10A NCAC 09 .0803 · Violation

Name of Operation: PRIMARY BEGINNINGS CHILD DEVELOPMENT CENTERS #3 Facility ID: 92003902 Consultant: BRIDGGETTE CAMPBELL Operation Type: Center Case Number: Visit Date: 2/7/2025 Number Present: 86 Completed Date: 2/7/2025 Age: From 0 To 5 Total Minutes: 255 Time In: 11:00 AM Time Out: 03:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor compliance with child care requirements for a routine unannounced assessment. This facility currently operates with a Five (5) Star License issued on 7-24-23. The last annual compliance visit was conducted on 1-17-24. Today’s visit was conducted with you, Holly Bryant, Center Director. Upon arrival to the facility, I was greeted by you. The children were observed outside on the playground enjoying the warm temperature, running about and engaging with each other. Children inside were engaged in activity centers and busy decorating and writing letters to their friends for “Send a Friend a Letter Day”. When the children were finished with their letters, they “delivered them to the post office” which was a large cardboard blue postage box. Today I did a walk-through visiting the seven (7) classrooms where children were in care. Compliance with capacity, supervision, discipline, attendance, program requirements, storage of hazardous substances, CPR & First Aid, permit restrictions, the required postings, and your staff record documentation was monitored as a partial assessment of applicable child care requirements. Medications and permission to administer medications were observed. The following violation of child care requirements was cited and must be corrected immediately. Technical assistance on how to maintain compliance was offered during today’s visit. Violation Number Comment Rule 843 A drug or medicine was administered after its expiration date. Located in the cabinet in space #4 an Epinephrine Injection for one child expired August 2024. 10A NCAC 09 .0803(1)(d) The above violation must be corrected immediately and a letter must be sent to me no later than 2-21-25 stating how the item was corrected and a plan to maintain compliance with the requirements. My mailing address is: PO Box 865, Knightdale, NC 27545-0865 or a correction letter can be emailed to: bridggette.campbell@dhhs.nc.gov. The following were discussed with you during today’s visit: • 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. • Technical Assistance was provided with the following suggestions that may be beneficial: Medication Authorization: Any medication, including epinephrine auto injections, on the premises must be monitored for an expiration date to ensure its effectiveness. Medication’s proper storage is essential to maintain its effectiveness for emergency use. It was suggested to monitor medications in the classrooms at least weekly being sure to look at the expiration dates on the medication and on the prescription labels. Contact your Child Care Health Consultant, Latasha Hopkins (919) 795-2234 latasha.hopkins@wake.gov to schedule training on medications. • It was suggested that you add signage on neon paper, on your cabinets that read “EMERGENCY MEDICATIONS HERE.” This signage will ensure that staff members know the location of emergency medications. • After the walkthrough of the facility, I discussed with you a concern that is not a violation of child care requirements but was brought to my attention. There was concern regarding an odor of a substance coming from a staff member’s coat. It was reported that the staff member appears sober. You stated that the concern had also been discussed with you, and you did a thorough investigation but never smelled anything coming from the staff member’s coat. You added that you instructed the staff member to be cautious of what is going on when she is being transported to work, as she is dropped off and picked up daily. You also explained that you did not receive any other reports of odors from parents or staff members. You were confident that this staff member, nor any other staff members are intoxicated at work and if you had any concerns with use of substances, the staff member would not be employed. During today’s visit, there was no smell of anything other than air sanitizer from the installed dispensers by Cintas. • Today you stated that you have not completed linking all your staff into the ABCMS Portal. Please finish linking all your staff asap. If you need assistance with your NCID, please reach out to the NCID Help Desk at 919-754-6000 or 800-722-3946, or visit https://it.nc.gov/support/ncid/reset-password-unlock-account. If you need assistance with the ABCMS Portal, please contact the Child Care Criminal Background Check Unit at (919) 814-6401 or email at DCDEE_ABCMS_Provider@dhhs.nc.gov. • Please continue to visit DCDEE’s website for child care updates at https://ncchildcare.ncdhhs.gov/. Thank you for your time and cooperation. If you have any further questions or concerns, please contact me. Bridggette Campbell PO BOX 865, Knightdale, NC 27545-0865 bridggette.campbell@dhhs.nc.gov (919) 819-9357 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: PRIMARY BEGINNINGS CHILD DEVELOPMENT CENTERS #3 Facility ID: 92003902 Consultant: BRIDGGETTE CAMPBELL Operation Type: Center Case Number: Visit Date: 2/7/2025 Number Present: 86 Completed Date: 2/7/2025 Age: From 0 To 5 Total Minutes: 255 Time In: 11:00 AM Time Out: 03:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor compliance with child care requirements for a routine unannounced assessment. This facility currently operates with a Five (5) Star License issued on 7-24-23. The last annual compliance visit was conducted on 1-17-24. Today’s visit was conducted with you, Holly Bryant, Center Director. Upon arrival to the facility, I was greeted by you. The children were observed outside on the playground enjoying the warm temperature, running about and engaging with each other. Children inside were engaged in activity centers and busy decorating and writing letters to their friends for “Send a Friend a Letter Day”. When the children were finished with their letters, they “delivered them to the post office” which was a large cardboard blue postage box. Today I did a walk-through visiting the seven (7) classrooms where children were in care. Compliance with capacity, supervision, discipline, attendance, program requirements, storage of hazardous substances, CPR & First Aid, permit restrictions, the required postings, and your staff record documentation was monitored as a partial assessment of applicable child care requirements. Medications and permission to administer medications were observed. The following violation of child care requirements was cited and must be corrected immediately. Technical assistance on how to maintain compliance was offered during today’s visit. Violation Number Comment Rule 843 A drug or medicine was administered after its expiration date. Located in the cabinet in space #4 an Epinephrine Injection for one child expired August 2024. 