three hours of on-going training. .1103(a) * 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 D. Titus-Johnson, Administrator. We reviewed the visit summary and violation(s) documented during today’s visit. Correct these immediately. Send evidence of correction to me so that I receive it no later than 9/5/2023. The compliance verification letter needs to state the facility name and license number and list each violation by Item # and describe in detail when and how each violation has been corrected. Also include the following documents/pictures to verify compliance: copies of training certificates and on-going training log for D. Swain. Send compliance verification letter in an email from the center’s official email address, heidi.riden@ecelearningacademy.com to my email address, Marjorie.White@dhhs.nc.gov. If sent from another email address, the center’s official address must be Cc’d in the compliance email. You may include the compliance verification as an attachment or in the body of the email. If sufficient information is not received by the due date, a follow-up visit may be conducted. *I will email a sample compliance verification letter to you. *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. A violation was documented that requires a follow-up visit. An unannounced visit will be made soon to verify correction. 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 or Jennifer.Linhardt@dhhs.nc.gov. TECHNICAL ASSISTANCE WITH DOCUMENTED VIOLATIONS: Grouping – Providing separate spaces indoors and outdoors for toddlers, 12 – 24 months, gives them the opportunity to safely explore and engage with their environment without having older, bigger children interfering with their play and possibly harming them due to their size and their higher levels of energy. Today, Group 2 and Group 3 were on the playground at the same time. Group 2 had seven (7) children, twenty months through two years of age, with two staff persons. Group 3 had sixteen children, three through five years of age, with two staff persons. The playground is one large space and does not have a separate space for younger children. You stated that a teacher called out today, causing you to be short-staffed. You thought having both groups go outdoors at the same time would make it easier because there were only 23 children outside. You forgot that one of the children in Group 2 was under two years of age. Except for the first and last operating hour of the day, infants can be routinely grouped with children younger than twenty-four months but may not be grouped with children two years of age and older. Children between twelve months and twenty-four months can be grouped with infants and children two years of age but may not be grouped with children three years of age and older. All children may be grouped during the first and last hour of the operating day if staff/child ratios and group size are maintained for the youngest child present. Today, Group 2 had nine children present, three toddlers and six children, two years of age. You moved two toddlers back to the infant room because there were only two babies present today. You could have also moved a two-year old up to the preschool class (16 children present) and still have been within staff/child ratio for a two-year (1:9 or 2:18). At naptime, you moved the oldest two-year old over to the preschool classroom. I encourage you to review NC Child Care Requirements related to staff/child ratios – 10A NCAC 09 .0718 so that when you are short-staffed, you can regroup children to maintain staff/child ratios and grouping requirements, allowing you as the administrator to float, do administrative duties and cook when needed. While regrouping is not the best option for children who need the stability of their teacher, friends and classroom but it is an option to use occasionally. Also ensure that Groups 1, 2, and 3 all have separate outdoor times scheduled. Medication Permission Forms - Medication permission forms provide information that could be critical to the administration of the medication and the care of the child and verify that the parent has authorized use of the medication for their child. Even topical medications such as diaper cream or sunscreen need to have completed medication forms to ensure that you are applying it how the parent expects you. MS (Space 1) – Has Aquaphor to be applied to his face but no medication permission form available *MS (Space 1) – Name of diaper cream on medication permission form is listed as Butt Paste but name of diaper cream observed is Triple Paste. *LM (Space 1) – Dates to apply Desitin is 7/10/23 with no expiration date; amount to be applied is not listed. *AR (Space 2) - Amount of Boudreaux’s Butt Paste to be applied is not listed. The medication permission forms must include the specific name of the medication. (Coppertone Baby vs. Sunscreen. Cutter Bug Repellant vs. Bug Spray. Albuterol vs. Inhaler). Medication permission forms are valid for a defined length of time and must be updated, if needed. I shared a Medication Flyer with this information. I encourage you to review the section in the NC Child Care Requirements on medication: 10A NCAC 09 .0803 Administering Medication in Child Care Centers and review with your staff. Determine who is responsible for receiving and reviewing medication and medication permission forms and checking them frequently to verify that they are current and complete. On-going Training – On-going training and professional development provides early learning staff opportunities to learn new skills and/or refresh previously learned skills. During your Annual Compliance visit on 5/24/2023, I monitored on-going training for staff. The following staff needed to complete the listed number of on-going training hours by 6/15/2023. D. Swain needed 3 hours K. Ellington needed 3 hours Today, I monitored their on-going training for the additional hours but the required number of hours for one of the staff persons was not available. D. Swain needs 3 hours by 9/5/2023 and 8 hours by 5/24/2024. (Her ITS/SIDS certification expires 10/20/2023 so she may want to complete that training for 1.5 to 2 hours of on-going training.) K. Ellington completed the required number of on-going training hours. All staff need to complete On-going Training Logs and attach their certificates to the log You stated that due to staffing issues, you have not been able