10A NCAC 09 .0701 · Violation

Name of Operation: TINY TREASURE KIDS INC. Facility ID: 92003113 Consultant: BRIDGGETTE CAMPBELL Operation Type: Center Case Number: Visit Date: 1/24/2025 Number Present: 19 Completed Date: 1/24/2025 Age: From 0 To 10 Total Minutes: 275 Time In: 12:00 PM Time Out: 04:35 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 One (1) Star License that was issued on 2-2-24. The NC Secretary of State website was reviewed on 1-24-25 and the status of the corporation’s name, Tiny Treasure Kids, Inc. was listed as “Current-Active.” The last sanitation inspection was completed on 1-23-25 with a “Superior” classification. The last fire inspection was conducted on 9-9-24. The last annual compliance visit was conducted on 2-13-24. Today’s visit was conducted with you, Michelle Williams-Speller, center director. You accompanied me as we visited each indoor and outdoor space. I monitored the four (4) classrooms in use for compliance with staff/child ratios, supervision, and staff interaction/discipline. The facility was also monitored for health and safety requirements both indoors and outdoors using the annual compliance monitoring checklist. Children were observed engaging in activity centers and in circle time singing songs on the carpet. The program requirements, along with equipment and furnishings were also observed. Compliance with staff records was documented by you and your new staff records, along with a sampling of your children’s records were reviewed today. This facility does not provide transportation. Medications and permission to administer medications were observed on the premises and monitored today. During today’s visit, an assessment of applicable child care requirements was conducted. The following violations of child care requirements were cited and must be corrected immediately. Technical assistance on how to maintain compliance was provided. Violation Number Comment Rule 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. Three staff members received medical reports after employment. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Two staff members did not complete the required annual on-going training. .1103(a) The above violations must be corrected immediately and a letter must be sent to me no later than 2-7-25 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: Staff Medical Information: A staff medical report with a physical examination from a health care professional is important for staff working with children because it helps identify potential underlying health issues and ensures that staff are physically and mentally capable of working with children. Federal law requires that an employer keep all medical information confidential and in separate medical files. Any staff medical statements, any proof of tuberculosis test or screening, and any completed health questionnaires must be included in a staff member's medical file, which must be maintained separately from that staff member's individual personnel file. The most current health forms can be accessed on the DCDEE website: https://ncchildcare.ncdhhs.gov/Provider/Provider-Documents-and-Forms. It was suggested to not let any new hire come into the facility to begin work without their completed staff medical report completed within the past 12 months and their negative TB test results or TB screening completed within the past 12 months. On-going Training: A key element of delivering high-quality care lies in the training and development of staff. Annual on-going training is important for staff working in childcare because, 1- Staff stay current with best practices in the field of early childhood education where it is constantly evolving, and professional development helps staff remain up-to-date with the latest research and practices; 2- Sets clear goals for personal and professional growth as on-going training supports staff development and enhances the quality of care and education provided to children; and 3- Builds enhancing skills where on-going training allows staff to improve their skills and become more effective educators. By empowering your staff with the skills and knowledge they need, you’ll create a thriving environment where children, families, and staff can flourish. Start prioritizing training today to see the positive ripple effects throughout your center. It is suggested to find trainings that meet the staff needs and interest and incorporate them into your calendar, as well as set a goal for staff to complete at least one to two trainings a month that will result in them completing the required annual on-going training hours. A handout with the requirements for on-going training were left with you today. Resources for on-going training were provided for you today. • You mentioned that staff have transcripts that need to be submitted. I instructed you on how to submit official transcripts via the National Student Clearinghouse. Remember if the college or university does not show up in the Clearinghouse then an unopened official transcript must be obtained and sent to the Workforce Unit. As well, remember that staff must “apply for a position” in WORKS when they submit a transcript either through the Clearinghouse OR through the mail. The WORKS website was provided for you today. • 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. • 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 proposed child care rules are proposed to go into effect August 2025. There will be three pathways for the QRIS Modernization: program assessment, classroom and instructional quality, and national accreditation. The QRIS Modernization gives licensed centers and family child care homes more flexibility to demonstrate quality. The new framework aims to provide providers with the opportunity to shine for what they are confident and good at. If you missed the information sessions on the QRIS Modernization, you can now watch recordings of the webinars for parents and providers, including one with live Spanish translation. Check out the QRIS Modernization page for videos, new resources and updates at https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization. • Please connect/link you and your staff in the criminal record check portal asap. Center directors can now access the Automated Background Check Management System (ABCMS), the DCDEE􀂶s criminal background check system. A handout titled Creating Connecting Applications in the Automated Background Check Management System (ABCMS) was provided today that provides instructions for connecting/linking you and your staff. 