10A NCAC 09 .0508 · Violation

Name of Operation: ALL ANNIE'S CHILDREN Facility ID: 24000165 Consultant: NATALIE M. POND Operation Type: Center Case Number: Visit Date: 12/9/2025 Number Present: 33 Completed Date: 12/9/2025 Age: From 0 To 5 Total Minutes: 330 Time In: 09:15 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. Heather Elliot, Child Care Consultant, assisted me with this visit. Your program currently operates with a Three Star Center License issued February 17, 2023. Restrictions on the license include a first shift capacity of 57 children ages 0 to 12, meets enhanced space, and children under 2 ½ years old in rooms with direct exits only. The last annual compliance visit was completed on January 7, 2025. The sanitation inspection was completed on June 12, 2025 with a “Superior” classification. The fire inspection was completed on May 13, 2025 and your facility was approved for daytime care only. The center's compliance history was reviewed with the operator. Prior to the visit the program’s eighteen-month compliance history was eighty-six percent (86%). L. Pollard, owner/administrator was present for the visit and accompanied us during classroom observations. There were fifty (50) children enrolled and thirty-three (33) children present. There were three (3) indoor spaces and two (2) outdoor spaces approved for use. One of the indoor spaces is divided into two groups, for a total of four (4) classrooms. Age-appropriate materials were accessible to all children and spaces were arranged into activity areas. In group one, infants received care according to individual needs. The infant and toddlers present were engaged in free play with a variety of materials and were moving about the room. Individual feeding schedules and safe sleep checks are being maintained. In group 2, children participated in a snowman art activity. In group 3, the children played with the teacher using puppets and telephones and were involved in individual changing routines. In group 4, the children were having breakfast that consisted of applesauce, sausage, hash browns, and milk. Supervision and staff-child ratios were observed and found to be in compliance. There were ten (10) staff members employed at this facility. Two (2) new staff and a percentage of veteran staff’s files were reviewed. A percentage of children’s files were reviewed. The following violation(s) were documented: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. Four of the six children's files reviewed did not have a signed statement of receipt of the summary of the NC Child Care Law. GS 110-102 428 A current activity plan was not posted for each group of children for reference. In space 4, the lesson plan posted was not dated and did not reflect current activities. GS 110-91(12); .0508(a) 468 When three year old children and older were in care, the materials and equipment in the activity area was not in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. In space 4, the book area and fine motor area did not contain enough materials to allow three children to use the area regardless of whether they choose the same or different activities. .0510(d)(1) 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. Two sippy cups in the kitchen refrigerator were not labeled with the children's names and the date. 15A NCAC 18A .2804(d) 705 Equipment and furnishings were not sturdy, stable and free of hazards. In space 2b, the paper attached to the back of the block shelf was torn and was being held by staples that were loose and easily removed. .0601(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In the hallway bathroom used by preschool children, there was an air freshener spray, a bottle of cleaner, and a lotion being stored in an unlocked cabinet under the sink. In space 2b, a bottle of disinfectant was being stored on top of the paper towel holder below five feet. In space 2a, a plug in air freshener with liquid was present in an outlet below 5 feet. .2820(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In space 1, a plastic bag was being used for storage in an unlocked cabinet under a sink accessible to the children. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. A monthly playground inspection was not documented for June, September, and October 2025. .0605(q) 1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. In the infant room, ITS-SIDS training for the two teachers present expired in September 2025. .1102(f) 1831 At least one child care provider, who has completed ITS-SIDS training was not present in the infant room, while children were in care. In the infant room, the ITS-SIDS training for the two teachers present had expired in September 2025. .01102 (f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. On the playground used by preschool children, the sand under the climbing structure was compacted and had grass growing within the fall zone. .0605(k)(1-4) 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 (18)-month compliance history score of at least seventy-five (75) percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before December 23, 2025, I must receive a written, dated, and signed compliance letter that describes accurately and in detail how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. Please note, if the compliance letter is not received by the agreed-upon date, a follow-up visit may be made to verify compliance. Mail or email the information to: Natalie Pond, Child Care Consultant P.O. Box 4 Wrightsville Beach, NC 28480 Natalie.m.pond@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance: Fall Zones: Today we discussed fall zones on the preschool playground. The sand under and around the climber/ slide structure is not the appropriate six inches of loose surfacing. We discussed removing the grass, tilling and adding additional sand to ensure that the depth of the sand is a resilient six inches. I suggest you create a weekly weeding schedule to remove the weeds throughout the sand surfacing. Equipment: In space 2B, I observed the furnishings in the space had staples sticking out of the shelves that could be easily removed by the children. Child Care Rule 09.0601(c) states that all equipment and furnishings are sturdy, stable, and free of hazards. Today we also discussed going through the toys on the playground to ensure that there are not any broken plastic toys present. Broken plastic may cause a child to pinch or possibly cut their fingers. When toys become broken, they must be removed from the play area as stated in G.S. 110-91(6); and Child Care Rule 09 .0601(b). Labeling of Children’s Cups In the kitchen, I observed that a few of the sippy cups were not labeled with the child’s name and date. Today we discussed that all sippy cups and bottles sent from home must be labeled appropriately with the child’s name and date to ensure that the correct child receives the correct cup. Storage of Hazardous Materials: Cleaner, lotion, and room deodorizing spray was/were found in the children’s shared women’s restroom under and on the counter and the disinfectant in Space 2A was on the paper towel dispenser and was not placed above 5 feet. Please review child care rules regarding storage and accessibility of potentially hazardous items. Items labeled “Keep out of reach of children” with no other warnings must be stored at a minimum of five feet off the floor. Hazardous cleaning supplies, including those kept under pressure in an aerosol can, as well as medications must be kept in locked storage. The definition of locked storage requires that the lock be unlocked with some type of device such as a key or combination. Regular childproofing locks do not meet this requirement. Ensure that all cleaning supplies and other items labeled “Keep out of reach of children” are kept inaccessible while children are in care. Today I suggested that since the bathrooms are a shared space, to complete a walk-through in the mornings to ensure that all items that state “Keep out of reach of children” are not accessible to the children. Also, we stated that the plug in air fresheners cannot be used as it contains chemicals that can potentially cause harm if ingested or touched. ITS-SIDS: All adults who provide care for infants 12 months or younger are required to be trained in Sudden Infant Death Syndrome (SIDS) risk reduction practices. The Infant/Toddler Safe Sleep and SIDS Risk Reduction in Child Care (ITS-SIDS) is the approved training. It prepares child care providers to follow their facility’s safe sleep policy. Child care centers licensed to care for infants 12 months and younger shall require child care administrators and all staff scheduled to work with infants, including volunteers counted in staff/child ratios, meet the following training requirements: Complete the ITS-SIDS training within 2 months of assuming responsibilities in the infant room, or within 90 days of assuming responsibility as a child care administrator. Complete the ITS-SIDS training again no more than 3 years from their previous ITS-SIDS training. Today, two of the staff members ITS-SIDS training had expired. You stated that you would be in contact with Smart Start to obtain the training for the two staff members immediately. In the meantime, at least one staff member that has a currently ITS-SIDS training must be present in the room caring for the infant children. Policies: Today we discussed the Safe Sleep policy and ensuring that all families get a copy and sign and date an acknowledgement form to keep in the children’s file. As rule .0606(c) states that a copy of the safe sleep policy is given to and/or explained to the parent of each child on or before the first day the infant attended the center. Today we discussed combining all the center’s policies, such as receipt of acknowledgement of operational policies, receipt of acknowledgement of the tobacco policy, parent participation plan, receipt of acknowledgement of Summary of the Law, and receipt of acknowledgement of the shaken baby and abusive head trauma policy on one form for the parents to initial beside, sign and date the bottom to help ensure that you have all the policies signed by the parents upon the child’s first day. Activity Plans: Child Care Rule 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS states (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. (b) For each group of children in care, the activity plan shall include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: (1) emotional and social development; (2) health and physical development; (3) approaches to play and learning; (4) language development and communication; and (5) cognitive development. In space 4, the activity plan posted did not have a date on the plan and the plan was not being followed, as the plan posted had the theme of fall and had activities about pumpkins. Plastic Bags: Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. According to rule .0604(q). In space 1, plastic bags were observed in the cabinet under the sink, assessable to the infant children that were in care. Today, we discussed removing the plastic bags and replacing the bags with a plastic bin with a lid. Materials: When preschool children three years old and older are in care the following shall apply: (1) the materials and equipment in an activity area should be in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. Additionally, Child Care Rule 10A NCAC 09 .0509 states the learning environment consists of the indoor and outdoor area which encourages child initiated and teacher supported activities as follows: (1) each center shall have developmentally appropriate equipment and materials accessible on a daily basis; (2) the materials and equipment indoors and outdoors shall be sufficient to provide a variety of play experiences that promote the children's emotional and social development, health and physical development, approaches to play and learning, language development, and communication and cognitive development. In space 4, there were not enough materials for the children to engage in play. Today, I observed the book area did not have additional language materials and the fine motor area had only puzzles. Emergency Medical Action Plan The Emergency Medical Action Plan Implementation Guide states that the plan is posted in an area that is easily assessable for staff and parents. Today, you posted the Emergency Medical Action Plan on your parent’s information board and made sure that it was posted in each of the classrooms. Make sure the Emergency Medical Action Plan remains posted, current, and made accessible to staff and parents. Window screens: In space 2B, the screens on the windows are torn and in need of repair. Torn screens can be a safety concern, especially with insect control. Today, we discussed replacing these screens, due to the windows being used during operating hours. Reminder: the fire inspection report must be submitted to DCDEE within one week of the inspection visit on a form provided by the Division. Qualification Letter: Today, we discussed having a Qualification Letter on-site for all therapists that come into the facility and that will be left alone with the children for any amount of time. We discussed having a file for therapist for you to keep their qualification letter on-site and available for review. If the therapist is always under the supervision of a qualified staff member, the therapist does not need a qualification letter on-site. Choosing a Pathway to the Stars: The new rules related to the star rated license system (QRIS) have been approved. The DCDEE team looks forward to working with child care facilities across the state to transition to the new QRIS system, also known as Pathways to the Stars, located in Section .3200 of the Child Care Rules. The transition has begun with the following informational opportunities: •You can review the rule roll out module in the DCDEE e-learning Moodle platform. •If you were unable to attend the webinars regarding Choosing a Pathway to the Stars, the sessions were recorded and are posted on the QRIS Modernization page. • Beginning In October, child care consultants will begin discussing the new rules during licensing visits. Consultants will review the pathway options, identify facility needs, answer questions, and work with the facility operator to establish an individualized timeline for transition to a new rated license within 12 months based on the pathway chosen. •Follow this link for detailed information: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRISModernization. Today, I completed a QRIS Conversation Template for your facility. You reported that your facility is choosing Pathway Two, Classroom and Instructional Quality and that you plan to apply in June 2026. A copy of this template is attached to this visit summary. We understand this is a big change and are committed to ensuring all providers have a good understanding of the new opportunities in order to make informed decisions on which pathway best suits the needs of the facility. We look forward to working with you on your pathway to the stars! Handwashing Procedures: According to Center for Disease Control and Prevention, Clean hands save lives. Handwashing is like a "do-it-yourself" vaccine—it involves five simple and effective steps (Wet, Lather, Scrub, Rinse, Dry) you can take to reduce the spread of diarrheal and respiratory illness so you can stay healthy. Regular handwashing, particularly before and after certain activities, is one of the best ways to remove germs, avoid getting sick, and prevent the spread of germs to others. It's quick, it's simple, and it can keep us all from getting sick. Handwashing is a win for everyone, except the germs. Today, we discussed reviewing the handwashing policies and procedures with your staff to ensure that proper handwashing is being performed during the day. Children must wash their hands upon arrival at the center, after each visit to the toilet, before eating, and before and after water play, after outside play, and/or after handling animals or animal cages. Staff must wash their hands thoroughly before beginning work, before/after handling food, before bottle feeding or serving other children, after toileting or handling body fluids, after diaper changing and/or after handling soiled items. Training opportunities: Every Relationship Matters Created by the ITTI Care Project, Every Relationship Matters! Strengthening Relationships between Adults in Child Care Settings for Directors, Teachers and FCCH Professionals is a free 1.5-hour training that highlights how important all the relationships that surround young children are. Address the Stress ITTI Care Project’s Address the Stress training is now available. This free 1-hour Wellness Workshop teaches ways to reduce stress and take care of YOU! Both are now available online via DCDEE Moodle! At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. Contact me with questions or concerns at 910-364-4898 or Natalie.m.pond@dhhs.nc.gov. If you need further assistance, please contact my supervisor at 910-824-0470 or kim.sherry@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .0509 · Violation