to follow up with them to ensure they completed the required number of hours. Planning for on-going training as part of the annual Professional Development Plan helps the administrator and staff person map out completion of on-going training for the upcoming year. On-going training is tracked from Annual Compliance visit to the one year anniversary. Have D. Swain complete the remaining on-going training by 9/5/2023. Send copies of her training certificates and her completed On-going Training Logs with your compliance letter. Review Row 18 (# hours to carry over) on the Staff Worksheets to determine how many on-going training hours other staff will need by 5/24/2024 (anniversary of your last Annual Compliance visit). *The Health and Safety Training available on Moodle on the DCDEE website and other free trainings can also be used to help staff meet on-going training hours. *Also available on Moodle is a training course on Supporting Children and Families Experiencing Homelessness. *NITTO – New Infant Toddler Teacher Orientation – 14 hours on Moodle *Trainings on the environment rating scales that count as on-going training hours are available on the NC Rated License Assessment Project (NCRLAP), www.ncrlap.org *ECE college coursework or coursework leading to an ECE degree counts towards on-going training hours. Each semester credit counts as 16 hours so a 3-credit classes also earns 48 hours of on-going training. *Check with your local Child Care Resource & Referral for available training. *The following offer on-line training opportunities at reasonable prices and accessible at times for your busy schedules: Southwestern Child Development Commission, www.swcdcinc.org – offers individual and group packages also ProSolutions courses are still available for a fee – offers individual and group packages also *Use the On-going Training Log to document training annually. Attach copies of certificates. GENERAL VISIT INFORMATION: Be knowledgeable of the child care laws and rules and environmental health rules; review them with your staff and assist them with understanding and implementing them to maintain compliance and keep children safe and healthy. The most recent versions of child care laws and rules (updated 7/1/23) and environmental health rules (updated 7/1/23) in North Carolina, the Items Number Listing (can be used as a detailed checklist of required items) and What’s New information are available on the DCDEE website, www.ncchildcare.ncdhhs.gov. Check the designated facility email at least weekly to stay current with communication and email blasts from DCDEE. If your email is not the facility email, sign up for email blasts on the What’s New page for general information and communication from DCDEE. Your local and regional Smart Start Partnerships and Child Care Resource and Referral Agencies are available to assist you with technical assistance and training on a multitude of topics including but not limited to: Environment Rating Scales, infant/toddler practices, healthy behaviors and classroom management, developmentally appropriate practice, EPR plans, activity plans, NC Foundations for Early Learning (developmental domains), etc. 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. *Children & Youth Partnership for Dare County: Phone - (252) 441-0614; website - www.darekids.org. *Albemarle Alliance for Children and Families (AACF) and Region 1 Child Care Resource and Referral: Phone (252) 333-1233; website - www.aacfnc.org . REMINDERS: 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. *Encourage staff to maintain copies of all initial hire documents, Qualifying Letters, training certificates, etc. in their own professional file maintained at home. *Make it easier on yourself and schedule annual updates for staff evaluations, professional development plans, health questionnaires, emergency information forms, and EPR plan and Emergency Medical Care Plan at the same time to streamline your staff updates. *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 and Five (5) Year Cycle Tracking Requirements – Review Row 17 on Staff Worksheet for staff members needing initial H&S Training or five-year renewal. New staff are required to complete Health & Safety Training (H&S Training) within one year of hire (CPR/First Aid and Recognizing and Responding to Suspicions of Child Maltreatment within 3 months of hire) and then complete training in all topic areas every five years. *Numerous staff were due for are due for CPR/First Aid Training this year. Look at Row 19 on the Staff Training Worksheet to schedule CPR/First Aid training before it expires. *C. Martin needed to complete Medication Administration to close out H&S Training by 11/14/23 *E. Dosaeva – due 7/31/2024; Recognizing and Responding to Suspicions of Child Maltreatment due 10/31/2024 Moodle Support - 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. Emergency Preparedness and Response (EPR) Requirements, Emergency Medical Care Plan (EMCP) and Ready-to-Go File – Your Emergency Preparedness and Response (EPR) Plan needs to be reviewed and updated annually in the Emergency Management Portal. You have reviewed the hard copy in 2023 but have not updated in the portal since August 2021. *Log into the Emergency Management Portal on the DCDEE website -> Provider tab -> Emergency Preparedness and Response -> Emergency Management Portal -> Log in using NCID used to create or update EPR Plan. Review EPR Plan and update as needed. Document review date on page 28. If changes are needed, print the plan up to page 29. If no changes are needed, print page 28 with the review date reflected. Review annually with staff and during orientation with new staff. Use this time to also review and update Emergency Medical Care Plan and review with staff also. * If you have questions, or need assistance with accessing your EPR Plan contact Amia M. Eaton, Training and Program Development Consultant Amia.Eaton@dhhs.nc.gov *Use this time to also review and update Emergency Medical Care Plan (EMCP) and review with staff also. Ensure that at least one person listed on the EMCP is always on-site. *Also update your Ready-to-Go File to include new students, remove former students, and add updated medication information. (Make sure a copy of the Child’s Application for Enrollment is added to the R2G File when a new child starts, or the application is updated.) ADDITIONAL COMMENTS: I