10A NCAC 09 .0803(1)(d) The above violation must be corrected immediately and a letter must be sent to me no later than 2-21-25 stating how the item was corrected and a plan to maintain compliance with the requirements. My mailing address is: PO Box 865, Knightdale, NC 27545-0865 or a correction letter can be emailed to: bridggette.campbell@dhhs.nc.gov. The following were discussed with you during today’s visit: • 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. • Technical Assistance was provided with the following suggestions that may be beneficial: Medication Authorization: Any medication, including epinephrine auto injections, on the premises must be monitored for an expiration date to ensure its effectiveness. Medication’s proper storage is essential to maintain its effectiveness for emergency use. It was suggested to monitor medications in the classrooms at least weekly being sure to look at the expiration dates on the medication and on the prescription labels. Contact your Child Care Health Consultant, Latasha Hopkins (919) 795-2234 latasha.hopkins@wake.gov to schedule training on medications. • It was suggested that you add signage on neon paper, on your cabinets that read “EMERGENCY MEDICATIONS HERE.” This signage will ensure that staff members know the location of emergency medications. • After the walkthrough of the facility, I discussed with you a concern that is not a violation of child care requirements but was brought to my attention. There was concern regarding an odor of a substance coming from a staff member’s coat. It was reported that the staff member appears sober. You stated that the concern had also been discussed with you, and you did a thorough investigation but never smelled anything coming from the staff member’s coat. You added that you instructed the staff member to be cautious of what is going on when she is being transported to work, as she is dropped off and picked up daily. You also explained that you did not receive any other reports of odors from parents or staff members. You were confident that this staff member, nor any other staff members are intoxicated at work and if you had any concerns with use of substances, the staff member would not be employed. During today’s visit, there was no smell of anything other than air sanitizer from the installed dispensers by Cintas. • Today you stated that you have not completed linking all your staff into the ABCMS Portal. Please finish linking all your staff asap. If you need assistance with your NCID, please reach out to the NCID Help Desk at 919-754-6000 or 800-722-3946, or visit https://it.nc.gov/support/ncid/reset-password-unlock-account. If you need assistance with the ABCMS Portal, please contact the Child Care Criminal Background Check Unit at (919) 814-6401 or email at DCDEE_ABCMS_Provider@dhhs.nc.gov. • Please continue to visit DCDEE’s website for child care updates at https://ncchildcare.ncdhhs.gov/. Thank you for your time and cooperation. If you have any further questions or concerns, please contact me. Bridggette Campbell PO BOX 865, Knightdale, NC 27545-0865 bridggette.campbell@dhhs.nc.gov (919) 819-9357 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 .0802 · Violation

Name of Operation: PRIMARY BEGINNINGS CHILD DEVELOPMENT CENTERS #3 Facility ID: 92003902 Consultant: BRIDGGETTE CAMPBELL Operation Type: Center Case Number: Visit Date: 11/6/2024 Number Present: 96 Completed Date: 11/6/2024 Age: From 0 To 5 Total Minutes: 445 Time In: 09:45 AM Time Out: 05:10 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor compliance with child care requirements for an annual compliance assessment. This facility currently operates with a Five (5) Star License that was issued on 7-24-23. The last sanitation inspection was completed on 11-4-24 with an “Superior” classification. The last approved fire inspection was conducted on 2-9-24. The NC Secretary of State website was reviewed today and this facility’s corporation’s name, Primary Beginnings, L.L.C. was listed as “Current-Active.” Today’s visit was conducted with you, Holly Bryant, center director. This facility has one (1) NC Pre-K classroom occupying space #7. The NC Pre-K program operates for a minimum of 7.0 hours a day from 8:45am – 3:30pm and attendance documenting time of arrival and departure is taken daily through the Procare app. USDA approved meals are served and menus are planned at least one week in advance. The center uses the approved Creative Curriculum Teaching Strategies Gold (TSG) as an early childhood teaching resource. The NC Pre-K classroom abides by a 1:9 staff/child ratio. NC Pre-K paperwork was reviewed during today’s visit. Children’s files were randomly selected verifying health assessments and/or developmental screenings were on file. The DCDEE NC Pre-K Program Monitoring Tool is used as a guide to ensure compliance with NC Pre-K requirements. The children were observed outside on the playground running about, riding trikes, and riding scooters. I monitored the seven (7) classrooms in use for compliance with staff/child ratios, supervision, and staff interaction/discipline. The program was also monitored for health and safety requirements both indoors and outdoors using the annual compliance monitoring checklist. Children completed daily activities with adequate supervision and engagement from the caregivers. The children were observed in circle time where a caregiver was reviewing the days of the week and talking about farm animals, interacting in activity centers, coming in from outdoors and completing handwashing routines, in circle time singing songs, and doing foot print art with infants. Lunch was observed being served and the children completed handwashing and toileting routines before naptime, where the children rested on cots with linens. The program requirements, along with equipment and furnishings were observed. Compliance with staff records will be documented by you. New staff records, along with children’s records were reviewed today. Medications observed on the premises were monitored. This facility does provide transportation as there was one (1) bus on the premises. The registration for the bus with license plate # TYY-2826 and the bus’s insurance information which expires on 7-9-2025 was observed. Compliance with transportation requirements in child care rule SECTION .1000 Transportation standards was observed and in compliance. The notebook with permission to transport, applications/emergency information and photos for the children being transported was observed, along with the logging of the attendance on the bus was observed. The following violations of child care requirements were cited during today’s visit and must be corrected immediately. Technical assistance on how to maintain compliance was provided. Violation Number Comment Rule 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. One (1) bottle in space #2 was not labeled with a date. 15A NCAC 18A .2804(d) 542 The written feeding plan was not modified as the child's needs changed. A feeding schedule for one (1) child in space #2 did not reflect the child's current eating habits. 