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. 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, please contact the Child Care Criminal Background Check Unit at (919) 814-6401 or email at DCDEE_ABCMS_Provider@dhhs.nc.gov . • A suggestion was made to save the most recent child care requirements in Chapter 9 effective November 1, 2024, to your desktop computer for easy access. As well as bookmark the Division of Child Development and Early Education on your computer for access to valuable resources like, the criminal background check link, forms and documents, what’s new, etc. • Your children’s files and staff files were organized today. Please maintain this system to ensure compliance. • 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. • 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: TINY TREASURE KIDS INC. Facility ID: 92003113 Consultant: BRIDGGETTE CAMPBELL Operation Type: Center Case Number: Visit Date: 1/24/2025 Number Present: 19 Completed Date: 1/24/2025 Age: From 0 To 10 Total Minutes: 275 Time In: 12:00 PM Time Out: 04:35 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 One (1) Star License that was issued on 2-2-24. The NC Secretary of State website was reviewed on 1-24-25 and the status of the corporation’s name, Tiny Treasure Kids, Inc. was listed as “Current-Active.” The last sanitation inspection was completed on 1-23-25 with a “Superior” classification. The last fire inspection was conducted on 9-9-24. The last annual compliance visit was conducted on 2-13-24. Today’s visit was conducted with you, Michelle Williams-Speller, center director. You accompanied me as we visited each indoor and outdoor space. I monitored the four (4) classrooms in use for compliance with staff/child ratios, supervision, and staff interaction/discipline. The facility was also monitored for health and safety requirements both indoors and outdoors using the annual compliance monitoring checklist. Children were observed engaging in activity centers and in circle time singing songs on the carpet. The program requirements, along with equipment and furnishings were also observed. Compliance with staff records was documented by you and your new staff records, along with a sampling of your children’s records were reviewed today. This facility does not provide transportation. Medications and permission to administer medications were observed on the premises and monitored today. During today’s visit, an assessment of applicable child care requirements was conducted. The following violations of child care requirements were cited and must be corrected immediately. Technical assistance on how to maintain compliance was provided. Violation Number Comment Rule 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. Three staff members received medical reports after employment. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Two staff members did not complete the required annual on-going training. .1103(a) The above violations must be corrected immediately and a letter must be sent to me no later than 2-7-25 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: Staff Medical Information: A staff medical report with a physical examination from a health care professional is important for staff working with children because it helps identify potential underlying health issues and ensures that staff are physically and mentally capable of working with children. Federal law requires that an employer keep all medical information confidential and in separate medical files. Any staff medical statements, any proof of tuberculosis test or screening, and any completed health questionnaires must be included in a staff member's medical file, which must be maintained separately from that staff member's individual personnel file. The most current health forms can be accessed on the DCDEE website: https://ncchildcare.ncdhhs.gov/Provider/Provider-Documents-and-Forms. It was suggested to not let any new hire come into the facility to begin work without their completed staff medical report completed within the past 12 months and their negative TB test results or TB screening completed within the past 12 months. On-going Training: A key element of delivering high-quality care lies in the training and development of staff. Annual on-going training is important for staff working in childcare because, 1- Staff stay current with best practices in the field of early childhood education where it is constantly evolving, and professional development helps staff remain up-to-date with the latest research and practices; 2- Sets clear goals for personal and professional growth as on-going training supports staff development and enhances the quality of care and education provided to children; and 3- Builds enhancing skills where on-going training allows staff to improve their skills and become more effective educators. By empowering your staff with the skills and knowledge they need, you’ll