shared information on the following topics: 1. Annual Licensing Fee 2. Environmental Health Rules Update 3. New Rules – July 2023 – enhanced outdoor space, cooperative arrangements, multi-age grouping 4. NC Rated License Assessment Project (NCRLAP) Resources 5. NCID TRANSITION BACK TO RATED LICENSE ASSESSMENTS AND COHORTS To transition back to rated license assessments, the Division has created a two-year Cohort Model. All facilities are assigned to one of three cohorts based on their current rated license assessment due date. Each cohort will have a year for preparation and a year for assessment. (However, you are encouraged to begin preparations now so that you are ready when your cohort group is due!) Your child care center is due for a three-year rated license reassessment by 2/23/2025 and has been assigned to Cohort 3. The Cohort 3 Rated License Preparation Year is from 7/1/2025 – 6/30/2026. During your preparation year, if you are interested in having the Environment Rating Scales completed, review the ITERS-R and ECERS-R by obtaining the manuals for each classroom and looking for assessment related resources at ncrlap.org. Request technical assistance and training for your staff from Children & Youth Partnership for Dare County. You can request and complete an ITERS-R and ECERS-R during your preparation year. If your scores help you meet or exceed your current star rating and you are ready to move forward with your rated license assessment, you may choose to do so during your preparation year. Your preparation year is also the time to continue to work on staff education and ensure that Works accounts are completed and up to date for staff members. Look at options to help staff earn the NC Early Childhood Credential (NCECC): completing EDU 119, applying for Early Educator Certification, completing and passing the new NCECC Equivalency Exam option available on Moodle. Encourage staff with the NCECC to enroll in additional college coursework to increase points in Education. TEACH Scholarships are available to help staff pay for educational expenses. Go to https://www.childcareservices.org/programs/teach-north-carolina/ . The Cohort 3 Rated License Assessment Year is from 7/1/2026 – 6/30/2027. During your assessment year you may choose to complete the ITERS-R and ECERS-R again at no cost even if you completed them during your preparation year. Use the feedback from your preparation year scores to create a plan to improve your scores. During this year, all education needs to be posted in Works. At some point during that year, you will have your rated license assessed. Technical Assistance to Improve ITERS-R Scores The website for the NC Rated License Assessment Project (NCRLAP), www.ncrlap.org , has a wealth of resources and training opportunities to help you intentionally prepare for your upcoming ITERS-R assessment. From the main webpage, you can access self-assessment tools to review each subscale in detail and determine how you can make improvements in each area. See “Thinking More About Space and Furnishing,” “Thinking More About Personal Care Routines,” “Thinking More About Language and Interactions,” “Thinking More About Activities,” and “Thinking More About Program Structure.” Taking the time to work through these activities with your staff and using that self-reflection to purchase materials, rearrange your classrooms, work on interactions, improve daily routines, etc. will help you improve your environment and your scores. Also check out the training options under the training tab. Trainings are both self-guided and live (virtual). You and your staff can earn training credit for participating in these trainings. In December 2021, you completed the modified ECERS-R and ITERS-R and scored lowest on Subscale 4: Activities of the ITERS-R. Review the following and consider ways to improve your scores. Item 14: Using books – Providing children, even toddlers and two’s, with intact books without torn or marked pages helps to promote the message that books are meant for looking at and reading and not for handling roughly. For this age of children, provide sturdy hard books, cloth books, or vinyl books that this age group can handle. Of course, close supervision is important and reading with children one-on-one to model how to enjoy a book without damaging it. Item 16: Active physical play – Accessing the playground from Spaces 1 and 2 involves walking through part of Space 3, through a gate and out the back door to the playground; therefore, the playground is not easily accessible for infants, toddlers, and two’s in Spaces 1 and 2. This item is out of your control. However, even though NC Child Care Requirements only require 30 minutes of outdoor time for infants and toddlers, the ITERS-R at the 5 point level requires at least 60 minutes. Develop a schedule that provides at least 60 minutes of outdoor time. Because you do not have a separate play space for infants and toddlers, remember that grouping requirements do not allow infants to be grouped with children older than one years of age. Children one-year of age may not be grouped with children older than two years of age so separate schedules for playground use will be needed. Item 17: Art – Providing even infants and toddlers with art materials, e.g., chunky crayons and paper, fingerpaints, chunky brushes and paint, gives them an opportunity to make marks on paper with their own hands, experiment with colors, develop hand/eye coordination, etc. Limiting them to coloring pages does not allow for creative expression. Item 18: Music and movement – Music in all classrooms should be used for a purpose and not played all day long. It is appropriate at group time for music and movement or singing songs and fingerplays. Soothing music is appropriate at naptime to help children relax and drift off to sleep. Playing music or the radio all day can be overstimulating for young children, distracts them from their play, and may make it difficult for them to hear the nuances of language and vocabulary as they develop language skills. Item 19: Blocks – Providing infants and toddlers with a space for block play allows them to build structures without other children walking through the space and possibly knocking them down. Your space for infants and toddlers is tight with much space taken up by cribs. Look at other arrangements for the activity areas to provide a dedicated space for