10 NCAC 09 .0902(a) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. There was no permission to administer A&D Ointment for a child in space #3 and permission to administer Aquaphor for a child in space #4 had expired. 10A NCAC 09 .0803(1)(a & b) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. A Seizure Action Plan for a child in space #4 was not on file as required. .0801(b) The above violations must be corrected immediately and a letter must be sent to me no later than 11-20-24 stating how the items were corrected and a plan to maintain compliance with the requirements. My mailing address is: PO Box 865, Knightdale, NC 27545-0865 or a correction letter can be emailed to: bridggette.campbell@dhhs.nc.gov. The following were discussed with you during today’s visit: • 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. • Technical Assistance was provided with the following suggestions that may be beneficial: Medical Action Plans: Medical action plans are crucial in child care centers because they provide clear, detailed instructions on how to manage a child's specific medical needs, ensuring staff can respond appropriately and safely in case of a medical emergency, especially for children with allergies, asthma, diabetes, or other chronic conditions, effectively preventing complications and protecting the child's health while in care. It is suggested that before you receive medication, that the parent complete or bring you the completed medical action plan and completed permission slip. Informing parents during their tour of your center and when providing information about requirements and expectations can eliminate confusion regarding what must accompany medications. Medication Authorization: Any medication on the premises must be labeled with the child’s name, be accompanied by a permission slip, filled out completely with the parent/guardian’s signature and date. Set a reminder to review/update medications in each classroom. You must remember the “five rights” of medication use: the right child, the right medication, the right time, the right dose, and the right route—all of which are generally regarded as a standard for safe medication practices. You and the caregivers must know what medication the parent/guardian authorized to be administered and how the parent/guardian wants medication given. If documentation is required after the medication is administered, then documentation with the required information must be completed and kept on file for six months. Having clear, detailed procedures for obtaining administered medication protects children from mistakes that can affect their health. It was suggested to reiterate in your monthly newsletter to parents that medication must accompany a permission slip and It was suggested all staff complete training on administering medications. Feeding Schedule: A documented feeding schedule from a parent is crucial because it ensures caregivers can consistently meet the infant's nutritional needs, provide appropriate feeding times based on their individual hunger cues, and maintain a predictable routine which is vital for an infant's sense of security and well-being while away from home. When children are dropped off in the morning, it may be helpful to have a conversation with the parent/guardian about any changes in the feeding habits and have them update the feeding schedule immediately. Bottles: Labeling bottles with the date prepared allows caregivers to easily identify which bottles are the freshest and should be used first, preventing the potential for feeding infants expired or too old formula/milk, which can be harmful to their health and could lead to foodborne illness due to bacteria growth. It is strongly suggested that prior to parents leaving the classroom, check behind them to ensure they have labeled each bottle with the infant’s name and the current date. • Please send me your completed staff and training worksheets asap. • We discussed placing a neon-colored sign on the cabinet doors with emergency medications to alert staff where the medications are stored. • You inquired about the child care rule 10A NCAC 09 .0802 regarding emergency medical care. It was clarified during today’s visit that emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. • We discussed record keeping is one of the most time-consuming tasks associated with operating a childcare program. It is an important part of licensure. As an administrator you must allow time to review all necessary documentation to ensure accuracy. Review medications, action plans, children’s files and staff files often to ensure the program is maintaining accurate licensing records. Organization and completeness of records is important to ensure easy access to information in emergency situations. We discussed making sure that you develop a record keeping system for children’s records and staff records that promotes organization and efficiency. Administrative staff must allow time to review all necessary documentation prior to employment of staff and prior to enrollment of children, to ensure accuracy and avoid non-compliance. • We also discussed extra papers that are not required in your files. It was suggested to use the children’s file checklist and the staff file checklist to organize the paperwork required for licensing. If possible, please put licensing paperwork together to prevent time being used to flip through paperwork that is not required by licensure. • Hold harmless has been extended until the new Quality Rating Improvement System (QRIS) (Star Rated License System) rules are implemented. The Governor signed Senate Bill 425 (now Session Law 2024-34), which includes the Quality Rating Improvement System (QRIS) modifications recommended to the Legislature by the NC Child Care Commission to update QRIS and create additional pathways for licensed child care facilities to earn star rated licenses. The Child Care Commission is currently in the process of drafting proposed child care rule language to begin the rulemaking process for implementing the new requirements. There will be three pathways for the QRIS Modernization: program assessment, classroom and instructional quality, and national accreditation. • Please link you and your staff asap. Center directors/owners can now access the Automated Background Check Management System (ABCMS), the DCDEE’s criminal background check system. This access will allow providers to: • See the real-time background check status of staff members. • Run a printable report of the staff roster to assist with compliance visits. • See new background check applicants and add to staff roster. Access to the ABCMS requires the successful completion of a Moodle course consisting of a short video followed by a test. The course is titled ABCMS Child Care Provider Portal Training - under the Early Childhood Professional Development Tab, then under the Criminal Background (CBC) tab. • Please continue to visit DCDEE’s website for child care updates at https://ncchildcare.ncdhhs.gov/. Thank you for your time and cooperation. If you have any further questions or concerns, please contact me. Bridggette Campbell PO BOX 865, Knightdale, NC 27545-0865 bridggette.campbell@dhhs.nc.gov (919) 819-9357 If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .0803 · Violation

Name of Operation: PRIMARY BEGINNINGS CHILD DEVELOPMENT CENTERS #3 Facility ID: 92003902 Consultant: BRIDGGETTE CAMPBELL Operation Type: Center Case Number: Visit Date: 11/6/2024 Number Present: 96 Completed Date: 11/6/2024 Age: From 0 To 5 Total Minutes: 445 Time In: 09:45 AM Time Out: 05:10 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor compliance with child care requirements for an annual compliance assessment. This facility currently operates with a Five (5) Star License that was issued on 7-24-23. The last sanitation inspection was completed on 11-4-24 with an “Superior” classification. The last approved fire inspection was conducted on 2-9-24. The NC Secretary of State website was reviewed today and this facility’s corporation’s name, Primary Beginnings, L.L.C. was listed as “Current-Active.” Today’s visit was conducted with you, Holly Bryant, center director. This facility has one (1) NC Pre-K classroom occupying space #7. The NC Pre-K program operates for a minimum of 7.0 hours a day from 8:45am – 3:30pm and attendance documenting time of arrival and departure is taken daily through the Procare app. USDA approved meals are served and menus are planned at least one week in advance. The center uses the approved Creative Curriculum Teaching Strategies Gold (TSG) as an early childhood teaching resource. The NC Pre-K classroom abides by a 1:9 staff/child ratio. NC Pre-K paperwork was reviewed during today’s visit. Children’s files were randomly selected verifying health assessments and/or developmental screenings were on file. The DCDEE NC Pre-K Program Monitoring Tool is used as a guide to ensure compliance with NC Pre-K requirements. The children were observed outside on the playground running about, riding trikes, and riding scooters. I monitored the seven (7) classrooms in use for compliance with staff/child ratios, supervision, and staff interaction/discipline. The program was also monitored for health and safety requirements both indoors and outdoors using the annual compliance monitoring checklist. Children completed daily activities with adequate supervision and engagement from the caregivers. The children were observed in circle time where a caregiver was reviewing the days of the week and talking about farm animals, interacting in activity centers, coming in from outdoors and completing handwashing routines, in circle time singing songs, and doing foot print art with infants. Lunch was observed being served and the children completed handwashing and toileting routines before naptime, where the children rested on cots with linens. The program requirements, along with equipment and furnishings were observed. Compliance with staff records will be documented by you. New staff records, along with children’s records were reviewed today. Medications observed on the premises were monitored. This facility does provide transportation as there was one (1) bus on the premises. The registration for the bus with license plate # TYY-2826 and the bus’s insurance information which expires on 7-9-2025 was observed. Compliance with transportation requirements in child care rule SECTION .1000 Transportation standards was observed and in compliance. The notebook with permission to transport, applications/emergency information and photos for the children being transported was observed, along with the logging of the attendance on the bus was observed. The following violations of child care requirements were cited during today’s visit and must be corrected immediately. Technical assistance on how to maintain compliance was provided. Violation Number Comment Rule 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. One (1) bottle in space #2 was not labeled with a date. 15A NCAC 18A .2804(d) 542 The written feeding plan was not modified as the child's needs changed. A feeding schedule for one (1) child in space #2 did not reflect the child's current eating habits. 10 NCAC 09 .0902(a) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. There was no permission to administer A&D Ointment for a child in space #3 and permission to administer Aquaphor for a child in space #4 had expired. 10A NCAC 09 .0803(1)(a & b) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. A Seizure Action Plan for a child in space #4 was not on file as required. .0801(b) The above violations must be corrected immediately and a letter must be sent to me no later than 11-20-24 stating how the items were corrected and a plan to maintain compliance with the requirements. My mailing address is: PO Box 865, Knightdale, NC 27545-0865 or a correction letter can be emailed to: bridggette.campbell@dhhs.nc.gov. The following were discussed with you during today’s visit: • 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. • Technical Assistance was provided with the following suggestions that may be beneficial: Medical Action Plans: Medical action plans are crucial in child care centers because they provide clear, detailed instructions on how to manage a child's specific medical needs, ensuring staff can respond appropriately and safely in case of a medical emergency, especially for children with allergies, asthma, diabetes, or other chronic conditions, effectively preventing complications and protecting the child's health while in care. It is suggested that before you receive medication, that the parent complete or bring you the completed medical action plan and completed permission slip. Informing parents during their tour of your center and when providing information about requirements and expectations can eliminate confusion regarding