Name of Operation: ALL ANNIE'S CHILDREN Facility ID: 24000165 Consultant: NATALIE M. POND Operation Type: Center Case Number: Visit Date: 12/9/2025 Number Present: 33 Completed Date: 12/9/2025 Age: From 0 To 5 Total Minutes: 330 Time In: 09:15 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. Heather Elliot, Child Care Consultant, assisted me with this visit. Your program currently operates with a Three Star Center License issued February 17, 2023. Restrictions on the license include a first shift capacity of 57 children ages 0 to 12, meets enhanced space, and children under 2 ½ years old in rooms with direct exits only. The last annual compliance visit was completed on January 7, 2025. The sanitation inspection was completed on June 12, 2025 with a “Superior” classification. The fire inspection was completed on May 13, 2025 and your facility was approved for daytime care only. The center's compliance history was reviewed with the operator. Prior to the visit the program’s eighteen-month compliance history was eighty-six percent (86%). L. Pollard, owner/administrator was present for the visit and accompanied us during classroom observations. There were fifty (50) children enrolled and thirty-three (33) children present. There were three (3) indoor spaces and two (2) outdoor spaces approved for use. One of the indoor spaces is divided into two groups, for a total of four (4) classrooms. Age-appropriate materials were accessible to all children and spaces were arranged into activity areas. In group one, infants received care according to individual needs. The infant and toddlers present were engaged in free play with a variety of materials and were moving about the room. Individual feeding schedules and safe sleep checks are being maintained. In group 2, children participated in a snowman art activity. In group 3, the children played with the teacher using puppets and telephones and were involved in individual changing routines. In group 4, the children were having breakfast that consisted of applesauce, sausage, hash browns, and milk. Supervision and staff-child ratios were observed and found to be in compliance. There were ten (10) staff members employed at this facility. Two (2) new staff and a percentage of veteran staff’s files were reviewed. A percentage of children’s files were reviewed. The following violation(s) were documented: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. Four of the six children's files reviewed did not have a signed statement of receipt of the summary of the NC Child Care Law. GS 110-102 428 A current activity plan was not posted for each group of children for reference. In space 4, the lesson plan posted was not dated and did not reflect current activities. GS 110-91(12); .0508(a) 468 When three year old children and older were in care, the materials and equipment in the activity area was not in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. In space 4, the book area and fine motor area did not contain enough materials to allow three children to use the area regardless of whether they choose the same or different activities. .0510(d)(1) 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. Two sippy cups in the kitchen refrigerator were not labeled with the children's names and the date. 15A NCAC 18A .2804(d) 705 Equipment and furnishings were not sturdy, stable and free of hazards. In space 2b, the paper attached to the back of the block shelf was torn and was being held by staples that were loose and easily removed. .0601(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In the hallway bathroom used by preschool children, there was an air freshener spray, a bottle of cleaner, and a lotion being stored in an unlocked cabinet under the sink. In space 2b, a bottle of disinfectant was being stored on top of the paper towel holder below five feet. In space 2a, a plug in air freshener with liquid was present in an outlet below 5 feet. .2820(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In space 1, a plastic bag was being used for storage in an unlocked cabinet under a sink accessible to the children. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. A monthly playground inspection was not documented for June, September, and October 2025. .0605(q) 1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. In the infant room, ITS-SIDS training for the two teachers present expired in September 2025. .1102(f) 1831 At least one child care provider, who has completed ITS-SIDS training was not present in the infant room, while children were in care. In the infant room, the ITS-SIDS training for the two teachers present had expired in September 2025. .01102 (f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. On the playground used by preschool children, the sand under the climbing structure was compacted and had grass growing within the fall zone. .0605(k)(1-4) 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 (18)-month compliance history score of at least seventy-five (75) percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before December 23, 2025, I must receive a written, dated, and signed compliance letter that describes accurately and in detail how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. Please note, if the compliance letter is not received by the agreed-upon date, a follow-up visit may be made to verify compliance. Mail or email the information to: Natalie Pond, Child Care Consultant P.O. Box 4 Wrightsville Beach, NC 28480 Natalie.m.pond@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance: Fall Zones: Today we discussed fall zones on the preschool playground. The sand under and around the climber/ slide structure is not the appropriate six inches of loose surfacing. We discussed removing the grass, tilling and adding additional sand to ensure that the depth of the sand is a resilient six inches. I suggest you create a weekly weeding schedule to remove the weeds throughout the sand surfacing. Equipment: In space 2B, I observed the furnishings in the space had staples sticking out of the shelves that could be easily removed by the children. Child Care Rule 09.0601(c) states that all equipment and furnishings are sturdy, stable, and free of hazards. Today we also discussed going through the toys on the playground to ensure that there are not any broken plastic toys present. Broken plastic may cause a child to pinch or possibly cut their fingers. When toys become broken, they must be removed from the play area as stated in G.S. 110-91(6); and Child Care Rule 09 .0601(b). Labeling of Children’s Cups In the kitchen, I observed that a few of the sippy cups were not labeled with the child’s name and date. Today we discussed that all sippy cups and bottles sent from home must be labeled appropriately with the child’s name and date to ensure that the correct child receives the correct cup. Storage of Hazardous Materials: Cleaner, lotion, and room deodorizing spray was/were found in the children’s shared women’s restroom under and on the counter and the disinfectant in Space 2A was on the paper towel dispenser and was not placed above 5 feet. Please review child care rules regarding storage and accessibility of potentially hazardous items. Items labeled “Keep out of reach of children” with no other warnings must be stored at a minimum of five feet off the floor. Hazardous cleaning supplies, including those kept under pressure in an aerosol can, as well as medications must be kept in locked storage. The definition of locked storage requires that the lock be unlocked with some type of device such as a key or combination. Regular childproofing locks do not meet this requirement. Ensure that all cleaning supplies and other items labeled “Keep out of reach of children” are kept inaccessible while children are in care. Today I suggested that since the bathrooms are a shared space, to complete a walk-through in the mornings to ensure that all items that state “Keep out of reach of children” are not accessible to the children. Also, we stated that the plug in air fresheners cannot be used as it contains chemicals that can potentially cause harm if ingested or touched. ITS-SIDS: All adults who provide care for infants 12 months or younger are required to be trained in Sudden Infant Death Syndrome (SIDS) risk reduction practices. The Infant/Toddler Safe Sleep and SIDS Risk Reduction in Child Care (ITS-SIDS) is the approved training. It prepares child care providers to follow their facility’s safe sleep policy. Child care centers licensed to care for infants 12 months and younger shall require child care administrators and all staff scheduled to work with infants, including volunteers counted in staff/child ratios, meet the following training requirements: Complete the ITS-SIDS training within 2 months of assuming responsibilities in the infant room, or within 90 days of assuming responsibility as a child care administrator. Complete the ITS-SIDS training again no more than 3 years from their previous ITS-SIDS training. Today, two of the staff members ITS-SIDS training had expired. You stated that you would be in contact with Smart Start to obtain the training for the two staff members immediately. In the meantime, at least one staff member that has a currently ITS-SIDS training must be present in the room caring for the infant children. Policies: Today we discussed the Safe Sleep policy and ensuring that all families get a copy and sign and date an acknowledgement form to keep in the children’s file. As rule .0606(c) states that a copy of the safe sleep policy is given to and/or explained to the parent of each child on or before the first day the infant attended the center. Today we discussed combining all the center’s policies, such as receipt of acknowledgement of operational policies, receipt of acknowledgement of the tobacco policy, parent participation plan, receipt of acknowledgement of Summary of the Law, and receipt of acknowledgement of the shaken baby and abusive head trauma policy on one form for the parents to initial beside, sign and date the bottom to help ensure that you have all the policies signed by the parents upon the child’s first day. Activity Plans: Child Care Rule 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS states (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. (b) For each group of children in care, the activity plan shall include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: (1) emotional and social development; (2) health and physical development; (3) approaches to play and learning; (4) language development and communication; and (5) cognitive development. In space 4, the activity plan posted did not have a date on the plan and the plan was not being followed, as the plan posted had the theme of fall and had activities about pumpkins. Plastic Bags: Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. According to rule .0604(q). In space 1, plastic bags were observed in the cabinet under the sink, assessable to the infant children that were in care. Today, we discussed removing the plastic bags and replacing the bags with a plastic bin with a lid. Materials: When preschool children three years old and older are in care the following shall apply: (1) the materials and equipment in an activity area should be in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. Additionally, Child Care Rule 10A NCAC 09 .0509 states the learning environment consists of the indoor and outdoor area which encourages child initiated and teacher supported activities as follows: (1) each center shall have developmentally appropriate equipment and materials accessible on a daily basis; (2) the materials and equipment indoors and outdoors shall be sufficient to provide a variety of play experiences that promote the children's emotional and social development, health and physical development, approaches to play and learning, language development, and communication and cognitive development. In space 4, there were not enough materials for the children to engage in play. Today, I observed the book area did not have additional language materials and the fine motor area had only puzzles. Emergency Medical Action Plan The Emergency Medical Action Plan Implementation Guide states that the plan is posted in an area that is easily assessable for staff and parents. Today, you posted the Emergency Medical Action Plan on your parent’s information board and made sure that it was posted in each of the classrooms. Make sure the Emergency Medical Action Plan remains posted, current, and made accessible to staff and parents. Window screens: In space 2B, the screens on the windows are torn and in need of repair. Torn screens can be a safety concern, especially with insect control. Today, we discussed replacing these screens, due to the windows being used during operating hours. Reminder: the fire inspection report must be submitted to DCDEE within one week of the inspection visit on a form provided by the Division. Qualification Letter: Today, we discussed having a Qualification Letter on-site for all therapists that come into the facility and that will be left alone with the children for any amount of time. We discussed having a file for therapist for you to keep their qualification letter on-site and available for review. If the therapist is always under the supervision of a qualified staff member, the therapist does not need a qualification letter on-site. Choosing a Pathway to the Stars: The new rules related to the star rated license system (QRIS) have been approved. The DCDEE team looks forward to working with child care facilities across the state to transition to the new QRIS system, also known as Pathways to the Stars, located in Section .3200 of the Child Care Rules. The transition has begun with the following informational opportunities: •You can review the rule roll out module in the DCDEE e-learning Moodle platform. •If you were unable to attend the webinars regarding Choosing a Pathway to the Stars, the sessions were recorded and are posted on the QRIS Modernization page. • Beginning In October, child care consultants will begin discussing the new rules during licensing visits. Consultants will review the pathway options, identify facility needs, answer questions, and work with the facility operator to establish an individualized timeline for transition to a new rated license within 12 months based on the pathway chosen. •Follow this link for detailed information: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRISModernization. Today, I completed a QRIS Conversation Template for your facility. You reported that your facility is choosing Pathway Two, Classroom and Instructional Quality and that you plan to apply in June 2026. A copy of this template is attached to this visit summary. We understand this is a big change and are committed to ensuring all providers have a good understanding of the new opportunities in order to make informed decisions on which pathway best suits the needs of the facility. We look forward to working with you on your pathway to the stars! Handwashing Procedures: According to Center for Disease Control and Prevention, Clean hands save lives. Handwashing is like a "do-it-yourself" vaccine—it involves five simple and effective steps (Wet, Lather, Scrub, Rinse, Dry) you can take to reduce the spread of diarrheal and respiratory illness so you can stay healthy. Regular handwashing, particularly before and after certain activities, is one of the best ways to remove germs, avoid getting sick, and prevent the spread of germs to others. It's quick, it's simple, and it can keep us all from getting sick. Handwashing is a win for everyone, except the germs. Today, we discussed reviewing the handwashing policies and procedures with your staff to ensure that proper handwashing is being performed during the day. Children must wash their hands upon arrival at the center, after each visit to the toilet, before eating, and before and after water play, after outside play, and/or after handling animals or animal cages. Staff must wash their hands thoroughly before beginning work, before/after handling food, before bottle feeding or serving other children, after toileting or handling body fluids, after diaper changing and/or after handling soiled items. Training opportunities: Every Relationship Matters Created by the ITTI Care Project, Every Relationship Matters! Strengthening Relationships between Adults in Child Care Settings for Directors, Teachers and FCCH Professionals is a free 1.5-hour training that highlights how important all the relationships that surround young children are. Address the Stress ITTI Care Project’s Address the Stress training is now available. This free 1-hour Wellness Workshop teaches ways to reduce stress and take care of YOU! Both are now available online via DCDEE Moodle! At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. Contact me with questions or concerns at 910-364-4898 or Natalie.m.pond@dhhs.nc.gov. If you need further assistance, please contact my supervisor at 910-824-0470 or kim.sherry@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-91 · Violation

