NC GS 110-90 · Violation

Name of Operation: INFANT/TODDLER CENTER OF FIRST BAPTIST CHURCH Facility ID: 9255056 Consultant: ANTIONETTE WILLIAMS Operation Type: Center Case Number: 0325-318L Visit Date: 4/1/2025 Number Present: 21 Completed Date: 4/1/2025 Age: From 0 To 3 Total Minutes: 235 Time In: 10:50 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of this unannounced visit was to investigate allegations of violations of child care requirements at this child care center. You, Nichelle Harris, Center Director, accompanied me on a walk-through of the center. I discussed the allegations with you and three additional staff members. Limited monitoring of child care requirements occurred during today’s visit. Staff/child ratios, group size, capacity, supervision, and permit restrictions complied. You accompanied me as I walked through the facility. There were twenty-one (21) children present. Allegation One (1): The allegation is a baby had bruising on their belly and previously a small bruise under their eye. According to you, on 3/21/2025, you received a withdrawal letter from a parent that stated on 3/20/2025 after their child was picked up, they found a bruise and red marks on the child’s torso and sought medical attention to have the child evaluated. When you spoke with the parent, you informed the parent that the staff did not see a bruise on the child while the child was in care at the facility. You asked the parent to send pictures. The parent sent a picture of the child’s torso that showed a bruise and red discoloration. You, Ms. Nichelle, explained that you changed the child’s diaper at 1:30 p.m. and did not notice a bruise on the child. According to your documentation, the child was picked up at 4:02 p.m. You stated you did not receive any communication from the parent regarding a bruise on 3/20/2025. Other staff interviewed stated they did not see or were notified of any bruise on the child on 3/20/2025. We also discussed the same child was observed by a staff member during drop off to have a small scratch under their eye a few weeks ago. When the child was picked up in the afternoon, the parent asked about the scratch under the child’s eye. You explained, according to the staff member, it was not the same parent that picked the child up in the afternoon. The staff member stated the scratch was present when the child was dropped off in the morning. The staff member did not document observing the scratch and did not ask the parent who dropped the child off about the scratch. I asked if incident reports were completed. You stated an incident report was not completed for either incident because they did not occur at the facility. The child was seen by a doctor for only one incident. The child has not returned to the facility. Today I observed the picture that was sent to the facility and observed the bruise on the child’s torso. I did not observe pictures of the child for the incident regarding a mark under the child’s eye. Based on interviews and a review of documents, there was not enough information to substantiate that the allegation reported occurred at the child care facility. This allegation is unsubstantiated. While the allegation in the report was unsubstantiated, a violation related to the incident report was cited due to the report not being completed once the facility was informed the child was taken to the doctor by the parent for an injury the parent thought occurred at the facility. Allegation Two (2): The allegation is that paperwork was not required prior to leaving a child at the facility. The reporter stated they were given paperwork at drop off and asked to return paperwork when the child was picked up. You and another staff member explained that newly enrolled children must attend for a part-day session before they are allowed to attend full day. You explained parents are required to have the forms completed and on file prior to the children attending the facility. Today I observed a child’s file the staff member gave me. This child was the same one referenced in the previous allegation. I reviewed the date of enrollment and the dates the parent documented the forms were completed. Both dates were for the same day. Required children’s records were on file for the child. Based on my review of records and my interview with staff, there was not enough information to substantiate this allegation. The allegation is unsubstantiated. Allegation Three (3): The allegation is an infant was asleep in a rocker/bouncy seat and on a boppy pillow. Today you explained a staff member was fired because she allowed an infant to sleep in a rocker/bouncy seat. The former staff member also allowed the same infant to sleep on a boppy pillow. The former staff member continued to allow infants to sleep in the rocker/bouncy seat even after she was reprimanded and instructed not to. You stated you and another staff member talked with her about your concerns, but she did not seem to understand why it was not allowed. You stated it may have been a source of convenience. One other staff member stated she observed the former staff member allowing the infant to sleep in the unapproved devices after the child fell asleep. She stated she did not confront the staff member about the incident because their was tension between them but did notify the Director. Staff explained the former staff member was assigned to that specific infant. You further explained you were concerned about some observations of the former staff member while she was working with infants. In February the former staff member was assigned training to complete through the Southwestern Child Development Commission including, Tummy Time Infant Play Position and another for Infants and Toddlers in the Outdoor Environment. The former staff member never completed the training. On 2/24/25 you conducted a staff meeting where you discussed safe sleep practices, infant feeding practices, diaper changing, and logging information on the electronic app used to communicate with parents. The former staff member was fired due to not improving after she was given the resources, training, and reminders. Today I observed children in two rooms for infants. Children in one room were moving around the space freely while other infants slept. Younger infants were asleep or having floor play time while awake. One infant played under and mobile while another was propped on a boppy pillow. Staff sat on the floor with infants while holding them and interacting with those on the floor. Another staff member completed a diaper change and appeared to follow proper diaper changing procedures. Staff completed the sleep charts, and I observed documentation of monitoring sleep positions for children in both rooms for infants. I did not observe children sleeping in the boppy pillow. There were no bouncy seats/rockers in the classroom. Based on your interview and confirmation of the allegation, the allegation was substantiated. Violation Number Comment Rule 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. It was confirmed that the facility was informed of a child possibly receiving an injury at the operation and an incident report was not completed. .0802 (e) 871 Center staff did not comply with the safe sleep policy. An infant was allowed to sleep on a boppy pillow and in a bouncy seat instead of being placed in a crib, bassinet, playpen, mat, or cot. 10A NCAC 09 .0606(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 violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before 4/15/2025, 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 any information submitted by you is 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: Antionette Williams 2201 Mail Service Center Raleigh, NC 27699 Antionette.williams@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) 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: Incident Report - When a parent informs you that they sought medical care for their child for an incident that they believe occurred at the facility, you should complete an incident report. You can also create a documentation page to document the details of the situation. Be sure to use the DCDEE incident report form to document what the parents shared. Seek information from classroom staff, review video footage if available to determine if an incident occurred at the center. If you are unable to determine if an incident occurred at the center, simply state what the parent shared and that you were unaware of any incidents that occurred at the center that would result in injuries or the need for medical care. If parents submit medical/dental care information, include that with the incident report. We discussed that you will complete an incident report for the recent incident you were informed about. You explained that on 3/21/2025 you talked with staff and expressed they are to complete wellness checks in the mornings as parents drop off children. If staff notice something of concern about the child, they are to ask the parent during drop off. If it is noticed after the parent leave, they are to message the parent in the app used for communicating with parents. They have also been instructed to immediately call the parent to get additional information if needed. Safe Sleep - Although the cause of many sudden infant deaths may not be known, researchers believe that some infants develop in a manner that makes it challenging for them to be aroused or to breathe when they experience a life-threatening challenge during sleep. Use of safe sleep policies, continued education of parents/guardians, expanded training efforts for child care professionals, statewide regulations and mandates, and increased monitoring and observation of infants while they are sleeping are critical to reduce the risk of sudden infant death syndrome in child care. You explained the staff member who did not follow the safe sleep practices was fired. You talked with staff on 3/21/25, and reiterated if infants fall asleep on the floor in a rocker, they are to immediately place the infant in the crib even if they are not assigned to that infant. You also reiterated that staff are to say something if they see other staff not following safe sleep practices. You stated you are seeking additional training for staff to complete as a refresher. The visit summary was completed and sent to you after today’s visit. You may contact me with questions at 919-819-9383 or antionette.williams@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.