block play. Item 20: Dramatic play – When toddlers are grouped with infants, they need to have appropriate dramatic play materials for their developmental age. This includes dress-up clothes, child-sized house furniture, cooking/eating equipment (pots and pans, dishes, spoons), play foods, dolls, doll furnishings, soft animals, small play buildings with accessories, toy telephones. Toddlers need to have at least two examples of at least seven of the nine categories listed. In addition, toddlers should be provided with child-sized furnishings such as a toddler-sized couch and soft chair, toddler size table for kitchen play. This item may be difficult for you to meet because of the small area in Space 1. Item 22: Nature/science – All children need to have daily experiences with nature. The outdoor playground has wood chips for resilient surfacing and artificial grass on the rest of the playground. Consider adding some planters with flowers or even vegetables (non-toxic, of course!). All classes could have the opportunity to plant and care for them. Add some bird feeders and birdhouses to attract wild birds to observe and talk about. Talk about the sun and wind and rain. It doesn’t have to be a weather report at group time; it can be casual discussion about the weather. Item 24: Promoting acceptance of diversity – Add materials, books and pictures that reflect a range of diversity that are easily accessible to the infants and toddlers daily. At least ten examples are required in at least for of the five categories of diversity: race, cultures, ages, abilities, and gender. Since dolls are required in Item 5.2, for materials think of having puppets, foreign play food, foreign dress-up materials, world music, etc. In 2020, you scored second lowest on Subscale 5: Interaction. Look at the following and consider ways to improve your scores: Interaction – Item 25: Supervision of play and learning – Close supervision for infants, toddlers and two’s requires staff to position themselves in the classroom to be able to always see and hear children to prevent injuries and typical toddler/two disputes/biting. When on the floor with children, find a spot where you can view the classroom and see all the children. Circulate throughout the space to provide guidance and assist with play materials. This age group learns about their world by putting things in their mouth. Remain close to children when they are eating and when using art materials. Work with staff to maintain communication so that they are aware of each other’s responsibilities. When one is diapering the other maintains visual supervision of the rest of the classroom. Item 26: Peer interaction – Even with toddlers and two’s, staff need to work with children to develop positive peer interactions. It’s one thing to handle typical disputes that involve pushing or hitting, but it is important to “model” how to play together, learn to share take turns. P. White, Healthy Behaviors Specialist, and W. Dickenson, Birth – Two Quality Initiative Specialist with Albemarle Alliance for Children and Families (AACF) are available at your request to provide training on working with infants, toddlers and two’s. Contact them at (252) 333-3205. Item 27: Staff-child interaction - Children need to be cared for in a nurturing manner based upon their individual needs. If a child is tired and cranky, give them a space to sleep even if it’s not naptime. If a child is hungry and cranky, give them something to eat even if it’s not meal or snack time. Responding to a child’s individual needs gives them a safe space to feel loved and nurtured. Item 28: Discipline – Again, children need to be cared for in a nurturing manner based upon their individual needs. At this age, effective discipline and guidance policies are geared towards setting up your environment to avoid conflict. Have duplicates of popular toys. Allow children time to play with favorite toys so that can interact with it without being disturbed from other children. Respond quickly to problems such as crying, fighting, hitting, pushing. Good lesson planning helps children transition from one activity to another and know what is next. 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: EAST COAST EARLY LEARNING ACADEMY Facility ID: 28000275 Consultant: MARJORIE WHITE Operation Type: Center Case Number: Visit Date: 8/21/2023 Number Present: 27 Completed Date: 8/21/2023 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced * The purpose of today’s Routine Unannounced visit was to monitor compliance with applicable child care requirements. Last Annual Compliance visit – 5/24/2023 Last Sanitation Inspection – 12/14/2022 with Superior Rating; expires 12/14/2023 Last Fire Inspection – 2/4/2023 with Satisfactory rating; approved for daytime only; expires 2/4/2024 *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. 18-month compliance history from 2/19/2022 – 8/18/2023 = 97% D. Titus-Johnson, Administrator, was present and assisted me with the visit. The facility currently operates with a Five-Star Center License, issued 2/23/2022, earning points in the following components: Program (6 PTS) + Education (6 PTS) + Quality Point (1 PT) = 13 Points = 5 Stars *Quality Point met and remains in effect: Staff benefits and an infrastructure of parent involvement The program was also monitored for compliance with implementing an approved curriculum (Creative Curriculum 5th edition) as required for all four and five star facilities where four-year old children are enrolled. The next rated license assessment is due by 2/23/2025. See below for more information about the Division’s plan to return to rated license assessments. This facility is owned by East Coast Academies, Inc. According to the NC Secretary of State's website, this corporation is current and active as of 8/18/2023. Please contact me prior to any information change regarding the ownership of this facility. Facility contact information and license information were current. Contact me to make any changes to address, phone, or email or to request changes to the license. I monitored the classrooms and spaces used for child care, kitchen, and outdoor play area for applicable child care center requirements using the Child Care Center Requirements, effective 7/1/2023 and Item Number Listing, effective 6/2022. I monitored four staff records and all program records. The facility does not offer