Name of Operation: ALL ANNIE'S CHILDREN Facility ID: 24000165 Consultant: NATALIE M. POND Operation Type: Center Case Number: Visit Date: 12/9/2025 Number Present: 33 Completed Date: 12/9/2025 Age: From 0 To 5 Total Minutes: 330 Time In: 09:15 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. Heather Elliot, Child Care Consultant, assisted me with this visit. Your program currently operates with a Three Star Center License issued February 17, 2023. Restrictions on the license include a first shift capacity of 57 children ages 0 to 12, meets enhanced space, and children under 2 ½ years old in rooms with direct exits only. The last annual compliance visit was completed on January 7, 2025. The sanitation inspection was completed on June 12, 2025 with a “Superior” classification. The fire inspection was completed on May 13, 2025 and your facility was approved for daytime care only. The center's compliance history was reviewed with the operator. Prior to the visit the program’s eighteen-month compliance history was eighty-six percent (86%). L. Pollard, owner/administrator was present for the visit and accompanied us during classroom observations. There were fifty (50) children enrolled and thirty-three (33) children present. There were three (3) indoor spaces and two (2) outdoor spaces approved for use. One of the indoor spaces is divided into two groups, for a total of four (4) classrooms. Age-appropriate materials were accessible to all children and spaces were arranged into activity areas. In group one, infants received care according to individual needs. The infant and toddlers present were engaged in free play with a variety of materials and were moving about the room. Individual feeding schedules and safe sleep checks are being maintained. In group 2, children participated in a snowman art activity. In group 3, the children played with the teacher using puppets and telephones and were involved in individual changing routines. In group 4, the children were having breakfast that consisted of applesauce, sausage, hash browns, and milk. Supervision and staff-child ratios were observed and found to be in compliance. There were ten (10) staff members employed at this facility. Two (2) new staff and a percentage of veteran staff’s files were reviewed. A percentage of children’s files were reviewed. The following violation(s) were documented: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. Four of the six children's files reviewed did not have a signed statement of receipt of the summary of the NC Child Care Law. GS 110-102 428 A current activity plan was not posted for each group of children for reference. In space 4, the lesson plan posted was not dated and did not reflect current activities. GS 110-91(12); .0508(a) 468 When three year old children and older were in care, the materials and equipment in the activity area was not in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. In space 4, the book area and fine motor area did not contain enough materials to allow three children to use the area regardless of whether they choose the same or different activities. .0510(d)(1) 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. Two sippy cups in the kitchen refrigerator were not labeled with the children's names and the date. 15A NCAC 18A .2804(d) 705 Equipment and furnishings were not sturdy, stable and free of hazards. In space 2b, the paper attached to the back of the block shelf was torn and was being held by staples that were loose and easily removed. .0601(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In the hallway bathroom used by preschool children, there was an air freshener spray, a bottle of cleaner, and a lotion being stored in an unlocked cabinet under the sink. In space 2b, a bottle of disinfectant was being stored on top of the paper towel holder below five feet. In space 2a, a plug in air freshener with liquid was present in an outlet below 5 feet. .2820(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In space 1, a plastic bag was being used for storage in an unlocked cabinet under a sink accessible to the children. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. A monthly playground inspection was not documented for June, September, and October 2025. .0605(q) 1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. In the infant room, ITS-SIDS training for the two teachers present expired in September 2025. .1102(f) 1831 At least one child care provider, who has completed ITS-SIDS training was not present in the infant room, while children were in care. In the infant room, the ITS-SIDS training for the two teachers present had expired in September 2025. .01102 (f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. On the playground used by preschool children, the sand under the climbing structure was compacted and had grass growing within the fall zone. .0605(k)(1-4) 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 (18)-month compliance history score of at least seventy-five (75) percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before December 23, 2025, I must receive a written, dated, and signed compliance letter that describes accurately and in detail how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. Please note, if the compliance letter is not received by the agreed-upon date, a follow-up visit may be made to verify compliance. Mail or email the information to: Natalie Pond, Child Care Consultant P.O. Box 4 Wrightsville Beach, NC 28480 Natalie.m.pond@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance: Fall Zones: Today we discussed fall zones on the preschool playground. The sand under and around the climber/ slide structure is not the appropriate six inches of loose surfacing. We discussed removing the grass, tilling and adding additional sand to ensure that the depth of the sand is a resilient six inches. I suggest you create a weekly weeding schedule to remove the weeds throughout the sand surfacing. Equipment: In space 2B, I observed the furnishings in the space had staples sticking out of the shelves that could be easily removed by the children. Child Care Rule 09.0601(c) states that all equipment and furnishings are sturdy, stable, and free of hazards. Today we also discussed going through the toys on the playground to ensure that there are not any broken plastic toys present. Broken plastic may cause a child to pinch or possibly cut their fingers. When toys become broken, they must be removed from the play area as stated in G.S. 110-91(6); and Child Care Rule 09 .0601(b). Labeling of Children’s Cups In the kitchen, I observed that a few of the sippy cups were not labeled with the child’s name and date. Today we discussed that all sippy cups and bottles sent from home must be labeled appropriately with the child’s name and date to ensure that the correct child receives the correct cup. Storage of Hazardous Materials: Cleaner, lotion, and room deodorizing spray was/were found in the children’s shared women’s restroom under and on the counter and the disinfectant in Space 2A was on the paper towel dispenser and was not placed above 5 feet. Please review child care rules regarding storage and accessibility of potentially hazardous items. Items labeled “Keep out of reach of children” with no other warnings must be stored at a minimum of five feet off the floor. Hazardous cleaning supplies, including those kept under pressure in an aerosol can, as well as medications must be kept in locked storage. The definition of locked storage requires that the lock be unlocked with some type of device such as a key or combination. Regular childproofing locks do not meet this requirement. Ensure that all cleaning supplies and other items labeled “Keep out of reach of children” are kept inaccessible while children are in care. Today I suggested that since the bathrooms are a shared space, to complete a walk-through in the mornings to ensure that all items that state “Keep out of reach of children” are not accessible to the children. Also, we stated that the plug in air fresheners cannot be used as it contains chemicals that can potentially cause harm if ingested or touched. ITS-SIDS: All adults who provide care for infants 12 months or younger are required to be trained in Sudden Infant Death Syndrome (SIDS) risk reduction practices. The Infant/Toddler Safe Sleep and SIDS Risk Reduction in Child Care (ITS-SIDS) is the approved training. It prepares child care providers to follow their facility’s safe sleep policy. Child care centers licensed to care for infants 12 months and younger shall require child care administrators and all staff scheduled to work with infants, including volunteers counted in staff/child ratios, meet the following training requirements: Complete the ITS-SIDS training within 2 months of assuming responsibilities in the infant room, or within 90 days of assuming responsibility as a child care administrator. Complete the ITS-SIDS training again no more than 3 years from their previous ITS-SIDS training. Today, two of the staff members ITS-SIDS training had expired. You stated that you would be in contact with Smart Start to obtain the training for the two staff members immediately. In the meantime, at least one staff member that has a currently ITS-SIDS training must be present in the room caring for the infant children. Policies: Today we discussed the Safe Sleep policy and ensuring that all families get a copy and sign and date an acknowledgement form to keep in the children’s file. As rule .0606(c) states that a copy of the safe sleep policy is given to and/or explained to the parent of each child on or before the first day the infant attended the center. Today we discussed combining all the center’s policies, such as receipt of acknowledgement of operational policies, receipt of acknowledgement of the tobacco policy, parent participation plan, receipt of acknowledgement of Summary of the Law, and receipt of acknowledgement of the shaken baby and abusive head trauma policy on one form for the parents to initial beside, sign and date the bottom to help ensure that you have all the policies signed by the parents upon the child’s first day. Activity Plans: Child Care Rule 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS states (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. (b) For each group of children in care, the activity plan shall include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: (1) emotional and social development; (2) health and physical development; (3) approaches to play and learning; (4) language development and communication; and (5) cognitive development. In space 4, the activity plan posted did not have a date on the plan and the plan was not being followed, as the plan posted had the theme of fall and had activities about pumpkins. Plastic Bags: Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. According to rule .0604(q). In space 1, plastic bags were observed in the cabinet under the sink, assessable to the infant children that were in care. Today, we discussed removing the plastic bags and replacing the bags with a plastic bin with a lid. Materials: When preschool children three years old and older are in care the following shall apply: (1) the materials and equipment in an activity area should be in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. Additionally, Child Care Rule 10A NCAC 09 .0509 states the learning environment consists of the indoor and outdoor area which encourages child initiated and teacher supported activities as follows: (1) each center shall have developmentally appropriate equipment and materials accessible on a daily basis; (2) the materials and equipment indoors and outdoors shall be sufficient to provide a variety of play experiences that promote the children's emotional and social development, health and physical development, approaches to play and learning, language development, and communication and cognitive development. In space 4, there were not enough materials for the children to engage in play. Today, I observed the book area did not have additional language materials and the fine motor area had only puzzles. Emergency Medical Action Plan The Emergency Medical Action Plan Implementation Guide states that the plan is posted in an area that is easily assessable for staff and parents. Today, you posted the Emergency Medical Action Plan on your parent’s information board and made sure that it was posted in each of the classrooms. Make sure the Emergency Medical Action Plan remains posted, current, and made accessible to staff and parents. Window screens: In space 2B, the screens on the windows are torn and in need of repair. Torn screens can be a safety concern, especially with insect control. Today, we discussed replacing these screens, due to the windows being used during operating hours. Reminder: the fire inspection report must be submitted to DCDEE within one week of the inspection visit on a form provided by the Division. Qualification Letter: Today, we discussed having a Qualification Letter on-site for all therapists that come into the facility and that will be left alone with the children for any amount of time. We discussed having a file for therapist for you to keep their qualification letter on-site and available for review. If the therapist is always under the supervision of a qualified staff member, the therapist does not need a qualification letter on-site. Choosing a Pathway to the Stars: The new rules related to the star rated license system (QRIS) have been approved. The DCDEE team looks forward to working with child care facilities across the state to transition to the new QRIS system, also known as Pathways to the Stars, located in Section .3200 of the Child Care Rules. The transition has begun with the following informational opportunities: •You can review the rule roll out module in the DCDEE e-learning Moodle platform. •If you were unable to attend the webinars regarding Choosing a Pathway to the Stars, the sessions were recorded and are posted on the QRIS Modernization page. • Beginning In October, child care consultants will begin discussing the new rules during licensing visits. Consultants will review the pathway options, identify facility