what must accompany medications. Medication Authorization: Any medication on the premises must be labeled with the child’s name, be accompanied by a permission slip, filled out completely with the parent/guardian’s signature and date. Set a reminder to review/update medications in each classroom. You must remember the “five rights” of medication use: the right child, the right medication, the right time, the right dose, and the right route—all of which are generally regarded as a standard for safe medication practices. You and the caregivers must know what medication the parent/guardian authorized to be administered and how the parent/guardian wants medication given. If documentation is required after the medication is administered, then documentation with the required information must be completed and kept on file for six months. Having clear, detailed procedures for obtaining administered medication protects children from mistakes that can affect their health. It was suggested to reiterate in your monthly newsletter to parents that medication must accompany a permission slip and It was suggested all staff complete training on administering medications. Feeding Schedule: A documented feeding schedule from a parent is crucial because it ensures caregivers can consistently meet the infant's nutritional needs, provide appropriate feeding times based on their individual hunger cues, and maintain a predictable routine which is vital for an infant's sense of security and well-being while away from home. When children are dropped off in the morning, it may be helpful to have a conversation with the parent/guardian about any changes in the feeding habits and have them update the feeding schedule immediately. Bottles: Labeling bottles with the date prepared allows caregivers to easily identify which bottles are the freshest and should be used first, preventing the potential for feeding infants expired or too old formula/milk, which can be harmful to their health and could lead to foodborne illness due to bacteria growth. It is strongly suggested that prior to parents leaving the classroom, check behind them to ensure they have labeled each bottle with the infant’s name and the current date. • Please send me your completed staff and training worksheets asap. • We discussed placing a neon-colored sign on the cabinet doors with emergency medications to alert staff where the medications are stored. • You inquired about the child care rule 10A NCAC 09 .0802 regarding emergency medical care. It was clarified during today’s visit that emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. • We discussed record keeping is one of the most time-consuming tasks associated with operating a childcare program. It is an important part of licensure. As an administrator you must allow time to review all necessary documentation to ensure accuracy. Review medications, action plans, children’s files and staff files often to ensure the program is maintaining accurate licensing records. Organization and completeness of records is important to ensure easy access to information in emergency situations. We discussed making sure that you develop a record keeping system for children’s records and staff records that promotes organization and efficiency. Administrative staff must allow time to review all necessary documentation prior to employment of staff and prior to enrollment of children, to ensure accuracy and avoid non-compliance. • We also discussed extra papers that are not required in your files. It was suggested to use the children’s file checklist and the staff file checklist to organize the paperwork required for licensing. If possible, please put licensing paperwork together to prevent time being used to flip through paperwork that is not required by licensure. • Hold harmless has been extended until the new Quality Rating Improvement System (QRIS) (Star Rated License System) rules are implemented. The Governor signed Senate Bill 425 (now Session Law 2024-34), which includes the Quality Rating Improvement System (QRIS) modifications recommended to the Legislature by the NC Child Care Commission to update QRIS and create additional pathways for licensed child care facilities to earn star rated licenses. The Child Care Commission is currently in the process of drafting proposed child care rule language to begin the rulemaking process for implementing the new requirements. There will be three pathways for the QRIS Modernization: program assessment, classroom and instructional quality, and national accreditation. • Please link you and your staff asap. Center directors/owners can now access the Automated Background Check Management System (ABCMS), the DCDEE’s criminal background check system. This access will allow providers to: • See the real-time background check status of staff members. • Run a printable report of the staff roster to assist with compliance visits. • See new background check applicants and add to staff roster. Access to the ABCMS requires the successful completion of a Moodle course consisting of a short video followed by a test. The course is titled ABCMS Child Care Provider Portal Training - under the Early Childhood Professional Development Tab, then under the Criminal Background (CBC) tab. • Please continue to visit DCDEE’s website for child care updates at https://ncchildcare.ncdhhs.gov/. Thank you for your time and cooperation. If you have any further questions or concerns, please contact me. Bridggette Campbell PO BOX 865, Knightdale, NC 27545-0865 bridggette.campbell@dhhs.nc.gov (919) 819-9357 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: PRIMARY BEGINNINGS CHILD DEVELOPMENT CENTERS #3 Facility ID: 92003902 Consultant: BRIDGGETTE CAMPBELL Operation Type: Center Case Number: Visit Date: 11/6/2024 Number Present: 96 Completed Date: 11/6/2024 Age: From 0 To 5 Total Minutes: 445 Time In: 09:45 AM Time Out: 05:10 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor compliance with child care requirements for an annual compliance assessment. This facility currently operates with a Five (5) Star License that was issued on 7-24-23. The last sanitation inspection was completed on 11-4-24 with an “Superior” classification. The last approved fire inspection was conducted on 2-9-24. The NC Secretary of State website was reviewed today and this facility’s corporation’s name, Primary Beginnings, L.L.C. was listed as “Current-Active.” Today’s visit was conducted with you, Holly Bryant, center director. This facility has one (1) NC Pre-K classroom occupying space #7. The NC Pre-K program operates for a minimum of 7.0 hours a day from 8:45am – 3:30pm and attendance documenting time of arrival and departure is taken daily through the Procare app. USDA approved meals