create a thriving environment where children, families, and staff can flourish. Start prioritizing training today to see the positive ripple effects throughout your center. It is suggested to find trainings that meet the staff needs and interest and incorporate them into your calendar, as well as set a goal for staff to complete at least one to two trainings a month that will result in them completing the required annual on-going training hours. A handout with the requirements for on-going training were left with you today. Resources for on-going training were provided for you today. • You mentioned that staff have transcripts that need to be submitted. I instructed you on how to submit official transcripts via the National Student Clearinghouse. Remember if the college or university does not show up in the Clearinghouse then an unopened official transcript must be obtained and sent to the Workforce Unit. As well, remember that staff must “apply for a position” in WORKS when they submit a transcript either through the Clearinghouse OR through the mail. The WORKS website was provided for you today. • 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. • 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 proposed child care rules are proposed to go into effect August 2025. There will be three pathways for the QRIS Modernization: program assessment, classroom and instructional quality, and national accreditation. The QRIS Modernization gives licensed centers and family child care homes more flexibility to demonstrate quality. The new framework aims to provide providers with the opportunity to shine for what they are confident and good at. If you missed the information sessions on the QRIS Modernization, you can now watch recordings of the webinars for parents and providers, including one with live Spanish translation. Check out the QRIS Modernization page for videos, new resources and updates at https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization. • Please connect/link you and your staff in the criminal record check portal asap. Center directors can now access the Automated Background Check Management System (ABCMS), the DCDEE􀂶s criminal background check system. A handout titled Creating Connecting Applications in the Automated Background Check Management System (ABCMS) was provided today that provides instructions for connecting/linking you and your staff. 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. 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, please contact the Child Care Criminal Background Check Unit at (919) 814-6401 or email at DCDEE_ABCMS_Provider@dhhs.nc.gov . • A suggestion was made to save the most recent child care requirements in Chapter 9 effective November 1, 2024, to your desktop computer for easy access. As well as bookmark the Division of Child Development and Early Education on your computer for access to valuable resources like, the criminal background check link, forms and documents, what’s new, etc. • Your children’s files and staff files were organized today. Please maintain this system to ensure compliance. • 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. • 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: TINY TREASURE KIDS INC. Facility ID: 92003113 Consultant: BRIDGGETTE CAMPBELL Operation Type: Center Case Number: Visit Date: 9/20/2024 Number Present: 25 Completed Date: 9/20/2024 Age: From 0 To 4 Total Minutes: 280 Time In: 10:20 AM Time Out: 03:00 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 Three (3) Star License issued on 7-24-19. The last annual compliance visit was conducted on 2 -13-24. Today’s visit was conducted with you, Michelle Williams-Speller, center director. Upon arrival to the facility, I was greeted by you. A walk-through of the facility monitoring the four (4) classrooms where children were in care was completed. Compliance with staff/child ratios, supervision, discipline, program requirements, storage of hazardous substances, CPR & First Aid, permit restrictions and various staff records documentation was monitored as a partial assessment of applicable child care requirements. A sampling of medications and permission to administer medications was observed. The children were observed on the playground, in activity centers, completing handwashing and toileting routines, at the table eating lunch, and resting on cots with linens. A caring and nurturing environment was observed as the caregivers met the children’s needs and interacted with the children. During today’s visit, a partial assessment of applicable child care requirements was conducted. The following violations were cited and must be corrected immediately. Technical assistance on how to maintain compliance was provided. Violation Number Comment Rule 811 Potentially hazardous items including but not limited to power tools, nails, chemicals, propane stoves, lawn mowers, gasoline, or kerosene were not stored in locked areas, removed from the premises, or made inaccessible to children. In space #1 in the unlocked door labeled FACP there were two bottles of Simply Truth Toilet Cleaner, Carbona Oxy Powered Steam Carpet Cleaner, Windex, Awesome Cleaner w/ Bleach, Liquid Plumr, and Drano Max Gel. .0604(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #1, Desitin and Boudreaux Butt Paste diaper creams, were not returned to the parent/guardian after the course of treatment. .0803(12) The above violations must be corrected immediately and a letter must be sent to me no later than 10-4-24 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: Storage of Hazardous Items- Intentional planning of the environment ensures a safe environment has been created which prevents and reduces injuries to young children. Items that require