needs, answer questions, and work with the facility operator to establish an individualized timeline for transition to a new rated license within 12 months based on the pathway chosen. •Follow this link for detailed information: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRISModernization. Today, I completed a QRIS Conversation Template for your facility. You reported that your facility is choosing Pathway Two, Classroom and Instructional Quality and that you plan to apply in June 2026. A copy of this template is attached to this visit summary. We understand this is a big change and are committed to ensuring all providers have a good understanding of the new opportunities in order to make informed decisions on which pathway best suits the needs of the facility. We look forward to working with you on your pathway to the stars! Handwashing Procedures: According to Center for Disease Control and Prevention, Clean hands save lives. Handwashing is like a "do-it-yourself" vaccine—it involves five simple and effective steps (Wet, Lather, Scrub, Rinse, Dry) you can take to reduce the spread of diarrheal and respiratory illness so you can stay healthy. Regular handwashing, particularly before and after certain activities, is one of the best ways to remove germs, avoid getting sick, and prevent the spread of germs to others. It's quick, it's simple, and it can keep us all from getting sick. Handwashing is a win for everyone, except the germs. Today, we discussed reviewing the handwashing policies and procedures with your staff to ensure that proper handwashing is being performed during the day. Children must wash their hands upon arrival at the center, after each visit to the toilet, before eating, and before and after water play, after outside play, and/or after handling animals or animal cages. Staff must wash their hands thoroughly before beginning work, before/after handling food, before bottle feeding or serving other children, after toileting or handling body fluids, after diaper changing and/or after handling soiled items. Training opportunities: Every Relationship Matters Created by the ITTI Care Project, Every Relationship Matters! Strengthening Relationships between Adults in Child Care Settings for Directors, Teachers and FCCH Professionals is a free 1.5-hour training that highlights how important all the relationships that surround young children are. Address the Stress ITTI Care Project’s Address the Stress training is now available. This free 1-hour Wellness Workshop teaches ways to reduce stress and take care of YOU! Both are now available online via DCDEE Moodle! At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. Contact me with questions or concerns at 910-364-4898 or Natalie.m.pond@dhhs.nc.gov. If you need further assistance, please contact my supervisor at 910-824-0470 or kim.sherry@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-102 · Violation

Name of Operation: ALL ANNIE'S CHILDREN Facility ID: 24000165 Consultant: NATALIE M. POND Operation Type: Center Case Number: Visit Date: 12/9/2025 Number Present: 33 Completed Date: 12/9/2025 Age: From 0 To 5 Total Minutes: 330 Time In: 09:15 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. Heather Elliot, Child Care Consultant, assisted me with this visit. Your program currently operates with a Three Star Center License issued February 17, 2023. Restrictions on the license include a first shift capacity of 57 children ages 0 to 12, meets enhanced space, and children under 2 ½ years old in rooms with direct exits only. The last annual compliance visit was completed on January 7, 2025. The sanitation inspection was completed on June 12, 2025 with a “Superior” classification. The fire inspection was completed on May 13, 2025 and your facility was approved for daytime care only. The center's compliance history was reviewed with the operator. Prior to the visit the program’s eighteen-month compliance history was eighty-six percent (86%). L. Pollard, owner/administrator was present for the visit and accompanied us during classroom observations. There were fifty (50) children enrolled and thirty-three (33) children present. There were three (3) indoor spaces and two (2) outdoor spaces approved for use. One of the indoor spaces is divided into two groups, for a total of four (4) classrooms. Age-appropriate materials were accessible to all children and spaces were arranged into activity areas. In group one, infants received care according to individual needs. The infant and toddlers present were engaged in free play with a variety of materials and were moving about the room. Individual feeding schedules and safe sleep checks are being maintained. In group 2, children participated in a snowman art activity. In group 3, the children played with the teacher using puppets and telephones and were involved in individual changing routines. In group 4, the children were having breakfast that consisted of applesauce, sausage, hash browns, and milk. Supervision and staff-child ratios were observed and found to be in compliance. There were ten (10) staff members employed at this facility. Two (2) new staff and a percentage of veteran staff’s files were reviewed. A percentage of children’s files were reviewed. The following violation(s) were documented: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. Four of the six children's files reviewed did not have a signed statement of receipt of the summary of the NC Child Care Law. GS 110-102 428 A current activity plan was not posted for each group of children for reference. In space 4, the lesson plan posted was not dated and did not reflect current activities. GS 110-91(12); .0508(a) 468 When three year old children and older were in care, the materials and equipment in the activity area was not in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. In space 4, the book area and fine motor area did not contain enough materials to allow three children to use the area regardless of whether they choose the same or different activities. .0510(d)(1) 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. Two sippy cups in the kitchen refrigerator were not labeled with the children's names and the date. 15A NCAC 18A .2804(d) 705 Equipment and furnishings were not sturdy, stable and free of hazards. In space 2b, the paper attached to the back of the block shelf was torn and was being held by staples that were loose and easily removed. .0601(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In the hallway bathroom used by preschool children, there was an air freshener spray, a bottle of cleaner, and a lotion being stored in an unlocked cabinet under the sink. In space 2b, a bottle of disinfectant was being stored on top of the paper towel holder below five feet. In space 2a, a plug in air freshener with liquid was present in an outlet below 5 feet. .2820(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In space 1, a plastic bag was being used for storage in an unlocked cabinet under a sink accessible to the children. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. A monthly playground inspection was not documented for June, September, and October 2025. .0605(q) 1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. In the infant room, ITS-SIDS training for the two teachers present expired in September 2025. .1102(f) 1831 At least one child care provider, who has completed ITS-SIDS training was not present in the infant room, while children were in care. In the infant room, the ITS-SIDS training for the two teachers present had expired in September 2025. .01102 (f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. On the playground used by preschool children, the sand under the climbing structure was compacted and had grass growing within the fall zone. .0605(k)(1-4) 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 (18)-month compliance history score of at least seventy-five (75) percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before December 23, 2025, I must receive a written, dated, and signed compliance letter that describes accurately and in detail how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. Please note, if the compliance letter is not received by the agreed-upon date, a follow-up visit may be made to verify compliance. Mail or email the information to: Natalie Pond, Child Care Consultant P.O. Box 4 Wrightsville Beach, NC 28480 Natalie.m.pond@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance: Fall Zones: Today we discussed fall zones on the preschool playground. The sand under and around the climber/ slide structure is not the appropriate six inches of loose surfacing. We discussed removing the grass, tilling and adding additional sand to ensure that the depth of the sand is a resilient six inches. I suggest you create a weekly weeding schedule to remove the weeds throughout the sand surfacing. Equipment: In space 2B, I observed the furnishings in the space had staples sticking out of the shelves that could be easily removed by the children. Child Care Rule 09.0601(c) states that all equipment and furnishings are sturdy, stable, and free of hazards. Today we also discussed going through the toys on the playground to ensure that there are not any broken plastic toys present. Broken plastic may cause a child to pinch or possibly cut their fingers. When toys become broken, they must be removed from the play area as stated in G.S. 110-91(6); and Child Care Rule 09 .0601(b). Labeling of Children’s Cups In the kitchen, I observed that a few of the sippy cups were not labeled with the child’s name and date. Today we discussed that all sippy cups and bottles sent from home must be labeled appropriately with the child’s name and date to ensure that the correct child receives the correct cup. Storage of Hazardous Materials: Cleaner, lotion, and room deodorizing spray was/were found in the children’s shared women’s restroom under and on the counter and the disinfectant in Space 2A was on the paper towel dispenser and was not placed above 5 feet. Please review child care rules regarding storage and accessibility of potentially hazardous items. Items labeled “Keep out of reach of children” with no other warnings must be stored at a minimum of five feet off the floor. Hazardous cleaning supplies, including those kept under pressure in an aerosol can, as well as medications must be kept in locked storage. The definition of locked storage requires that the lock be unlocked with some type of device such as a key or combination. Regular childproofing locks do not meet this requirement. Ensure that all cleaning supplies and other items labeled “Keep out of reach of children” are kept inaccessible while children are in care. Today I suggested that since the bathrooms are a shared space, to complete a walk-through in the mornings to ensure that all items that state “Keep out of reach of children” are not accessible to the children. Also, we stated that the plug in air fresheners cannot be used as it contains chemicals that can potentially cause harm if ingested or touched. ITS-SIDS: All adults who provide care for infants 12 months or younger are required to be trained in Sudden Infant Death Syndrome (SIDS) risk reduction practices. The Infant/Toddler Safe Sleep and SIDS Risk Reduction in Child Care (ITS-SIDS) is the approved training. It prepares child care providers to follow their facility’s safe sleep policy. Child care centers licensed to care for infants 12 months and younger shall require child care administrators and all staff scheduled to work with infants, including volunteers counted in staff/child ratios, meet the following training requirements: Complete the ITS-SIDS training within 2 months of assuming responsibilities in the infant room, or within 90 days of assuming responsibility as a child care administrator. Complete the ITS-SIDS training again no more than 3 years from their previous ITS-SIDS training. Today, two of the staff members ITS-SIDS training had expired. You stated that you would be in contact with Smart Start to obtain the training for the two staff members immediately. In the meantime, at least one staff member that has a currently ITS-SIDS training must be present in the room caring for the infant children. Policies: Today we discussed the Safe Sleep policy and ensuring that all families get a copy and sign and date an acknowledgement form to keep in the children’s file. As rule .0606(c) states that a copy of the safe sleep policy is given to and/or explained to the parent of each child on or before the first day the infant attended the center. Today we discussed combining all the center’s policies, such as receipt of acknowledgement of operational policies, receipt of acknowledgement of the tobacco policy, parent participation plan, receipt of acknowledgement of Summary of the Law, and receipt of acknowledgement of the shaken baby and abusive head trauma policy on one form for the parents to initial beside, sign and date the bottom to help ensure that you have all the policies signed by the parents upon the child’s first day. Activity Plans: Child Care Rule 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS states (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. (b) For each group of children in care, the activity plan shall include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: (1) emotional and social development; (2) health and physical development; (3) approaches to play and learning; (4) language development and communication; and (5) cognitive development. In space 4, the activity plan posted did not have a date on the plan and the plan was not being followed, as the plan posted had the theme of fall and had activities about pumpkins. Plastic Bags: Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. According to rule .0604(q). In space 1, plastic bags were observed in the cabinet under the sink, assessable to the infant children that were in care. Today, we discussed removing the plastic bags and replacing the bags with a plastic bin with a lid. Materials: When preschool children three years old and older are in care the following shall apply: (1) the materials and equipment in an activity area should be in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. Additionally, Child Care Rule 10A NCAC 09 .0509 states the learning environment consists of the indoor and outdoor area which encourages child initiated and teacher supported activities as follows: (1) each center shall have developmentally appropriate equipment and materials accessible on a daily basis; (2) the materials and equipment indoors and outdoors shall be sufficient to provide a variety of play experiences that promote the children's emotional and social development, health and physical development, approaches to play and learning, language development, and communication and cognitive development. In space 4, there were not enough materials for the children to engage in play. Today, I observed the book area did not have additional language materials and the fine motor area had only puzzles. Emergency Medical Action Plan The Emergency Medical Action Plan Implementation Guide states that the plan is posted in an area that is easily assessable for staff and parents. Today, you posted the Emergency Medical Action Plan on your parent’s information board and made sure that it was posted in each of the classrooms. Make sure the Emergency Medical Action Plan remains posted, current, and made accessible to staff and parents. Window screens: In space 2B, the screens on the windows are torn and in need of repair. Torn screens can be a safety concern, especially with insect control. Today, we discussed replacing these screens, due to the windows being used during operating hours. Reminder: the fire inspection report must be submitted to DCDEE within one week of the inspection visit on a form provided by the Division. Qualification Letter: Today, we discussed having a Qualification Letter on-site for all therapists that come into the facility and that will be left alone with the children for any amount of time. We discussed having a file for therapist for you to keep their qualification letter on-site and available for