are served and menus are planned at least one week in advance. The center uses the approved Creative Curriculum Teaching Strategies Gold (TSG) as an early childhood teaching resource. The NC Pre-K classroom abides by a 1:9 staff/child ratio. NC Pre-K paperwork was reviewed during today’s visit. Children’s files were randomly selected verifying health assessments and/or developmental screenings were on file. The DCDEE NC Pre-K Program Monitoring Tool is used as a guide to ensure compliance with NC Pre-K requirements. The children were observed outside on the playground running about, riding trikes, and riding scooters. I monitored the seven (7) classrooms in use for compliance with staff/child ratios, supervision, and staff interaction/discipline. The program was also monitored for health and safety requirements both indoors and outdoors using the annual compliance monitoring checklist. Children completed daily activities with adequate supervision and engagement from the caregivers. The children were observed in circle time where a caregiver was reviewing the days of the week and talking about farm animals, interacting in activity centers, coming in from outdoors and completing handwashing routines, in circle time singing songs, and doing foot print art with infants. Lunch was observed being served and the children completed handwashing and toileting routines before naptime, where the children rested on cots with linens. The program requirements, along with equipment and furnishings were observed. Compliance with staff records will be documented by you. New staff records, along with children’s records were reviewed today. Medications observed on the premises were monitored. This facility does provide transportation as there was one (1) bus on the premises. The registration for the bus with license plate # TYY-2826 and the bus’s insurance information which expires on 7-9-2025 was observed. Compliance with transportation requirements in child care rule SECTION .1000 Transportation standards was observed and in compliance. The notebook with permission to transport, applications/emergency information and photos for the children being transported was observed, along with the logging of the attendance on the bus was observed. The following violations of child care requirements were cited during today’s visit and must be corrected immediately. Technical assistance on how to maintain compliance was provided. Violation Number Comment Rule 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. One (1) bottle in space #2 was not labeled with a date. 15A NCAC 18A .2804(d) 542 The written feeding plan was not modified as the child's needs changed. A feeding schedule for one (1) child in space #2 did not reflect the child's current eating habits. 10 NCAC 09 .0902(a) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. There was no permission to administer A&D Ointment for a child in space #3 and permission to administer Aquaphor for a child in space #4 had expired. 10A NCAC 09 .0803(1)(a & b) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. A Seizure Action Plan for a child in space #4 was not on file as required. .0801(b) The above violations must be corrected immediately and a letter must be sent to me no later than 11-20-24 stating how the items were corrected and a plan to maintain compliance with the requirements. My mailing address is: PO Box 865, Knightdale, NC 27545-0865 or a correction letter can be emailed to: bridggette.campbell@dhhs.nc.gov. The following were discussed with you during today’s visit: • 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. • Technical Assistance was provided with the following suggestions that may be beneficial: Medical Action Plans: Medical action plans are crucial in child care centers because they provide clear, detailed instructions on how to manage a child's specific medical needs, ensuring staff can respond appropriately and safely in case of a medical emergency, especially for children with allergies, asthma, diabetes, or other chronic conditions, effectively preventing complications and protecting the child's health while in care. It is suggested that before you receive medication, that the parent complete or bring you the completed medical action plan and completed permission slip. Informing parents during their tour of your center and when providing information about requirements and expectations can eliminate confusion regarding what must accompany medications. Medication Authorization: Any medication on the premises must be labeled with the child’s name, be accompanied by a permission slip, filled out completely with the parent/guardian’s signature and date. Set a reminder to review/update medications in each classroom. You must remember the “five rights” of medication use: the right child, the right medication, the right time, the right dose, and the right route—all of which are generally regarded as a standard for safe medication practices. You and the caregivers must know what medication the parent/guardian authorized to be administered and how the parent/guardian wants medication given. If documentation is required after the medication is administered, then documentation with the required information must be completed and kept on file for six months. Having clear, detailed procedures for obtaining administered medication protects children from mistakes that can affect their health. It was suggested to reiterate in your monthly newsletter to parents that medication must accompany a permission slip and It was suggested all staff complete training on administering medications. Feeding Schedule: A documented feeding schedule from a parent is crucial because it ensures caregivers can consistently meet the infant's nutritional needs, provide appropriate feeding times based on their individual hunger cues, and maintain a predictable routine which is vital for an infant's sense of security and well-being while away from home. When children are dropped off in the morning, it may be helpful to have a conversation with the parent/guardian about any changes in the feeding habits and have them update the feeding schedule immediately. Bottles: Labeling bottles with the date prepared allows caregivers to easily identify which bottles are the freshest and should be used first, preventing the potential for feeding infants expired or too old formula/milk, which can be harmful to their health and could lead to foodborne illness due to bacteria growth. It is strongly suggested that prior to parents leaving the classroom, check behind them to ensure they have labeled each bottle with the infant’s name and the current date. • Please send me your completed staff and training worksheets asap. • We discussed placing a neon-colored sign on