transportation. Center Observations: Parent information was posted at the entrance. Documentation of arrival and departure was available. Two infants and two toddlers were playing in Space 1. The younger infant was playing with toys in the bouncy seat while the older infant crawled on the mat and played with toys. The teacher later held the smaller infant and played with him. The two toddlers played with the different types of rain sticks while the teacher talked to them about the sounds and the colors. The children, twenty months through from Space 2 and Space 3 were outdoors. It was hot, but the shade structure provided relief from the sun. They played on the portable climber and in the dramatic play houses. When they returned indoors, they used the bathroom and washed their hands. Both groups engaged in indoor free play while the teachers assisted and supervised. Lunch was fish sticks, carrots, mandarin oranges, and milk. After lunch children rested on linen-covered cots. Documentation of safe sleep checks was available for the infants. I observed and documented the following violations during today’s visit. Violation Number Comment Rule 318 Children between 12 and 24 months of age were grouped with children 3 years of age or older. Group 2, that included seven children, twenty months through two years of age, was on the playground at the same time as Group 3, that included sixteen children, three through five years of age. 10A NCAC 09 .0713(a)(6) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In Space 1, Aquaphor was administered to a child without a completed medication permission form. A medication permission form for a diaper cream reflected the incorrect name of the diaper cream, Butt Paste instead of Triple Paste. A medication permission form for Desitin did not include the one year authorization dates or the specific amount to be applied. In Space 2, a medication permission form for Beaudreaux's Buttpaste did not specify the amount of diaper cream to be applied. 10A NCAC 09 .0803(1)(a & b) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. A staff person completed five of eight required on-going training hours by the due date, June 14, 2023 and was short three hours of on-going training. .1103(a) * 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 D. Titus-Johnson, Administrator. We reviewed the visit summary and violation(s) documented during today’s visit. Correct these immediately. Send evidence of correction to me so that I receive it no later than 9/5/2023. The compliance verification letter needs to state the facility name and license number and list each violation by Item # and describe in detail when and how each violation has been corrected. Also include the following documents/pictures to verify compliance: copies of training certificates and on-going training log for D. Swain. Send compliance verification letter in an email from the center’s official email address, heidi.riden@ecelearningacademy.com to my email address, Marjorie.White@dhhs.nc.gov. If sent from another email address, the center’s official address must be Cc’d in the compliance email. You may include the compliance verification as an attachment or in the body of the email. If sufficient information is not received by the due date, a follow-up visit may be conducted. *I will email a sample compliance verification letter to you. *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. A violation was documented that requires a follow-up visit. An unannounced visit will be made soon to verify correction. 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 or Jennifer.Linhardt@dhhs.nc.gov. TECHNICAL ASSISTANCE WITH DOCUMENTED VIOLATIONS: Grouping – Providing separate spaces indoors and outdoors for toddlers, 12 – 24 months, gives them the opportunity to safely explore and engage with their environment without having older, bigger children interfering with their play and possibly harming them due to their size and their higher levels of energy. Today, Group 2 and Group 3 were on the playground at the same time. Group 2 had seven (7) children, twenty months through two years of age, with two staff persons. Group 3 had sixteen children, three through five years of age, with two staff persons. The playground is one large space and does not have a separate space for younger children. You stated that a teacher called out today, causing you to be short-staffed. You thought having both groups go outdoors at the same time would make it easier because there were only 23 children outside. You forgot that one of the children in Group 2 was under two years of age. Except for the first and last operating hour of the day, infants can be routinely grouped with children younger than twenty-four months but may not be grouped with children two years of age and older. Children between twelve months and twenty-four months can be grouped with infants and children two years of age but may not be grouped with children three years of age and older. All children may be grouped during the first and last hour of the operating day if staff/child ratios and group size are maintained for the youngest child present. Today, Group 2 had nine children present, three toddlers and six children, two years of age. You moved two toddlers back to the infant room because there were only two babies present today. You could have also moved a two-year old up to the preschool class (16 children present) and still have been within staff/child ratio for a two-year (1:9 or 2:18). At naptime, you moved the oldest two-year old over to the preschool classroom. I encourage you to review NC Child Care Requirements related to staff/child ratios – 10A NCAC 09 .0718 so that when you are short-staffed, you can regroup children to maintain staff/child ratios and grouping requirements, allowing you as the administrator to float, do administrative duties and cook when needed. While regrouping is not the best option for children who need the stability of their teacher, friends and classroom but it is an option to use occasionally. Also ensure that Groups 1, 2, and 3 all have separate outdoor times scheduled. Medication Permission Forms - Medication permission forms provide information that could be critical to the administration of the medication and the care of the child and verify that the parent has authorized use of the medication for their child. Even topical medications such as diaper cream