review. If the therapist is always under the supervision of a qualified staff member, the therapist does not need a qualification letter on-site. Choosing a Pathway to the Stars: The new rules related to the star rated license system (QRIS) have been approved. The DCDEE team looks forward to working with child care facilities across the state to transition to the new QRIS system, also known as Pathways to the Stars, located in Section .3200 of the Child Care Rules. The transition has begun with the following informational opportunities: •You can review the rule roll out module in the DCDEE e-learning Moodle platform. •If you were unable to attend the webinars regarding Choosing a Pathway to the Stars, the sessions were recorded and are posted on the QRIS Modernization page. • Beginning In October, child care consultants will begin discussing the new rules during licensing visits. Consultants will review the pathway options, identify facility needs, answer questions, and work with the facility operator to establish an individualized timeline for transition to a new rated license within 12 months based on the pathway chosen. •Follow this link for detailed information: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRISModernization. Today, I completed a QRIS Conversation Template for your facility. You reported that your facility is choosing Pathway Two, Classroom and Instructional Quality and that you plan to apply in June 2026. A copy of this template is attached to this visit summary. We understand this is a big change and are committed to ensuring all providers have a good understanding of the new opportunities in order to make informed decisions on which pathway best suits the needs of the facility. We look forward to working with you on your pathway to the stars! Handwashing Procedures: According to Center for Disease Control and Prevention, Clean hands save lives. Handwashing is like a "do-it-yourself" vaccine—it involves five simple and effective steps (Wet, Lather, Scrub, Rinse, Dry) you can take to reduce the spread of diarrheal and respiratory illness so you can stay healthy. Regular handwashing, particularly before and after certain activities, is one of the best ways to remove germs, avoid getting sick, and prevent the spread of germs to others. It's quick, it's simple, and it can keep us all from getting sick. Handwashing is a win for everyone, except the germs. Today, we discussed reviewing the handwashing policies and procedures with your staff to ensure that proper handwashing is being performed during the day. Children must wash their hands upon arrival at the center, after each visit to the toilet, before eating, and before and after water play, after outside play, and/or after handling animals or animal cages. Staff must wash their hands thoroughly before beginning work, before/after handling food, before bottle feeding or serving other children, after toileting or handling body fluids, after diaper changing and/or after handling soiled items. Training opportunities: Every Relationship Matters Created by the ITTI Care Project, Every Relationship Matters! Strengthening Relationships between Adults in Child Care Settings for Directors, Teachers and FCCH Professionals is a free 1.5-hour training that highlights how important all the relationships that surround young children are. Address the Stress ITTI Care Project’s Address the Stress training is now available. This free 1-hour Wellness Workshop teaches ways to reduce stress and take care of YOU! Both are now available online via DCDEE Moodle! At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. Contact me with questions or concerns at 910-364-4898 or Natalie.m.pond@dhhs.nc.gov. If you need further assistance, please contact my supervisor at 910-824-0470 or kim.sherry@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-91 · Violation

Name of Operation: ALL ANNIE'S CHILDREN Facility ID: 24000165 Consultant: NATALIE M. POND Operation Type: Center Case Number: Visit Date: 12/9/2025 Number Present: 33 Completed Date: 12/9/2025 Age: From 0 To 5 Total Minutes: 330 Time In: 09:15 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. Heather Elliot, Child Care Consultant, assisted me with this visit. Your program currently operates with a Three Star Center License issued February 17, 2023. Restrictions on the license include a first shift capacity of 57 children ages 0 to 12, meets enhanced space, and children under 2 ½ years old in rooms with direct exits only. The last annual compliance visit was completed on January 7, 2025. The sanitation inspection was completed on June 12, 2025 with a “Superior” classification. The fire inspection was completed on May 13, 2025 and your facility was approved for daytime care only. The center's compliance history was reviewed with the operator. Prior to the visit the program’s eighteen-month compliance history was eighty-six percent (86%). L. Pollard, owner/administrator was present for the visit and accompanied us during classroom observations. There were fifty (50) children enrolled and thirty-three (33) children present. There were three (3) indoor spaces and two (2) outdoor spaces approved for use. One of the indoor spaces is divided into two groups, for a total of four (4) classrooms. Age-appropriate materials were accessible to all children and spaces were arranged into activity areas. In group one, infants received care according to individual needs. The infant and toddlers present were engaged in free play with a variety of materials and were moving about the room. Individual feeding schedules and safe sleep checks are being maintained. In group 2, children participated in a snowman art activity. In group 3, the children played with the teacher using puppets and telephones and were involved in individual changing routines. In group 4, the children were having breakfast that consisted of applesauce, sausage, hash browns, and milk. Supervision and staff-child ratios were observed and found to be in compliance. There were ten (10) staff members employed at this facility. Two (2) new staff and a percentage of veteran staff’s files were reviewed. A percentage of children’s files were reviewed. The following violation(s) were documented: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. Four of the six children's files reviewed did not have a signed statement of receipt of the summary of the NC Child Care Law. GS 110-102 428 A current activity plan was not posted for each group of children for reference. In space 4, the lesson plan posted was not dated and did not reflect current activities. GS 110-91(12); .0508(a) 468 When three year old children and older were in care, the materials and equipment in the activity area was not in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. In space 4, the book area and fine motor area did not contain enough materials to allow three children to use the area regardless of whether they choose the same or different activities. .0510(d)(1) 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. Two sippy cups in the kitchen refrigerator were not labeled with the children's names and the date. 15A NCAC 18A .2804(d) 705 Equipment and furnishings were not sturdy, stable and free of hazards. In space 2b, the paper attached to the back of the block shelf was torn and was being held by staples that were loose and easily removed. .0601(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In the hallway bathroom used by preschool children, there was an air freshener spray, a bottle of cleaner, and a lotion being stored in an unlocked cabinet under the sink. In space 2b, a bottle of disinfectant was being stored on top of the paper towel holder below five feet. In space 2a, a plug in air freshener with liquid was present in an outlet below 5 feet. .2820(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In space 1, a plastic bag was being used for storage in an unlocked cabinet under a sink accessible to the children. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. A monthly playground inspection was not documented for June, September, and October 2025. .0605(q) 1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. In the infant room, ITS-SIDS training for the two teachers present expired in September 2025. .1102(f) 1831 At least one child care provider, who has completed ITS-SIDS training was not present in the infant room, while children were in care. In the infant room, the ITS-SIDS training for the two teachers present had expired in September 2025. .01102 (f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. On the playground used by preschool children, the sand under the climbing structure was compacted and had grass growing within the fall zone. .0605(k)(1-4) 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 (18)-month compliance history score of at least seventy-five (75) percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before December 23, 2025, I must receive a written, dated, and signed compliance letter that describes accurately and in detail how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. Please note, if the compliance letter is not received by the agreed-upon date, a follow-up visit may be made to verify compliance. Mail or email the information to: Natalie Pond, Child Care Consultant P.O. Box 4 Wrightsville Beach, NC 28480 Natalie.m.pond@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance: Fall Zones: Today we discussed fall zones on the preschool playground. The sand under and around the climber/ slide structure is not the appropriate six inches of loose surfacing. We discussed removing the grass, tilling and adding additional sand to ensure that the depth of the sand is a resilient six inches. I suggest you create a weekly weeding schedule to remove the weeds throughout the sand surfacing. Equipment: In space 2B, I observed the furnishings in the space had staples sticking out of the shelves that could be easily removed by the children. Child Care Rule 09.0601(c) states that all equipment and furnishings are sturdy, stable, and free of hazards. Today we also discussed going through the toys on the playground to ensure that there are not any broken plastic toys present. Broken plastic may cause a child to pinch or possibly cut their fingers. When toys become broken, they must be removed from the play area as stated in G.S. 110-91(6); and Child Care Rule 09 .0601(b). Labeling of Children’s Cups In the kitchen, I observed that a few of the sippy cups were not labeled with the child’s name and date. Today we discussed that all sippy cups and bottles sent from home must be labeled appropriately with the child’s name and date to ensure that the correct child receives the correct cup. Storage of Hazardous Materials: Cleaner, lotion, and room deodorizing spray was/were found in the children’s shared women’s restroom under and on the counter and the disinfectant in Space 2A was on the paper towel dispenser and was not placed above 5 feet. Please review child care rules regarding storage and accessibility of potentially hazardous items. Items labeled “Keep out of reach of children” with no other warnings must be stored at a minimum of five feet off the floor. Hazardous cleaning supplies, including those kept under pressure in an aerosol can, as well as medications must be kept in locked storage. The definition of locked storage requires that the lock be unlocked with some type of device such as a key or combination. Regular childproofing locks do not meet this requirement. Ensure that all cleaning supplies and other items labeled “Keep out of reach of children” are kept inaccessible while children are in care. Today I suggested that since the bathrooms are a shared space, to complete a walk-through in the mornings to ensure that all items that state “Keep out of reach of children” are not accessible to the children. Also, we stated that the plug in air fresheners cannot be used as it contains chemicals that can potentially cause harm if ingested or touched. ITS-SIDS: All adults who provide care for infants 12 months or younger are required to be trained in Sudden Infant Death Syndrome (SIDS) risk reduction practices. The Infant/Toddler Safe Sleep and SIDS Risk Reduction in Child Care (ITS-SIDS) is the approved training. It prepares child care providers to follow their facility’s safe sleep policy. Child care centers licensed to care for infants 12 months and younger shall require child care administrators and all staff scheduled to work with infants, including volunteers counted in staff/child ratios, meet the following training requirements: Complete the ITS-SIDS training within 2 months of assuming responsibilities in the infant room, or within 90 days of assuming responsibility as a child care administrator. Complete the ITS-SIDS training again no more than 3 years from their previous ITS-SIDS training. Today, two of the staff members ITS-SIDS training had expired. You stated that you would be in contact with Smart Start to obtain the training for the two staff members immediately. In the meantime, at least one staff member that has a currently ITS-SIDS training must be present in the room caring for the infant children. Policies: Today we discussed the Safe Sleep policy and ensuring that all families get a copy and sign and date an acknowledgement form to keep in the children’s file. As rule .0606(c) states that a copy of the safe sleep policy is given to and/or explained to the parent of each child on or before the first day the infant attended the center. Today we discussed combining all the center’s policies, such as receipt of acknowledgement of operational policies, receipt of acknowledgement of the tobacco policy, parent participation plan, receipt of acknowledgement of Summary of the Law, and receipt of acknowledgement of the shaken baby and abusive head trauma policy on one form for the parents to initial beside, sign and date the bottom to help ensure that you have all the policies signed by the parents upon the child’s first day. Activity Plans: Child Care Rule 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS states (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. (b) For each group of children in care, the activity plan shall include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: (1) emotional and social development; (2) health and physical development; (3) approaches to play and learning; (4) language development and communication; and (5) cognitive development. In space 4, the activity plan posted did not have a date on the plan and the plan was not being followed, as the plan posted had the theme of fall and had activities about pumpkins. Plastic Bags: Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. According to rule .0604(q). In space 1, plastic bags were observed in the cabinet under the sink, assessable to the infant children that were in care. Today, we discussed removing the plastic bags and replacing the bags with a plastic bin with a lid. Materials: When preschool children three years old and older are in care the following shall apply: (1) the materials and equipment in an activity area should be in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. Additionally, Child Care Rule 10A NCAC 09 .0509 states the learning environment consists of the indoor and outdoor area which encourages child initiated and teacher supported activities as follows: (1) each center shall have developmentally appropriate equipment and materials accessible on a daily basis; (2) the materials and equipment indoors and outdoors shall be sufficient to provide a variety of play experiences that promote the children's emotional and social development, health and physical development, approaches to play and learning, language development, and communication and cognitive development. In space 4, there were not enough materials for the children to engage in play. Today, I observed the book area did not have additional language materials and the fine motor area had only puzzles. Emergency Medical Action Plan The Emergency Medical Action Plan Implementation Guide states that the plan is posted in an area that is easily assessable for staff and