the cabinet doors with emergency medications to alert staff where the medications are stored. • You inquired about the child care rule 10A NCAC 09 .0802 regarding emergency medical care. It was clarified during today’s visit that emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. • We discussed record keeping is one of the most time-consuming tasks associated with operating a childcare program. It is an important part of licensure. As an administrator you must allow time to review all necessary documentation to ensure accuracy. Review medications, action plans, children’s files and staff files often to ensure the program is maintaining accurate licensing records. Organization and completeness of records is important to ensure easy access to information in emergency situations. We discussed making sure that you develop a record keeping system for children’s records and staff records that promotes organization and efficiency. Administrative staff must allow time to review all necessary documentation prior to employment of staff and prior to enrollment of children, to ensure accuracy and avoid non-compliance. • We also discussed extra papers that are not required in your files. It was suggested to use the children’s file checklist and the staff file checklist to organize the paperwork required for licensing. If possible, please put licensing paperwork together to prevent time being used to flip through paperwork that is not required by licensure. • Hold harmless has been extended until the new Quality Rating Improvement System (QRIS) (Star Rated License System) rules are implemented. The Governor signed Senate Bill 425 (now Session Law 2024-34), which includes the Quality Rating Improvement System (QRIS) modifications recommended to the Legislature by the NC Child Care Commission to update QRIS and create additional pathways for licensed child care facilities to earn star rated licenses. The Child Care Commission is currently in the process of drafting proposed child care rule language to begin the rulemaking process for implementing the new requirements. There will be three pathways for the QRIS Modernization: program assessment, classroom and instructional quality, and national accreditation. • Please link you and your staff asap. Center directors/owners can now access the Automated Background Check Management System (ABCMS), the DCDEE’s criminal background check system. This access will allow providers to: • See the real-time background check status of staff members. • Run a printable report of the staff roster to assist with compliance visits. • See new background check applicants and add to staff roster. Access to the ABCMS requires the successful completion of a Moodle course consisting of a short video followed by a test. The course is titled ABCMS Child Care Provider Portal Training - under the Early Childhood Professional Development Tab, then under the Criminal Background (CBC) tab. • Please continue to visit DCDEE’s website for child care updates at https://ncchildcare.ncdhhs.gov/. Thank you for your time and cooperation. If you have any further questions or concerns, please contact me. Bridggette Campbell PO BOX 865, Knightdale, NC 27545-0865 bridggette.campbell@dhhs.nc.gov (919) 819-9357 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: PRIMARY BEGINNINGS CHILD DEVELOPMENT CENTERS #3 Facility ID: 92003902 Consultant: BRIDGGETTE CAMPBELL Operation Type: Center Case Number: Visit Date: 1/17/2024 Number Present: 68 Completed Date: 1/17/2024 Age: From 0 To 5 Total Minutes: 310 Time In: 10:15 AM Time Out: 03:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor compliance with child care requirements for an annual compliance assessment. This facility currently operates with a 5 Star License that was issued on 7-24-23. This facility was licensed on 1-26-23. The last sanitation inspection was completed on 1-26-23 with a “Superior” classification. The last fire inspection was conducted on 1-24-23. The NC Secretary of State website was reviewed on 1-17-23 and the corporation’s name, Primary Beginnings, L.L.C. was listed as “Current-Active.” Today’s visit was conducted with you, Holly Bryant, center director. I monitored the six (6) classrooms in use for compliance with staff/child ratios, supervision, and staff interaction/discipline. The program was also monitored for health and safety requirements both indoors and outdoors using the annual compliance monitoring checklist. The facility opened at 10:30am due to the weather and the children completed daily activities with adequate supervision. The children were observed in circle time where one group discussed Martin Luther King, Jr. and equality along with the different color of skin tones and another group discussed dental care. The children were also observed eating lunch and appropriate handwashing routines occurred. Updates have been made to the playgrounds. On the toddler playground a new stationary play structure was added with poured rubber surfacing. On the preschool/preK playground a child-sized arbor and a mud kitchen has been added, along with gardening beds where the children are growing bok choy, winter lettuce, carrots, onions, and beans. The program requirements, along with equipment and furnishings were also observed. Compliance with staff records was documented by you. New staff records, along with ten (10) children’s records were reviewed today. This facility does not provide transportation. Medications and permission to administer medications were observed. During today’s visit, an assessment of applicable child care requirements was conducted and the following violation of child care requirements was cited. Technical assistance on how to maintain compliance was provided today. Violation Number Comment Rule 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. Permission to administer Epi-Pens for three (3) children was not available. 