locked storage were improperly stored in unlocked storage closets. It is extremely important that staff are taking the required time to lock doors, store hazardous items properly either in locked storage or five feet up from the finished floor. A hazardous storage checklist was provided today. Leftover Medication: We discussed record keeping and monitoring 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 and complete tasks accordingly. It's important for medication to be returned to the parent after a course of treatment to ensure proper disposal and prevent potential misuse or accidental ingestion, as leftover medication can pose a safety risk if not handled correctly. If medication is on the premises, it must be labeled with the child’s name, be accompanied by a permission slip with current dates of treatment, and filled out completely with the parent/guardian’s signature and date. Set a reminder to review/update/send home medications in each classroom. • Your refrigerator thermometer in the classroom for infants is difficult to read. The red line in the thermometer is spotted, it may need to be replaced. • When parents label bottles, please look over the bottles to ensure they have labeled them with the correct dates. One child’s bottles were labeled with the date 9-21-24, which is tomorrow’s date. • Hold harmless has been extended until the new QRIS (Star Rated License System) rules are implemented (SB 425). Providers in Cohort 1 are not required to continue with a rated license assessment unless preferring to, and providers in Cohort 2 do not need to start their preparation year assessment unless preferring to move forward with an assessment. Prep year scales and assessment year scales are optional and up to your discretion at this time. • 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: TINY TREASURE KIDS INC. Facility ID: 92003113 Consultant: BRIDGGETTE CAMPBELL Operation Type: Center Case Number: Visit Date: 2/13/2024 Number Present: 46 Completed Date: 2/13/2024 Age: From 0 To 5 Total Minutes: 360 Time In: 11:00 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 unannounced visit was to monitor compliance with child care requirements for an annual compliance assessment. This facility currently operates with a Three (3) Star License that was issued on 7-24-19. The last sanitation inspection was completed on 1-25-24 with an “Superior” classification. The last approved fire inspection was conducted on 9-25-23. Today’s visit was conducted with you, Angela Wilson, center director. I monitored the four (4) 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. The children were observed outside on the playground, on the carpet counting, reviewing colors and letters, and at the table with manipulatives. Appropriate diapering and handwashing routines were also observed. The program requirements, along with equipment and furnishings were observed. Compliance with staff records was documented by you. New staff records, along with children’s records were reviewed today. Medications and authorization to administer medications was observed. You stated this facility does not provide transportation. The following violations of child care requirements were observed during today’s visit and must be corrected immediately. Technical assistance on how to maintain compliance was provided today. Violation Number Comment Rule 445 For children under three years of age, developmentally appropriate toys and activities were not provided as outlined in Rule. In space #1, age appropriate books, blocks, dolls, pretend play materials, musical toys, sensory toys and fine motor toys were not available and offered in sufficient quantity to allow all children to use them at some time during the day and to allow for a range of choices. In space #2, books and blocks were not available. .0510 (e ) (1)(A-G) 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. In the refrigerator in space #1, two bottles were observed without the child's name labeled on the bottles. 15A NCAC 18A .2804(d) 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 Budesonide Inhalation Suspension for one child was not available. 10A NCAC 09 .0803(1)(a & b) 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 was not available for Albuterol that had been administered to a child. .0803(13)(a-e); .2318(3) 892 The center's safe sleep policy was not posted in a prominent place in the infant room where parents and caregivers were able to view daily. The center's safe sleep policy was not posted in the room for infants, space #1. .0606(b) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Documentation of orientation was not on file for an employee hired on 1-28-24. .1101(a)(b) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The facility's EPR Plan had not been updated since 1-30-23. .0607(e) 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. An asthma action plan was not available for two children with asthma medications on the premises. .0801(b) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. A staff medical report was not on file for one staff member hired on 1-28-24. .0701(d) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. Two children's files did not have documented acknowledgement of receipt of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. .0608(b)(1-6) The above violations must be corrected immediately and a corrective action letter must be sent to me no later than 2-27-24 stating how the violations were 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 2-27-24, a return visit to your program may be made to monitor for compliance of the violations. Additional violations may be documented if the item has not been corrected or addressed. The following were discussed with you during