parents. Today, you posted the Emergency Medical Action Plan on your parent’s information board and made sure that it was posted in each of the classrooms. Make sure the Emergency Medical Action Plan remains posted, current, and made accessible to staff and parents. Window screens: In space 2B, the screens on the windows are torn and in need of repair. Torn screens can be a safety concern, especially with insect control. Today, we discussed replacing these screens, due to the windows being used during operating hours. Reminder: the fire inspection report must be submitted to DCDEE within one week of the inspection visit on a form provided by the Division. Qualification Letter: Today, we discussed having a Qualification Letter on-site for all therapists that come into the facility and that will be left alone with the children for any amount of time. We discussed having a file for therapist for you to keep their qualification letter on-site and available for review. If the therapist is always under the supervision of a qualified staff member, the therapist does not need a qualification letter on-site. Choosing a Pathway to the Stars: The new rules related to the star rated license system (QRIS) have been approved. The DCDEE team looks forward to working with child care facilities across the state to transition to the new QRIS system, also known as Pathways to the Stars, located in Section .3200 of the Child Care Rules. The transition has begun with the following informational opportunities: •You can review the rule roll out module in the DCDEE e-learning Moodle platform. •If you were unable to attend the webinars regarding Choosing a Pathway to the Stars, the sessions were recorded and are posted on the QRIS Modernization page. • Beginning In October, child care consultants will begin discussing the new rules during licensing visits. Consultants will review the pathway options, identify facility needs, answer questions, and work with the facility operator to establish an individualized timeline for transition to a new rated license within 12 months based on the pathway chosen. •Follow this link for detailed information: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRISModernization. Today, I completed a QRIS Conversation Template for your facility. You reported that your facility is choosing Pathway Two, Classroom and Instructional Quality and that you plan to apply in June 2026. A copy of this template is attached to this visit summary. We understand this is a big change and are committed to ensuring all providers have a good understanding of the new opportunities in order to make informed decisions on which pathway best suits the needs of the facility. We look forward to working with you on your pathway to the stars! Handwashing Procedures: According to Center for Disease Control and Prevention, Clean hands save lives. Handwashing is like a "do-it-yourself" vaccine—it involves five simple and effective steps (Wet, Lather, Scrub, Rinse, Dry) you can take to reduce the spread of diarrheal and respiratory illness so you can stay healthy. Regular handwashing, particularly before and after certain activities, is one of the best ways to remove germs, avoid getting sick, and prevent the spread of germs to others. It's quick, it's simple, and it can keep us all from getting sick. Handwashing is a win for everyone, except the germs. Today, we discussed reviewing the handwashing policies and procedures with your staff to ensure that proper handwashing is being performed during the day. Children must wash their hands upon arrival at the center, after each visit to the toilet, before eating, and before and after water play, after outside play, and/or after handling animals or animal cages. Staff must wash their hands thoroughly before beginning work, before/after handling food, before bottle feeding or serving other children, after toileting or handling body fluids, after diaper changing and/or after handling soiled items. Training opportunities: Every Relationship Matters Created by the ITTI Care Project, Every Relationship Matters! Strengthening Relationships between Adults in Child Care Settings for Directors, Teachers and FCCH Professionals is a free 1.5-hour training that highlights how important all the relationships that surround young children are. Address the Stress ITTI Care Project’s Address the Stress training is now available. This free 1-hour Wellness Workshop teaches ways to reduce stress and take care of YOU! Both are now available online via DCDEE Moodle! At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. Contact me with questions or concerns at 910-364-4898 or Natalie.m.pond@dhhs.nc.gov. If you need further assistance, please contact my supervisor at 910-824-0470 or kim.sherry@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: ALL ANNIE'S CHILDREN Facility ID: 24000165 Consultant: NATALIE M. POND Operation Type: Center Case Number: Visit Date: 12/9/2025 Number Present: 33 Completed Date: 12/9/2025 Age: From 0 To 5 Total Minutes: 330 Time In: 09:15 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. Heather Elliot, Child Care Consultant, assisted me with this visit. Your program currently operates with a Three Star Center License issued February 17, 2023. Restrictions on the license include a first shift capacity of 57 children ages 0 to 12, meets enhanced space, and children under 2 ½ years old in rooms with direct exits only. The last annual compliance visit was completed on January 7, 2025. The sanitation inspection was completed on June 12, 2025 with a “Superior” classification. The fire inspection was completed on May 13, 2025 and your facility was approved for daytime care only. The center's compliance history was reviewed with the operator. Prior to the visit the program’s eighteen-month compliance history was eighty-six percent (86%). L. Pollard, owner/administrator was present for the visit and accompanied us during classroom observations. There were fifty (50) children enrolled and thirty-three (33) children present. There were three (3) indoor spaces and two (2) outdoor spaces approved for use. One of the indoor spaces is divided into two groups, for a total of four (4) classrooms. Age-appropriate materials were accessible to all children and spaces were arranged into activity areas. In group one, infants received care according to individual needs. The infant and toddlers present were engaged in free play with a variety of materials and were moving about the room. Individual feeding schedules and safe sleep checks are being maintained. In group 2, children participated in a snowman art activity. In group 3, the children played with the teacher using puppets and telephones and were involved in individual changing routines. In group 4, the children were having breakfast that consisted of applesauce, sausage, hash browns, and milk. Supervision and staff-child ratios were observed and found to be in compliance. There were ten (10) staff members employed at this facility. Two (2) new staff and a percentage of veteran staff’s files were reviewed. A percentage of children’s files were reviewed. The following violation(s) were documented: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. Four of the six children's files reviewed did not have a signed statement of receipt of the summary of the NC Child Care Law. GS 110-102 428 A current activity plan was not posted for each group of children for reference. In space 4, the lesson plan posted was not dated and did not reflect current activities. GS 110-91(12); .0508(a) 468 When three year old children and older were in care, the materials and equipment in the activity area was not in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. In space 4, the book area and fine motor area did not contain enough materials to allow three children to use the area regardless of whether they choose the same or different activities. .0510(d)(1) 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. Two sippy cups in the kitchen refrigerator were not labeled with the children's names and the date. 15A NCAC 18A .2804(d) 705 Equipment and furnishings were not sturdy, stable and free of hazards. In space 2b, the paper attached to the back of the block shelf was torn and was being held by staples that were loose and easily removed. .0601(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In the hallway bathroom used by preschool children, there was an air freshener spray, a bottle of cleaner, and a lotion being stored in an unlocked cabinet under the sink. In space 2b, a bottle of disinfectant was being stored on top of the paper towel holder below five feet. In space 2a, a plug in air freshener with liquid was present in an outlet below 5 feet. .2820(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In space 1, a plastic bag was being used for storage in an unlocked cabinet under a sink accessible to the children. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. A monthly playground inspection was not documented for June, September, and October 2025. .0605(q) 1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. In the infant room, ITS-SIDS training for the two teachers present expired in September 2025. .1102(f) 1831 At least one child care provider, who has completed ITS-SIDS training was not present in the infant room, while children were in care. In the infant room, the ITS-SIDS training for the two teachers present had expired in September 2025. .01102 (f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. On the playground used by preschool children, the sand under the climbing structure was compacted and had grass growing within the fall zone. .0605(k)(1-4) 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 (18)-month compliance history score of at least seventy-five (75) percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before December 23, 2025, I must receive a written, dated, and signed compliance letter that describes accurately and in detail how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. Please note, if the compliance letter is not received by the agreed-upon date, a follow-up visit may be made to verify compliance. Mail or email the information to: Natalie Pond, Child Care Consultant P.O. Box 4 Wrightsville Beach, NC 28480 Natalie.m.pond@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance: Fall Zones: Today we discussed fall zones on the preschool playground. The sand under and around the climber/ slide structure is not the appropriate six inches of loose surfacing. We discussed removing the grass, tilling and adding additional sand to ensure that the depth of the sand is a resilient six inches. I suggest you create a weekly weeding schedule to remove the weeds throughout the sand surfacing. Equipment: In space 2B, I observed the furnishings in the space had staples sticking out of the shelves that could be easily removed by the children. Child Care Rule 09.0601(c) states that all equipment and furnishings are sturdy, stable, and free of hazards. Today we also discussed going through the toys on the playground to ensure that there are not any broken plastic toys present. Broken plastic may cause a child to pinch or possibly cut their fingers. When toys become broken, they must be removed from the play area as stated in G.S. 110-91(6); and Child Care Rule 09 .0601(b). Labeling of Children’s Cups In the kitchen, I observed that a few of the sippy cups were not labeled with the child’s name and date. Today we discussed that all sippy cups and bottles sent from home must be labeled appropriately with the child’s name and date to ensure that the correct child receives the correct cup. Storage of Hazardous Materials: Cleaner, lotion, and room deodorizing spray was/were found in the children’s shared women’s restroom under and on the counter and the disinfectant in Space 2A was on the paper towel dispenser and was not placed above 5 feet. Please review child care rules regarding storage and accessibility of potentially hazardous items. Items labeled “Keep out of reach of children” with no other warnings must be stored at a minimum of five feet off the floor. Hazardous cleaning supplies, including those kept under pressure in an aerosol can, as well as medications must be kept in locked storage. The definition of locked storage requires that the lock be unlocked with some type of device such as a key or combination. Regular childproofing locks do not meet this requirement. Ensure that all cleaning supplies and other items labeled “Keep out of reach of children” are kept inaccessible while children are in care. Today I suggested that since the bathrooms are a shared space, to complete a walk-through in the mornings to ensure that all items that state “Keep out of reach of children” are not accessible to the children. Also, we stated that the plug in air fresheners cannot be used as it contains chemicals that can potentially cause harm if ingested or touched. ITS-SIDS: All adults who provide care for infants 12 months or younger are required to be trained in Sudden Infant Death Syndrome (SIDS) risk reduction practices. The Infant/Toddler Safe Sleep and SIDS Risk Reduction in Child Care (ITS-SIDS) is the approved training. It prepares child care providers to follow their facility’s safe sleep policy. Child care centers licensed to care for infants 12 months and younger shall require child care administrators and all staff scheduled to work with infants, including volunteers counted in staff/child ratios, meet the following training requirements: Complete the ITS-SIDS training within 2 months of assuming responsibilities in the infant room, or within 90 days of assuming responsibility as a child care administrator. Complete the ITS-SIDS training again no more than 3 years from their previous ITS-SIDS training. Today, two of the staff members ITS-SIDS training had expired. You stated that you would be in contact with Smart Start to obtain the training for the two staff members immediately. In the meantime, at least one staff member that has a currently ITS-SIDS training must be present in the room caring for the infant children. Policies: Today we discussed the Safe Sleep policy and ensuring that all families get a copy and sign and date an acknowledgement form to keep in the children’s file. As rule .0606(c) states that a copy of the safe sleep policy is given to and/or explained to the parent of each child on or before the first day the infant attended the center. Today we discussed combining all the center’s policies, such as receipt of acknowledgement of operational policies, receipt of acknowledgement of the tobacco policy, parent participation plan, receipt of acknowledgement of Summary of the Law, and receipt of acknowledgement of the shaken baby and abusive head trauma policy on one form for the parents to initial beside, sign and date the bottom to help ensure that you have all the policies signed by the parents upon the child’s first day. Activity Plans: Child Care Rule 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS states (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. (b) For each group of children in care, the activity plan shall include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: (1) emotional and social development; (2) health and physical development; (3) approaches to play and learning; (4) language development and communication; and (5) cognitive development. In space 4, the activity plan posted did not have a date on the plan and the plan was not being followed, as the plan posted had the theme of fall and had activities about pumpkins. Plastic Bags: Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. According to rule .0604(q). In space 1, plastic bags were observed in the cabinet under the sink, assessable to the infant children that were in care. Today, we discussed removing the plastic bags and replacing the bags with a plastic bin with a lid. Materials: When preschool children three years old and older are in care the following shall apply: (1) the materials and equipment in an activity area should be in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. Additionally, Child Care Rule 10A NCAC 09 .0509 states the