or sunscreen need to have completed medication forms to ensure that you are applying it how the parent expects you. MS (Space 1) – Has Aquaphor to be applied to his face but no medication permission form available *MS (Space 1) – Name of diaper cream on medication permission form is listed as Butt Paste but name of diaper cream observed is Triple Paste. *LM (Space 1) – Dates to apply Desitin is 7/10/23 with no expiration date; amount to be applied is not listed. *AR (Space 2) - Amount of Boudreaux’s Butt Paste to be applied is not listed. The medication permission forms must include the specific name of the medication. (Coppertone Baby vs. Sunscreen. Cutter Bug Repellant vs. Bug Spray. Albuterol vs. Inhaler). Medication permission forms are valid for a defined length of time and must be updated, if needed. I shared a Medication Flyer with this information. I encourage you to review the section in the NC Child Care Requirements on medication: 10A NCAC 09 .0803 Administering Medication in Child Care Centers and review with your staff. Determine who is responsible for receiving and reviewing medication and medication permission forms and checking them frequently to verify that they are current and complete. On-going Training – On-going training and professional development provides early learning staff opportunities to learn new skills and/or refresh previously learned skills. During your Annual Compliance visit on 5/24/2023, I monitored on-going training for staff. The following staff needed to complete the listed number of on-going training hours by 6/15/2023. D. Swain needed 3 hours K. Ellington needed 3 hours Today, I monitored their on-going training for the additional hours but the required number of hours for one of the staff persons was not available. D. Swain needs 3 hours by 9/5/2023 and 8 hours by 5/24/2024. (Her ITS/SIDS certification expires 10/20/2023 so she may want to complete that training for 1.5 to 2 hours of on-going training.) K. Ellington completed the required number of on-going training hours. All staff need to complete On-going Training Logs and attach their certificates to the log You stated that due to staffing issues, you have not been able to follow up with them to ensure they completed the required number of hours. Planning for on-going training as part of the annual Professional Development Plan helps the administrator and staff person map out completion of on-going training for the upcoming year. On-going training is tracked from Annual Compliance visit to the one year anniversary. Have D. Swain complete the remaining on-going training by 9/5/2023. Send copies of her training certificates and her completed On-going Training Logs with your compliance letter. Review Row 18 (# hours to carry over) on the Staff Worksheets to determine how many on-going training hours other staff will need by 5/24/2024 (anniversary of your last Annual Compliance visit). *The Health and Safety Training available on Moodle on the DCDEE website and other free trainings can also be used to help staff meet on-going training hours. *Also available on Moodle is a training course on Supporting Children and Families Experiencing Homelessness. *NITTO – New Infant Toddler Teacher Orientation – 14 hours on Moodle *Trainings on the environment rating scales that count as on-going training hours are available on the NC Rated License Assessment Project (NCRLAP), www.ncrlap.org *ECE college coursework or coursework leading to an ECE degree counts towards on-going training hours. Each semester credit counts as 16 hours so a 3-credit classes also earns 48 hours of on-going training. *Check with your local Child Care Resource & Referral for available training. *The following offer on-line training opportunities at reasonable prices and accessible at times for your busy schedules: Southwestern Child Development Commission, www.swcdcinc.org – offers individual and group packages also ProSolutions courses are still available for a fee – offers individual and group packages also *Use the On-going Training Log to document training annually. Attach copies of certificates. GENERAL VISIT INFORMATION: Be knowledgeable of the child care laws and rules and environmental health rules; review them with your staff and assist them with understanding and implementing them to maintain compliance and keep children safe and healthy. The most recent versions of child care laws and rules (updated 7/1/23) and environmental health rules (updated 7/1/23) in North Carolina, the Items Number Listing (can be used as a detailed checklist of required items) and What’s New information are available on the DCDEE website, www.ncchildcare.ncdhhs.gov. Check the designated facility email at least weekly to stay current with communication and email blasts from DCDEE. If your email is not the facility email, sign up for email blasts on the What’s New page for general information and communication from DCDEE. Your local and regional Smart Start Partnerships and Child Care Resource and Referral Agencies are available to assist you with technical assistance and training on a multitude of topics including but not limited to: Environment Rating Scales, infant/toddler practices, healthy behaviors and classroom management, developmentally appropriate practice, EPR plans, activity plans, NC Foundations for Early Learning (developmental domains), etc. 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. *Children & Youth Partnership for Dare County: Phone - (252) 441-0614; website - www.darekids.org. *Albemarle Alliance for Children and Families (AACF) and Region 1 Child Care Resource and Referral: Phone (252) 333-1233; website - www.aacfnc.org . REMINDERS: 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. *Encourage staff to maintain copies of all initial hire documents, Qualifying Letters, training certificates, etc. in their own professional file maintained at home. *Make it easier on yourself and schedule annual updates for staff evaluations, professional development plans, health questionnaires, emergency information forms, and EPR plan and Emergency Medical Care Plan at the same time to streamline your staff updates. *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 and Five (5) Year Cycle Tracking Requirements – Review Row 17 on Staff Worksheet for staff members needing initial H&S Training or five-year renewal. New staff are required to complete Health & Safety Training (H&S Training) within one year of hire (CPR/First Aid and Recognizing and Responding to Suspicions of Child Maltreatment within 3 months of hire) and then complete training in all topic areas every five years. *Numerous staff were due for are due for CPR/First Aid Training this year. Look at Row 19 on the Staff Training Worksheet to schedule CPR/First Aid training before it expires. *C. Martin needed to complete Medication Administration to close out H&S Training by 11/14/23 *E. Dosaeva – due 7/31/2024; Recognizing and Responding to Suspicions of Child Maltreatment due 10/31/2024 Moodle Support - 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. Emergency Preparedness and Response (EPR) Requirements, Emergency Medical Care Plan (EMCP) and Ready-to-Go File – Your Emergency Preparedness and Response (EPR) Plan needs to be reviewed and updated annually in the Emergency Management Portal. You have reviewed the hard copy in 2023 but have not updated in the portal since August 2021. *Log into the Emergency Management Portal on the DCDEE website -> Provider tab -> Emergency Preparedness and Response -> Emergency Management Portal -> Log in using NCID used to create or update EPR Plan. Review EPR Plan and update as needed. Document review date on page 28. If changes are needed, print the plan up to page 29. If no changes are needed, print page 28 with the review date reflected. Review annually with staff and during orientation with new staff. Use this time to also review and update Emergency Medical Care Plan and review with staff also. * If you have questions, or need assistance with accessing your EPR Plan contact Amia M. Eaton, Training and Program Development Consultant Amia.Eaton@dhhs.nc.gov *Use this time to also review and update Emergency Medical Care Plan (EMCP) and review with staff also. Ensure that at least one person listed on the EMCP is always on-site. *Also update your Ready-to-Go File to include new students, remove former students, and add updated medication information. (Make sure a copy of the Child’s Application for Enrollment is added to the R2G File when a new child starts, or the application is updated.) ADDITIONAL COMMENTS: I shared information on the following topics: 1. Annual Licensing Fee 2. Environmental Health Rules Update 3. New Rules – July 2023 – enhanced outdoor space, cooperative arrangements, multi-age grouping 4. NC Rated License Assessment Project (NCRLAP) Resources 5. NCID TRANSITION BACK TO RATED LICENSE ASSESSMENTS AND COHORTS To transition back to rated license assessments, the Division has created a two-year Cohort Model. All facilities are assigned to one of three cohorts based on their current rated license assessment due date. Each cohort will have a year for preparation and a year for assessment. (However, you are encouraged to begin preparations now so that you are ready when your cohort group is due!) Your child care center is due for a three-year rated license reassessment by 2/23/2025 and has been assigned to Cohort 3. The Cohort 3 Rated License Preparation Year is from 7/1/2025 – 6/30/2026. During your preparation year, if you are interested in having the Environment Rating Scales completed, review the ITERS-R and ECERS-R by obtaining the manuals for each classroom and looking for assessment related resources at ncrlap.org. Request technical assistance and training for your staff from Children & Youth Partnership for Dare County. You can request and complete an ITERS-R and ECERS-R during your preparation year. If your scores help you meet or exceed your current star rating and you are ready to move forward with your rated license assessment, you may choose to do so during your preparation year. Your preparation year is also the time to continue to work on staff education and ensure that Works accounts are completed and up to date for staff members. Look at options to help staff earn the NC Early Childhood Credential (NCECC): completing EDU 119, applying for Early Educator Certification, completing and passing the new NCECC Equivalency Exam option available on Moodle. Encourage staff with the NCECC to enroll in additional college coursework to increase points in Education. TEACH Scholarships are available to help staff pay for educational expenses. Go to https://www.childcareservices.org/programs/teach-north-carolina/ . The Cohort 3 Rated License Assessment Year is from 7/1/2026 – 6/30/2027. During your assessment year you may choose to complete the ITERS-R and ECERS-R again at no cost even if you completed them during your preparation year. Use the feedback from your preparation year scores to create a plan to improve your scores. During this year, all education needs to be posted in Works. At some point during that year, you will have your rated license assessed. Technical Assistance to Improve ITERS-R Scores The website for the NC Rated License Assessment Project (NCRLAP), www.ncrlap.org , has a wealth of resources and training opportunities to help you intentionally prepare for your upcoming ITERS-R assessment. From the main webpage, you can access self-assessment tools to review each subscale in detail and determine how you can make improvements in each area. See “Thinking More About Space and Furnishing,” “Thinking More About Personal Care Routines,” “Thinking More About Language and Interactions,” “Thinking More About Activities,” and “Thinking More About Program Structure.” Taking the time to work through these activities with your staff and using that self-reflection to purchase materials, rearrange your classrooms, work on interactions, improve daily routines, etc. will help you improve your environment and your scores. Also check out the training options under the training tab. Trainings are both self-guided and live (virtual). You and your staff can earn training credit for participating in these trainings. In December 2021, you completed the modified ECERS-R and ITERS-R and scored lowest on Subscale 4: Activities of the ITERS-R. Review the following and consider ways to improve your scores. Item 14: Using books – Providing children, even toddlers and two’s, with intact books without torn or marked pages helps to promote the message that books are meant for looking at and reading and not for handling roughly. For this age of children, provide sturdy hard books, cloth books, or vinyl books that this age group can handle. Of course, close supervision