today’s visit: • The pre-service requirements for administrators form needs to be filled out, signed and sent to me asap. • It took a long time to review staff files today because there were multiple copies of the same paperwork. The staff files need to be organized and the multiple copies removed for ease of review. The staff file checklist was provided for you today and it was strongly suggested that you put the paperwork in the order listed on the checklist. Please remember that the medical information, the annual Health Questionnaires, TB test results, and the Staff Medical Report must be kept separate from the other staff file paperwork. A red folder was observed for medical information. • In reviewing children’s files and medication permission slips, please ensure that parents have filled out the paperwork thoroughly and correctly. Ensure that parents completely fill out the top portion of the Children’s Medical Report with the child’s medical history. • To save paper, you stated that you would add the shaken baby policy receipt information to your parent acknowledgement form that contains other statements of receipt. I would strongly recommend as you are revising your children’s file paperwork to remove the option of permission to play outside the fenced area or not to play outside the fenced area statements. It was explained that if the children must evacuate in an emergency situation out the front door or you have the fire truck visit the center, children will not be within the fenced area. You have an additional statement on another form in the children’s files that indicates permission for children to play outside the fenced area and some parents have signed this statement. It would be ideal for all parents to sign this permission to play outside the fenced area statement instead of giving them a choice. • Contact your Child Care Health Consultant, Latasha Boyles, latasha.boyles@wake.gov, cell: (919) 795-2234 to provide training on health and safety practices and medications and permission to administer medications. • CPR and First Aid will need to be renewed for several staff soon. Please go ahead and schedule this training to prevent any violations. • Emergency medication was observed in the office. It is strongly recommended that emergency medication be kept five feet off the floor, in the classroom of the child that the emergency medication is prescribed for. If there is an emergency need to administer the medication, you will not have to retrieve the medication from the office, the medication will be located where the child is. • Hold harmless legislation was extended and signed into law on Monday June 12th, 2023. This legislation allows facilities to remain at their current star level without a reassessment until June 30, 2024 and when reassessed it reduces the education evaluation requirements for lead teachers from 75% to 50% until June of 2026. To prepare for the reassessment process, DCDEE has developed a cohort system. There are three cohorts, and each includes a preparation year and a reassessment year. Your facility is in cohort two. I recommend you consider completing the following tasks and activities that will help prepare you for your reassessment year, which will be sometime between July 1, 2025 and June 30, 2026. If possible, we will align the reassessment with your annual compliance visit timeframe. • Have all staff update WORKS accounts to reflect all currently completed coursework (DCDEE-WORKS) • Determine whether you wish to have Environment Rating Scale (ERS) Assessments [ITERS-R, ECERS-R, SACERS-U] conducted • Request technical assistance with your child care consultant and local partners • Participate in local CCR&R and NCPC quality related training/workshops (CCRR Information) • Reach out to your local Community College to discuss educational opportunities • Review NCRLAP website ERS resources (www.NCRLAP.org). To help review ERS requirements and think carefully about the current characteristics and practices in your program and classrooms, check out the Thinking More worksheets. A worksheet is available for each subscale of each rating scale. • Consider requesting an ERS assessment (free of charge) during the preparation year. Remember the scores can be used in a variety of ways o ERS assessments can be requested during the preparation year and scores can be used as guidance to enhance program quality o If desired, assessment scores can be used during the preparation year if the operator wants to move forward with a rated license reassessment o Assessment scores can be saved to use during the reassessment year o Facilities can request another ERS assessment (free of charge) in your reassessment year for any ERS assessment scoring less than a 5.0. • A suggestion was made to save the most recent child care requirements in Chapter 9 effective January 2024, to your desktop computer for easy access. • Please register asap for the required pre-enrollment webinar https://rtiorg.zoom.us/webinar/register/WN_vmlhG6iRS26BdkV8SZSaDw#/ to participate in the Clean Classrooms for Carolina Kids Program. 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. • As well, it has been approximately 3 years since the requirement for the Clean Water for Carolina Kids water testing was done at this facility on 7-14-21. Please visit the website for Clean Water for Carolina Kids (https://www.cleanwaterforuskids.org/en/carolina/) to order the test kit and have your water retested. When the Environmental Health Specialist visits to conduct an inspection, water testing not completed within the 3 years will result in a provisional sanitation classification. • 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. • 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.