learning environment consists of the indoor and outdoor area which encourages child initiated and teacher supported activities as follows: (1) each center shall have developmentally appropriate equipment and materials accessible on a daily basis; (2) the materials and equipment indoors and outdoors shall be sufficient to provide a variety of play experiences that promote the children's emotional and social development, health and physical development, approaches to play and learning, language development, and communication and cognitive development. In space 4, there were not enough materials for the children to engage in play. Today, I observed the book area did not have additional language materials and the fine motor area had only puzzles. Emergency Medical Action Plan The Emergency Medical Action Plan Implementation Guide states that the plan is posted in an area that is easily assessable for staff and parents. Today, you posted the Emergency Medical Action Plan on your parent’s information board and made sure that it was posted in each of the classrooms. Make sure the Emergency Medical Action Plan remains posted, current, and made accessible to staff and parents. Window screens: In space 2B, the screens on the windows are torn and in need of repair. Torn screens can be a safety concern, especially with insect control. Today, we discussed replacing these screens, due to the windows being used during operating hours. Reminder: the fire inspection report must be submitted to DCDEE within one week of the inspection visit on a form provided by the Division. Qualification Letter: Today, we discussed having a Qualification Letter on-site for all therapists that come into the facility and that will be left alone with the children for any amount of time. We discussed having a file for therapist for you to keep their qualification letter on-site and available for review. If the therapist is always under the supervision of a qualified staff member, the therapist does not need a qualification letter on-site. Choosing a Pathway to the Stars: The new rules related to the star rated license system (QRIS) have been approved. The DCDEE team looks forward to working with child care facilities across the state to transition to the new QRIS system, also known as Pathways to the Stars, located in Section .3200 of the Child Care Rules. The transition has begun with the following informational opportunities: •You can review the rule roll out module in the DCDEE e-learning Moodle platform. •If you were unable to attend the webinars regarding Choosing a Pathway to the Stars, the sessions were recorded and are posted on the QRIS Modernization page. • Beginning In October, child care consultants will begin discussing the new rules during licensing visits. Consultants will review the pathway options, identify facility needs, answer questions, and work with the facility operator to establish an individualized timeline for transition to a new rated license within 12 months based on the pathway chosen. •Follow this link for detailed information: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRISModernization. Today, I completed a QRIS Conversation Template for your facility. You reported that your facility is choosing Pathway Two, Classroom and Instructional Quality and that you plan to apply in June 2026. A copy of this template is attached to this visit summary. We understand this is a big change and are committed to ensuring all providers have a good understanding of the new opportunities in order to make informed decisions on which pathway best suits the needs of the facility. We look forward to working with you on your pathway to the stars! Handwashing Procedures: According to Center for Disease Control and Prevention, Clean hands save lives. Handwashing is like a "do-it-yourself" vaccine—it involves five simple and effective steps (Wet, Lather, Scrub, Rinse, Dry) you can take to reduce the spread of diarrheal and respiratory illness so you can stay healthy. Regular handwashing, particularly before and after certain activities, is one of the best ways to remove germs, avoid getting sick, and prevent the spread of germs to others. It's quick, it's simple, and it can keep us all from getting sick. Handwashing is a win for everyone, except the germs. Today, we discussed reviewing the handwashing policies and procedures with your staff to ensure that proper handwashing is being performed during the day. Children must wash their hands upon arrival at the center, after each visit to the toilet, before eating, and before and after water play, after outside play, and/or after handling animals or animal cages. Staff must wash their hands thoroughly before beginning work, before/after handling food, before bottle feeding or serving other children, after toileting or handling body fluids, after diaper changing and/or after handling soiled items. Training opportunities: Every Relationship Matters Created by the ITTI Care Project, Every Relationship Matters! Strengthening Relationships between Adults in Child Care Settings for Directors, Teachers and FCCH Professionals is a free 1.5-hour training that highlights how important all the relationships that surround young children are. Address the Stress ITTI Care Project’s Address the Stress training is now available. This free 1-hour Wellness Workshop teaches ways to reduce stress and take care of YOU! Both are now available online via DCDEE Moodle! At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. Contact me with questions or concerns at 910-364-4898 or Natalie.m.pond@dhhs.nc.gov. If you need further assistance, please contact my supervisor at 910-824-0470 or kim.sherry@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: ALL ANNIE'S CHILDREN Facility ID: 24000165 Consultant: JENNIFER GARNER Operation Type: Center Case Number: Visit Date: 1/7/2025 Number Present: 38 Completed Date: 1/7/2025 Age: From 0 To 5 Total Minutes: 195 Time In: 08:30 AM Time Out: 11:45 AM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance with applicable child care requirements pertinent to this visit type. This facility currently operates with a Three Star issued February 17, 2023. Restrictions include: a first shift capacity of 57 children 0-12 years of age, meets enhanced space, and children under 2 ½ years old in rooms with direct exits only. Restrictions were in compliance today. The last annual compliance visit was conducted January 11, 2024. A Superior sanitation rating was earned September 25, 2024, and a fire inspection was conducted June 12, 2024; the facility was approved for day time care only. Prior to the visit, the facility had an eighteen-month compliance history score of 88%. Owner/Administrator Linda Pollard was present and available for consultation today. Three indoor spaces and two outdoor spaces are approved for use; Indoor Space 2 is separated into two distinct spaces using furniture. Infants and children one year of age in Space 1 were observed in individual feeding and sleeping routines as well as play activities. Safe sleep practices including documentation were monitored and appeared in compliance today based on staff reports of the infant’s nap times. Children in space 2a and 2b were observed having breakfast. Breakfast today consisted of blueberry muffins, bacon, cooked apples and milk. After breakfast children participated in free play. In Space 3, preschool children were observed during an interactive group time. After group time children had breakfast. All staff members employed more than one year have completed the Health and Safety trainings as outlined in Child Care Rule 10A NCAC 09 .1102, and staff members employed at least five years have now repeated all topics as required. Child Care programs are expected to always achieve and maintain compliance with child care rules, and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The following violations were observed today and must be corrected immediately: Violation Number Comment Rule 468 When three year old children and older were in care, the materials and equipment in the activity area was not in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. In space 2a, 2b and 3 materials in each activity area were not in sufficient quantity to allow three children to choose the same or different activities. .0510(d)(1) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space 3 aerosol spray, cleaning wipes and cleaners were store in an unlocked cabinet under the sink accessible to children. .2820(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic bags stored in a low filing cabinet and in the art drawers were accessible to children under three-years-old. .0604(q) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The sand surfacing had grass growing thorough it keeping it compact. .0605(k)(1-4) A compliance letter including detailed information about how all violations have been corrected must be received by January 17, 2025. Include any supporting documentation with your response (if applicable). Your letter will be used as verification that violations have been corrected and compliance is maintained; your written response is considered a legal document so must be accurate and truthful. If you email the compliance letter, it must be sent using the email address registered with DCDEE and include your facility name and ID number. If sufficient information is not received by the due date, a follow-up visit will be conducted. Technical Assistance Regarding Violations Cited: Five of the following activity areas must be available daily: art and other creative play, children's books, blocks and block building, manipulatives, and family living and dramatic play. In your preschool classrooms have the following activity areas: art, blocks, dramatic play, manipulatives and language. Art materials were not stored in a way to be easily accessible to children. Crayons were in contains with screw-top lids. Some art supplies were stored in drawers with solids fronts so you could not see what was in the drawer. Some art supplies were stored in a closed cabinet. The book areas only contained books, no additional materials. Each book area will need least 2 other items designed to promote language development like puppets, flannel board & flannel accessories, books on tape/CD. Your dramatic play areas were missing dress up clothes. You stated you took the dress-up clothes home over the weekend to wash them. Manipulatives were scattered thought the space. Organize each activity area and ensure materials are displayed and easily accessible to children. Remember the materials and equipment in an activity area shall be in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. When times are removed for cleaning, replacement items need to be added in the interim. In space 2a and 2b, plastic bags were accessible in the drawers containing art materials. For the safety of the children, ensure any plastic bags used for storage are kept inaccessible to children under the age of three years old by keeping them at a minimum height of five feet off the floor. Please review child care rules regarding storage and accessibility of potentially hazardous items. Items labeled “Keep out of reach of children” with no other warnings must be stored at a minimum of five feet off the floor. Hazardous cleaning supplies, including those kept under pressure in an aerosol can, as well as medications must be kept in locked storage. The definition of locked storage requires that the lock be unlocked with some type of device such as a key or combination. Regular childproofing locks do not meet this requirement. Ensure that all cleaning supplies and other items labeled “Keep out of reach of children” are kept inaccessible while children are in care. I suggest having a replacement cabinet lock on site in the event a lock is misplaced. Today we discussed fall zones on the preschool playground. The sand under and around the climber/ slide structure is not the appropriate six inches of loose surfacing. We discussed removing the grass and tilling the sand to ensure that the depth of the sand is a resilient six inches. I suggest you create a weekly weeding schedule to remove the weeds throughout the sand surfacing. Technical Assistance Stay up to date with the Division of Child Development and Early Education by visiting www.ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. Click on the “What’s New” tab for important updates impacting child care in North Carolina. North Carolina child care administrators can now view and edit their facility’s staff roster in ABCMS, the DCDEE’s criminal background check system. Provider Access to ABCMS allows administrators 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. To get started, complete the ABCMS Child Care Provider Portal Training in Moodle—a video tutorial followed by a few questions. The ABCMS portal is now being used to meet the requirement of notifying the Division of staff changes (see email sent 11/25/24 for more information). Compliance with this requirement will be monitored during future visits. Rated License Information As discussed during the July 30, 2024 Routine Unannounced visit, the “hold harmless” state of rated license reassessments has been extended until the new Quality Rating Improvement System (QRIS) rules are put in place. Starting on February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—will be used for DCDEE environment rating scale assessments. The DCDEE and the North Carolina Rated License Assessment Project (NCRLAP) are collaboratively working on preparations for the transition to the third editions. These third editions come with a spiral binding at the top, replacing the current revised editions. Visit the NCRLAP’s website for more information about updated resources, credit hour trainings, and outreach assessment opportunities to help you become familiar with these tools. Regarding education standards, when new QRIS rules are implemented, education requirements will be different, but it is still critical that all staff in key positions have complete WORKS evaluations to assist with the rated license reassessment process. Please let me know if you need assistance with DCDEE WORKS or education evaluation. Reminders According to the Clean Classrooms for Carolina Kids program you have not completed your enrollment for lead and asbestos hazards in building infrastructure. Please see steps below: 1. Sign Up – Pre-enrollment webinars are available at cleanwaterforUSkids.org/carolina or paste https://bit.ly/3CK-webinar into your web browser to see available dates and times for the next month. 2. Enroll – At www.cleanwaterforUSkids.org/carolina using the PIN and complete the enrollment surveys for three program sections: 1) lead in water, 2) lead-based paint, and 3) asbestos. 3. Evaluate Hazards - The program will ship your facility a water sample kit and may coordinate an on-site visit by a professional to assess for lead-based paint and asbestos hazards, if needed. 4. Receive Results – Receive your results, recommendations, and water mitigation support, if needed. 5. Request Reimbursement - If you choose to conduct lead-based paint or asbestos mitigation, you can request reimbursement from NC DHHS. Visit the web site at: https://www.ncdhhs.gov/divisions/public-health/asbestos-and-lead-based-paint-reimbursement-program-arpa The reporting period for child care immunizations is now open. Reporting for 2024-2025 has been extended due to Hurricane Helene. Children have a grace period from requirements until November 30, 2024, and reports will be accepted until January 15, 2025. Use this link to submit your report: https://survey.alchemer.com/s3/7955242/2024-2025-Child-Care-Immunization-Report. Send any questions regarding child care immunization reporting to immunization.reports@dhhs.nc.gov. Documentation was completed and reviewed on site, printed and signed. Remember it is your responsibility to comply with all child care rules and requirements at all times. Contact me at Jennifer.j.garner@dhhs.nc.gov at (910)824-1447 with any questions or concerns. 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: ratio. Open / not marked corrected.