is important and reading with children one-on-one to model how to enjoy a book without damaging it. Item 16: Active physical play – Accessing the playground from Spaces 1 and 2 involves walking through part of Space 3, through a gate and out the back door to the playground; therefore, the playground is not easily accessible for infants, toddlers, and two’s in Spaces 1 and 2. This item is out of your control. However, even though NC Child Care Requirements only require 30 minutes of outdoor time for infants and toddlers, the ITERS-R at the 5 point level requires at least 60 minutes. Develop a schedule that provides at least 60 minutes of outdoor time. Because you do not have a separate play space for infants and toddlers, remember that grouping requirements do not allow infants to be grouped with children older than one years of age. Children one-year of age may not be grouped with children older than two years of age so separate schedules for playground use will be needed. Item 17: Art – Providing even infants and toddlers with art materials, e.g., chunky crayons and paper, fingerpaints, chunky brushes and paint, gives them an opportunity to make marks on paper with their own hands, experiment with colors, develop hand/eye coordination, etc. Limiting them to coloring pages does not allow for creative expression. Item 18: Music and movement – Music in all classrooms should be used for a purpose and not played all day long. It is appropriate at group time for music and movement or singing songs and fingerplays. Soothing music is appropriate at naptime to help children relax and drift off to sleep. Playing music or the radio all day can be overstimulating for young children, distracts them from their play, and may make it difficult for them to hear the nuances of language and vocabulary as they develop language skills. Item 19: Blocks – Providing infants and toddlers with a space for block play allows them to build structures without other children walking through the space and possibly knocking them down. Your space for infants and toddlers is tight with much space taken up by cribs. Look at other arrangements for the activity areas to provide a dedicated space for block play. Item 20: Dramatic play – When toddlers are grouped with infants, they need to have appropriate dramatic play materials for their developmental age. This includes dress-up clothes, child-sized house furniture, cooking/eating equipment (pots and pans, dishes, spoons), play foods, dolls, doll furnishings, soft animals, small play buildings with accessories, toy telephones. Toddlers need to have at least two examples of at least seven of the nine categories listed. In addition, toddlers should be provided with child-sized furnishings such as a toddler-sized couch and soft chair, toddler size table for kitchen play. This item may be difficult for you to meet because of the small area in Space 1. Item 22: Nature/science – All children need to have daily experiences with nature. The outdoor playground has wood chips for resilient surfacing and artificial grass on the rest of the playground. Consider adding some planters with flowers or even vegetables (non-toxic, of course!). All classes could have the opportunity to plant and care for them. Add some bird feeders and birdhouses to attract wild birds to observe and talk about. Talk about the sun and wind and rain. It doesn’t have to be a weather report at group time; it can be casual discussion about the weather. Item 24: Promoting acceptance of diversity – Add materials, books and pictures that reflect a range of diversity that are easily accessible to the infants and toddlers daily. At least ten examples are required in at least for of the five categories of diversity: race, cultures, ages, abilities, and gender. Since dolls are required in Item 5.2, for materials think of having puppets, foreign play food, foreign dress-up materials, world music, etc. In 2020, you scored second lowest on Subscale 5: Interaction. Look at the following and consider ways to improve your scores: Interaction – Item 25: Supervision of play and learning – Close supervision for infants, toddlers and two’s requires staff to position themselves in the classroom to be able to always see and hear children to prevent injuries and typical toddler/two disputes/biting. When on the floor with children, find a spot where you can view the classroom and see all the children. Circulate throughout the space to provide guidance and assist with play materials. This age group learns about their world by putting things in their mouth. Remain close to children when they are eating and when using art materials. Work with staff to maintain communication so that they are aware of each other’s responsibilities. When one is diapering the other maintains visual supervision of the rest of the classroom. Item 26: Peer interaction – Even with toddlers and two’s, staff need to work with children to develop positive peer interactions. It’s one thing to handle typical disputes that involve pushing or hitting, but it is important to “model” how to play together, learn to share take turns. P. White, Healthy Behaviors Specialist, and W. Dickenson, Birth – Two Quality Initiative Specialist with Albemarle Alliance for Children and Families (AACF) are available at your request to provide training on working with infants, toddlers and two’s. Contact them at (252) 333-3205. Item 27: Staff-child interaction - Children need to be cared for in a nurturing manner based upon their individual needs. If a child is tired and cranky, give them a space to sleep even if it’s not naptime. If a child is hungry and cranky, give them something to eat even if it’s not meal or snack time. Responding to a child’s individual needs gives them a safe space to feel loved and nurtured. Item 28: Discipline – Again, children need to be cared for in a nurturing manner based upon their individual needs. At this age, effective discipline and guidance policies are geared towards setting up your environment to avoid conflict. Have duplicates of popular toys. Allow children time to play with favorite toys so that can interact with it without being disturbed from other children. Respond quickly to problems such as crying, fighting, hitting, pushing. Good lesson planning helps children transition from one activity to another and know what is next. 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