10A NCAC 09 .0803 · Violation

Name of Operation: TINY TREASURE KIDS INC. Facility ID: 92003113 Consultant: BRIDGGETTE CAMPBELL Operation Type: Center Case Number: Visit Date: 8/24/2023 Number Present: 23 Completed Date: 8/24/2023 Age: From 0 To 5 Total Minutes: 180 Time In: 02:00 PM Time Out: 05:00 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 (3) Three Star License issued on 7-24-19. The last annual compliance visit was conducted on 2-16-23. Today’s visit was conducted with you, Angela Wilson, new Center Director. Upon arrival to the facility, I was greeted by you. I was accompanied during a walk-through of the facility visiting the four (4) classrooms occupied by children. Compliance with staff/child ratios, supervision, discipline, program requirements, storage of hazardous substances, CPR & First Aid, permit restrictions and various staff records documentation was monitored as a partial assessment of applicable child care requirements. Medication was observed in the Ready to Go Bag. The children were observed in activity centers, coloring at the table with crayons, at the table reading books, and completing toileting routines. During today’s visit, a partial assessment of applicable child care requirements was conducted. The following violations of child care requirements were cited and must be corrected immediately. Technical assistance on how to maintain compliance with the violations cited was provided. Violation Number Comment Rule 805 Fire drills were not practiced monthly and/or the drill record was incomplete. Documentation of a fire drill for July 2023 was not available. .0604(t); .0302(d)(5) 843 A drug or medicine was administered after its expiration date. Epinephrine Injection located in the administrator's office expired in January 2023. 10A NCAC 09 .0803(1)(d) 853 Incident logs were not completed and maintained as required. An incident that occured on 8-11-23 was documented on an incident report form, however was not logged on the incident log as required. .0802(g)(1-6) 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 medical report was not on file for a child care provider and for the center director. 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 11-21-22 did not have TB test results on file. .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 had BLS Certification on file, which is not an approved First Aid course. .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. A staff member had BLS Certification on file, which is not an approved CPR course. .1102(d) 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. An allergy action plan was not completed for a child that had an Epinephrine Injection medication on the premises. .0801(b) 1898 Staff did not complete the health and safety training within one year of employment. Documentation was not available that a staff member hired on 8-16-22 completed the health and safety trainings as required. .1102(a) 9999 Diapers were not disposed of in a plastic-lined, covered receptacle. Dipers were observed in trash cans without a lid in space #2 and space #3. This is a violation of a sanitation requirement in 15A NCAC 18A .2819(d)(4). The above violations must be corrected immediately and a letter must be sent to me no later than 9-7-23 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. If I do not receive your letter by 9-7-23 and/or if you do not address the violations, a return visit to your program may be made to monitor for compliance of the violations. Additional violations may be documented if the situation has not been corrected or addressed. The following were discussed with you during today's visit: • The importance of maintaining organized files with the required paperwork was discussed. Please make time to organize all files and required paperwork so it may be easily accessible. Checklist were shared with you today to assist you with organizing your files. • Please contact the fire inspector so they can provide your annual fire inspection, conducted on 7-12-23 on the DCDEE form. Once you receive the form, please email it to me. • Today you stated that all your training certificates were not on the premises. Please place all your required training certificates (EPR Training, ITS-SIDS, Recognizing and Responding to Suspicions of Maltreatment Training, all Health & Safety Trainings, Playground Safety Training, and BSAC Training) in your staff file immediately. If you can not locate these training certificates, then you must take the trainings asap. • Your staff evaluations are due in November 2023. • Update the EPR Ready to Go File to include current children’s emergency information and current staff emergency information. The Ready to Go File Checklist was provided for you today. It was suggested to place all of the required items for the Ready to Go File in one binder for ease of accessibility in an emergency. • Medication forms should not have “As Needed.” Have the parent to update the medication authorization form to include detailed instructions. As well, medication authorization must be signed by the parent/guardian. • 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. • 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.