10A NCAC 09 .0803(1)(a & b) The above violation must be corrected immediately and a corrective action letter must be sent to me no later than 1-31-24 stating how the violation was corrected and a plan to maintain compliance with the requirements. My mailing address is: PO Box 865, Knightdale, NC 27545-0865 or a corrective action letter can be emailed to: bridggette.campbell@dhhs.nc.gov. If I do not receive your letter by 1-31-23 and/or if you do not address the violation, a return visit to your program may be made to monitor for compliance of the violation. Additional violations may be documented if the situation has not been corrected or addressed. The following were discussed with you today: • Your annual fire inspection is due before 1-24-24. Request your annual fire inspection soon using the link on the City of Raleigh’s website https://forms.office.com/Pages/ResponsePage.aspx?id=RuE68EXZJEmVwHtmHDDdu2RN12j4tVxIt0L2duWxfC1UMTFBVUk2N0lUSFZUTlJRN01MUERFVVhKNS4u. • Contact Environmental Health to request your annual sanitation inspection. • The NC Child Care Health and Safety Resource Center is a valuable resource where you can find skills-based training and technical assistance from your Child Care Health Consultant on specific medications or health conditions, as well as the new poster on Stand-Up Changing Procedures. Sign up for their quarterly newsletter and find updated resources at www.healthychildcare.unc.edu or 800-367-2229, choose option 1, then 2. • The Healthy Social Behaviors (HSB) Project supports teachers to promote healthy social-emotional development and reduce the expulsion rate among young children in licensed child care centers across North Carolina. Specialists are available with early childhood education backgrounds who are passionate about empowering teachers to develop learning environments and teaching practices that promote prosocial skills in young children. A flyer with the challenging behaviors hotline information was provided today. • Register asap for the Clean Classrooms for Carolina Kids program required pre-enrollment webinar https://rtiorg.zoom.us/webinar/register/WN_vmlhG6iRS26BdkV8SZSaDw#/. The Clean Classrooms for Carolina Kids program helps fulfill North Carolina requirements (NC 10A NCAC 41C.1001-1007, NC 154A NCAC 18A.2816) for public schools and child care facilities related to lead in water, lead-based paint, and asbestos. The goal is to identify and eliminate exposure to lead and asbestos hazards where North Carolina children learn and play. • Please continue to visit DCDEE’s website for child care updates at https://ncchildcare.ncdhhs.gov/. Contact me if you have questions or concerns: Bridggette Campbell PO Box 865, Knightdale, NC 27545-0865 bridggette.campbell@dhhs.nc.gov (919) 819-9357 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 .2818 · Violation

Name of Operation: PRIMARY BEGINNINGS CHILD DEVELOPMENT CENTERS #3 Facility ID: 92003902 Consultant: BRIDGGETTE CAMPBELL Operation Type: Center Case Number: 0823-438L Visit Date: 9/6/2023 Number Present: 45 Completed Date: 9/6/2023 Age: From 0 To 4 Total Minutes: 190 Time In: 08:45 AM Time Out: 11:55 AM 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 investigate allegations of non-compliance with child care requirements. Today’s visit was conducted with you, Holly Bryant, center director. This facility operates with a Five (5) Star License issued on 7-24-23. Upon arrival to the facility, there was no management up front. I proceeded to the classrooms to take staff/child ratios and look for management. In space #2, the first classroom that I entered there were seven (7) one (1) year olds with one (1) caregiver. I observed the assistant director who was shifting children around to various classrooms. In space #5, the fourth classroom that I entered there were eleven (11) three (3) year olds present with one (1) caregiver. You were a caregiver in the classroom for infants and you explained that the caregiver was running late, stuck in traffic. I communicated that we would talk as soon as you could leave the classroom. Once you came into the office you were informed of the allegations regarding staff/child ratios and supervision. It was alleged that staff/child ratios are not maintained during the mornings around 8:30am-8:45am. You explained that you have one (1) caregiver out on maternity leave, one (1) caregiver that quit, two (2) caregivers that were late this morning, and the cook was out sick today. You added that you try to keep the classrooms in compliance with staff/child ratios until caregivers arrive by shifting the children. When caregivers were interviewed, they corroborated that staff/child ratios are not always maintained as required. Based on my observations and conversations with staff, the allegation regarding staff/child ratios is substantiated. See violation below. An additional allegation regarding supervision was investigated. It was alleged that due to the number of the children/staff child ratio being out of compliance in the classrooms, caregivers can not supervise the children. You stated that children are adequately supervision. You added that you and the assistant director are constantly walking the hallway, in and out of classrooms observing and assisting where needed. Despite the staff/child ratio being out of compliance in two (2) classrooms, during today’s visit adequate supervision was maintained as required. Based on my observations, the allegation regarding supervision is unsubstantiated. Violation Number Comment Rule 1756 Enhanced staff/child ratios and group sizes were not met. At 8:49am in space # 2 there were seven (7) one (1) year olds observed with one (1) caregiver. . In space #5, there were eleven (11) three (3) year olds observed with one (1) caregiver. 10A NCAC 09 .2818 The above violation must be corrected immediately and a letter must be sent to me no later than 9-20-23 stating how the item was corrected and a plan to maintain compliance with the requirements. My mailing address is: PO Box 865, Knightdale, NC 27545-0865 or a correction letter can be emailed to: bridggette.campbell@dhhs.nc.gov. If I do not receive your letter by 9-20-23 and/or if you do not address the violation, a return visit to your program may be made to monitor for compliance of the violation. Additional violations may be documented if the situation has not been corrected or addressed. The following were discussed with you during today's visit: • Staff/child ratios play an important role in supporting overall quality and education outcomes in child care facilities. As a result, staff/child ratios have been written into the rules to help ensure child safety and wellbeing. Please revisit your staff schedules to see if changes can be made to accommodate the times when parents drop off in the mornings. At your scheduled staff meeting this evening you can take this opportunity to reiterate the importance of maintaining staff/child ratios. • Your toddler playground in front of the facility is being renovated and new equipment with pour-in-place surfacing in being installed. Remember all commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible. • A follow-up visit will be conducted in the near future to monitor for compliance. • Please continue to visit DCDEE’s website for child care updates at https://ncchildcare.ncdhhs.gov/. Thank you for your time and cooperation. If you have any questions or concerns, please do not hesitate to contact me. Bridggette Campbell PO Box 865 Knightdale, NC 27545-0865 bridggette.campbell@dhhs.nc.gov (919) 819-9357 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.