10A NCAC 09 .0701 · Violation

Name of Operation: TINY TREASURE KIDS INC. Facility ID: 92003113 Consultant: BRIDGGETTE CAMPBELL Operation Type: Center Case Number: Visit Date: 8/24/2023 Number Present: 23 Completed Date: 8/24/2023 Age: From 0 To 5 Total Minutes: 180 Time In: 02:00 PM Time Out: 05:00 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 (3) Three Star License issued on 7-24-19. The last annual compliance visit was conducted on 2-16-23. Today’s visit was conducted with you, Angela Wilson, new Center Director. Upon arrival to the facility, I was greeted by you. I was accompanied during a walk-through of the facility visiting the four (4) classrooms occupied by children. Compliance with staff/child ratios, supervision, discipline, program requirements, storage of hazardous substances, CPR & First Aid, permit restrictions and various staff records documentation was monitored as a partial assessment of applicable child care requirements. Medication was observed in the Ready to Go Bag. The children were observed in activity centers, coloring at the table with crayons, at the table reading books, and completing toileting routines. During today’s visit, a partial assessment of applicable child care requirements was conducted. The following violations of child care requirements were cited and must be corrected immediately. Technical assistance on how to maintain compliance with the violations cited was provided. Violation Number Comment Rule 805 Fire drills were not practiced monthly and/or the drill record was incomplete. Documentation of a fire drill for July 2023 was not available. .0604(t); .0302(d)(5) 843 A drug or medicine was administered after its expiration date. Epinephrine Injection located in the administrator's office expired in January 2023. 10A NCAC 09 .0803(1)(d) 853 Incident logs were not completed and maintained as required. An incident that occured on 8-11-23 was documented on an incident report form, however was not logged on the incident log as required. .0802(g)(1-6) 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 medical report was not on file for a child care provider and for the center director. 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 11-21-22 did not have TB test results on file. .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 had BLS Certification on file, which is not an approved First Aid course. .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. A staff member had BLS Certification on file, which is not an approved CPR course. .1102(d) 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. An allergy action plan was not completed for a child that had an Epinephrine Injection medication on the premises. .0801(b) 1898 Staff did not complete the health and safety training within one year of employment. Documentation was not available that a staff member hired on 8-16-22 completed the health and safety trainings as required. .1102(a) 9999 Diapers were not disposed of in a plastic-lined, covered receptacle. Dipers were observed in trash cans without a lid in space #2 and space #3. This is a violation of a sanitation requirement in 15A NCAC 18A .2819(d)(4). The above violations must be corrected immediately and a letter must be sent to me no later than 9-7-23 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. If I do not receive your letter by 9-7-23 and/or if you do not address the violations, a return visit to your program may be made to monitor for compliance of the violations. Additional violations may be documented if the situation has not been corrected or addressed. The following were discussed with you during today's visit: • The importance of maintaining organized files with the required paperwork was discussed. Please make time to organize all files and required paperwork so it may be easily accessible. Checklist were shared with you today to assist you with organizing your files. • Please contact the fire inspector so they can provide your annual fire inspection, conducted on 7-12-23 on the DCDEE form. Once you receive the form, please email it to me. • Today you stated that all your training certificates were not on the premises. Please place all your required training certificates (EPR Training, ITS-SIDS, Recognizing and Responding to Suspicions of Maltreatment Training, all Health & Safety Trainings, Playground Safety Training, and BSAC Training) in your staff file immediately. If you can not locate these training certificates, then you must take the trainings asap. • Your staff evaluations are due in November 2023. • Update the EPR Ready to Go File to include current children’s emergency information and current staff emergency information. The Ready to Go File Checklist was provided for you today. It was suggested to place all of the required items for the Ready to Go File in one binder for ease of accessibility in an emergency. • Medication forms should not have “As Needed.” Have the parent to update the medication authorization form to include detailed instructions. As well, medication authorization must be signed by the parent/guardian. • 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. • 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