NC GS 110-90 · Violation

Name of Operation: ALL ANNIE'S CHILDREN Facility ID: 24000165 Consultant: JENNIFER GARNER Operation Type: Center Case Number: Visit Date: 1/7/2025 Number Present: 38 Completed Date: 1/7/2025 Age: From 0 To 5 Total Minutes: 195 Time In: 08:30 AM Time Out: 11:45 AM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance with applicable child care requirements pertinent to this visit type. This facility currently operates with a Three Star issued February 17, 2023. Restrictions include: a first shift capacity of 57 children 0-12 years of age, meets enhanced space, and children under 2 ½ years old in rooms with direct exits only. Restrictions were in compliance today. The last annual compliance visit was conducted January 11, 2024. A Superior sanitation rating was earned September 25, 2024, and a fire inspection was conducted June 12, 2024; the facility was approved for day time care only. Prior to the visit, the facility had an eighteen-month compliance history score of 88%. Owner/Administrator Linda Pollard was present and available for consultation today. Three indoor spaces and two outdoor spaces are approved for use; Indoor Space 2 is separated into two distinct spaces using furniture. Infants and children one year of age in Space 1 were observed in individual feeding and sleeping routines as well as play activities. Safe sleep practices including documentation were monitored and appeared in compliance today based on staff reports of the infant’s nap times. Children in space 2a and 2b were observed having breakfast. Breakfast today consisted of blueberry muffins, bacon, cooked apples and milk. After breakfast children participated in free play. In Space 3, preschool children were observed during an interactive group time. After group time children had breakfast. All staff members employed more than one year have completed the Health and Safety trainings as outlined in Child Care Rule 10A NCAC 09 .1102, and staff members employed at least five years have now repeated all topics as required. Child Care programs are expected to always achieve and maintain compliance with child care rules, and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The following violations were observed today and must be corrected immediately: Violation Number Comment Rule 468 When three year old children and older were in care, the materials and equipment in the activity area was not in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. In space 2a, 2b and 3 materials in each activity area were not in sufficient quantity to allow three children to choose the same or different activities. .0510(d)(1) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space 3 aerosol spray, cleaning wipes and cleaners were store in an unlocked cabinet under the sink accessible to children. .2820(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic bags stored in a low filing cabinet and in the art drawers were accessible to children under three-years-old. .0604(q) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The sand surfacing had grass growing thorough it keeping it compact. .0605(k)(1-4) A compliance letter including detailed information about how all violations have been corrected must be received by January 17, 2025. Include any supporting documentation with your response (if applicable). Your letter will be used as verification that violations have been corrected and compliance is maintained; your written response is considered a legal document so must be accurate and truthful. If you email the compliance letter, it must be sent using the email address registered with DCDEE and include your facility name and ID number. If sufficient information is not received by the due date, a follow-up visit will be conducted. Technical Assistance Regarding Violations Cited: Five of the following activity areas must be available daily: art and other creative play, children's books, blocks and block building, manipulatives, and family living and dramatic play. In your preschool classrooms have the following activity areas: art, blocks, dramatic play, manipulatives and language. Art materials were not stored in a way to be easily accessible to children. Crayons were in contains with screw-top lids. Some art supplies were stored in drawers with solids fronts so you could not see what was in the drawer. Some art supplies were stored in a closed cabinet. The book areas only contained books, no additional materials. Each book area will need least 2 other items designed to promote language development like puppets, flannel board & flannel accessories, books on tape/CD. Your dramatic play areas were missing dress up clothes. You stated you took the dress-up clothes home over the weekend to wash them. Manipulatives were scattered thought the space. Organize each activity area and ensure materials are displayed and easily accessible to children. Remember the materials and equipment in an activity area shall be in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. When times are removed for cleaning, replacement items need to be added in the interim. In space 2a and 2b, plastic bags were accessible in the drawers containing art materials. For the safety of the children, ensure any plastic bags used for storage are kept inaccessible to children under the age of three years old by keeping them at a minimum height of five feet off the floor. Please review child care rules regarding storage and accessibility of potentially hazardous items. Items labeled “Keep out of reach of children” with no other warnings must be stored at a minimum of five feet off the floor. Hazardous cleaning supplies, including those kept under pressure in an aerosol can, as well as medications must be kept in locked storage. The definition of locked storage requires that the lock be unlocked with some type of device such as a key or combination. Regular childproofing locks do not meet this requirement. Ensure that all cleaning supplies and other items labeled “Keep out of reach of children” are kept inaccessible while children are in care. I suggest having a replacement cabinet lock on site in the event a lock is misplaced. Today we discussed fall zones on the preschool playground. The sand under and around the climber/ slide structure is not the appropriate six inches of loose surfacing. We discussed removing the grass and tilling the sand to ensure that the depth of the sand is a resilient six inches. I suggest you create a weekly weeding schedule to remove the weeds throughout the sand surfacing. Technical Assistance Stay up to date with the Division of Child Development and Early Education by visiting www.ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. Click on the “What’s New” tab for important updates impacting child care in North Carolina. North Carolina child care administrators can now view and edit their facility’s staff roster in ABCMS, the DCDEE’s criminal background check system. Provider Access to ABCMS allows administrators 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. To get started, complete the ABCMS Child Care Provider Portal Training in Moodle—a video tutorial followed by a few questions. The ABCMS portal is now being used to meet the requirement of notifying the Division of staff changes (see email sent 11/25/24 for more information). Compliance with this requirement will be monitored during future visits. Rated License Information As discussed during the July 30, 2024 Routine Unannounced visit, the “hold harmless” state of rated license reassessments has been extended until the new Quality Rating Improvement System (QRIS) rules are put in place. Starting on February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—will be used for DCDEE environment rating scale assessments. The DCDEE and the North Carolina Rated License Assessment Project (NCRLAP) are collaboratively working on preparations for the transition to the third editions. These third editions come with a spiral binding at the top, replacing the current revised editions. Visit the NCRLAP’s website for more information about updated resources, credit hour trainings, and outreach assessment opportunities to help you become familiar with these tools. Regarding education standards, when new QRIS rules are implemented, education requirements will be different, but it is still critical that all staff in key positions have complete WORKS evaluations to assist with the rated license reassessment process. Please let me know if you need assistance with DCDEE WORKS or education evaluation. Reminders According to the Clean Classrooms for Carolina Kids program you have not completed your enrollment for lead and asbestos hazards in building infrastructure. Please see steps below: 1. Sign Up – Pre-enrollment webinars are available at cleanwaterforUSkids.org/carolina or paste https://bit.ly/3CK-webinar into your web browser to see available dates and times for the next month. 2. Enroll – At www.cleanwaterforUSkids.org/carolina using the PIN and complete the enrollment surveys for three program sections: 1) lead in water, 2) lead-based paint, and 3) asbestos. 3. Evaluate Hazards - The program will ship your facility a water sample kit and may coordinate an on-site visit by a professional to assess for lead-based paint and asbestos hazards, if needed. 4. Receive Results – Receive your results, recommendations, and water mitigation support, if needed. 5. Request Reimbursement - If you choose to conduct lead-based paint or asbestos mitigation, you can request reimbursement from NC DHHS. Visit the web site at: https://www.ncdhhs.gov/divisions/public-health/asbestos-and-lead-based-paint-reimbursement-program-arpa The reporting period for child care immunizations is now open. Reporting for 2024-2025 has been extended due to Hurricane Helene. Children have a grace period from requirements until November 30, 2024, and reports will be accepted until January 15, 2025. Use this link to submit your report: https://survey.alchemer.com/s3/7955242/2024-2025-Child-Care-Immunization-Report. Send any questions regarding child care immunization reporting to immunization.reports@dhhs.nc.gov. Documentation was completed and reviewed on site, printed and signed. Remember it is your responsibility to comply with all child care rules and requirements at all times. Contact me at Jennifer.j.garner@dhhs.nc.gov at (910)824-1447 with any questions or concerns. 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 .0901 · Violation

Name of Operation: ALL ANNIE'S CHILDREN Facility ID: 24000165 Consultant: AMY WANGLER Operation Type: Center Case Number: Visit Date: 8/1/2024 Number Present: 37 Completed Date: 8/1/2024 Age: From 0 To 5 Total Minutes: 140 Time In: 12:10 PM Time Out: 02:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance with applicable child care requirements pertinent to this visit type. This facility currently operates with a Three Star issued February 17, 2023. Restrictions include: a first shift capacity of 57 children 0-12 years of age, meets enhanced space, and children under 2 ½ years old in rooms with direct exits only. Restrictions were in compliance today. The last annual compliance visit was conducted January 11, 2024. A Superior sanitation rating was earned January 11, 2024, and a fire inspection was conducted June 12, 2024; the facility was approved for day time care only. Prior to the visit, the facility had an eighteen-month compliance history score of 87%. Owner/Administrator Linda Pollard was present and available for consultation today. Three indoor spaces and two outdoor spaces are approved for use; Indoor Space #2 is separated into two distinct spaces using furniture. Infants and children one and two years of age in Space #1 were observed in individual feeding and sleeping routines as well as play activities. Four children slept in cribs, two children ate snacks in high chairs, and the other two children were being rocked by staff members or playing freely in the carpeted areas. Safe sleep practices including documentation were monitored and appeared in compliance today based on staff reports of the infant’s nap times. Children two and three years of age in Spaces #2a and #2b participated in rest time routines. They rested on cots with individual linens, lights were dimmed and soft music played. Staff members comforted and assisted children who were not yet asleep in settling down. In Space #3, preschool children had just finished lunch and were transitioning to rest time routines as well. After rest time, a snack of Goldfish crackers and apples was planned. One new staff member has been hired since the Annual Compliance visit. Child Care programs are expected to always achieve and maintain compliance with child care rules, and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The following violations were observed today and must be corrected immediately: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The facility's last fire inspection was conducted June 1, 2023, and the next inspection was not conducted until June 12, 2024. 10A NCAC 09 .0304(a) 316 Children under one year of age were not kept separate from children two years and older. An infant was observed and reported as routinely being cared for with a child who had turned two years of age. 10A NCAC 09 .0713(a)(5) 853 Incident logs were not completed and maintained as required. The incident log observed today was incomplete. .0802(g)(1-6) 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 who began employment in April 2024 has not complete First Aid certification from an approved agency. .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 who began employment in April 2024 has not completed CPR training from an approved agency. .1102(d) A compliance letter including detailed information about how all violations have been corrected must be received by August 15, 2024. Include any supporting documentation with your response (if applicable). Your letter will be used as verification that violations have been corrected and compliance is maintained; your written response is considered a legal document so must be accurate and truthful. If you email the compliance letter, it must be sent using the email address registered with DCDEE and include your facility name and ID number. If sufficient information is not received by the due date, a follow-up visit will be conducted. Technical Assistance Regarding Violations Cited For the safety of the children and staff, Child Care Rules require operators to schedule and obtain a fire inspection within 12 months of the facility’s previous fire inspection. Today you stated you called early to request your inspection, but the Fire Marshal could not get you scheduled until after 12 months had passed. Moving forward, I suggest noting the date of your most recent inspection on a calendar and setting a reminder for yourself to call and request your inspection at least two to three months in advance of the deadline. The original approved annual fire inspection report should be submitted to me within one week of the inspection visit on the form provided by the Division; you submitted a copy of the inspection conducted June 12, 2024 today. Regarding keeping children of different age groups separate, I reminded you today that unless it is the first and last operating hour of the day, infants may not be grouped with children two years of age and older, and children one year of age may not be grouped with older children unless all children are under three years of age. Today you stated you did not have room on your roll to move the child in Space #1 up to Space #2b when she turned two years of age, however I shared with you that this child could not remain in Space #1 when the newly enrolled infant is present. I advised you to move the two-year-old to Space #2b today as only six children were present, and ratios could be maintained. You stated on the days when the infant is present, you will care for the two-year-old in Space #2a or 2b as long as ratios and group sizes may be maintained. Otherwise, you may need to tell her parents she cannot stay if there is no room for her in one of those classes. Keep in mind, you also have the option of moving a three-year-old from Space #2a to Space #3 if it will help create room. You stated you will follow this plan until school starts at the end of August, when you know you will have room to move several children on your rolls. As discussed, CPR and First Aid training must be an approved course taught by an approved agency. You must also ensure new staff members obtain certification within 90 days and current staff members never let their certifications expire. Today I emailed you the list of approved course and agencies. You stated you have invited a trainer from an approved agency to conduct training at the center next week and you will ensure everyone who needs it takes it. Technical assistance was also provided today regarding Incident Logs. As discussed, each time a child is injured at the center an Incident Report must be written, a copy must be offered to the parent and signed or refused, and the report must be logged on the Incident Log. Today you completed your Incident Log during the visit and stated you will check it once a week moving forward to ensure completion. Remember, you must also submit any incident reports which resulted in medical treatment to me via email or mail. Technical Assistance Violations of nutrition rules were not cited due to the visit type, however the following technical assistance was provided: Child Care Rule 10A NCAC 09 .0901(j) GENERAL NUTRITION REQUIREMENTS states that staff shall role model appropriate eating behaviors by consuming only food or beverages that meet the nutritional requirements specified in this Rule in the presence of children in care. Unhealthy snacks or soft drinks that staff might consume do not follow these requirements and should not be consumed in the classroom or in the presence of children. In addition, Child Care Rule 10A NCAC 09.0901 requires meals and snacks served to children in a child care center to comply with the USDA meal patterns for children in child care. The meal patterns require a specific number and type of components for each meal or snack; as discussed today, your afternoon snack must include at least two different components from the list, and water does not count as a component. The meal patterns were also emailed to you today. Rated License Information The “hold harmless” state of rated license reassessments has been extended until the new Quality Rating Improvement System standards are put in place. This means that you will not be required to have a reassessment according to timelines discussed previously, however you may request one voluntarily. Today I encouraged you to review information about the new standards as it becomes available and to plan on training your staff on the new assessment tools if you are interested in Environment Rating Scales assessments. I will share more information as I am able. As a reminder, to maintain Education points, all lead teachers must have the NCECC and 50% of lead teachers must have an Associate’s Degree in Early Childhood Education (ECE) or related field with 12 semester hours (SH) ECE coursework and one year of experience. Today I verified that C. Monroe’s evaluation is complete showing her two-year degree, but I. Hampton still needs to register for a WORKS account, apply for a lead teacher position and mail her official transcript for evaluation. Please let me know if you need assistance with DCDEE WORKS or education evaluation. Reminders As discussed, due to the nature of violations cited, a follow-up visit may be conducted in the near future to verify compliance. It’s time to enroll your facility in the Clean Classrooms for Carolina Kids program to identify and eliminate exposure to lead and asbestos hazards in building infrastructure. This program is an expansion of Clean Water for Carolina Kids, which previously tested all child care centers in the state for lead in water at drinking and food preparation taps. As this is a legislatively mandated effort, facilities are required to meet rule requirements to have tap water tested every three years and to have inspections for lead paint and asbestos if applicable. Please see steps below: 1. Sign Up – Pre-enrollment webinars are available at cleanwaterforUSkids.org/carolina or paste https://bit.ly/3CK-webinar into your web browser to see available dates and times for the next month. 2. Enroll – At www.cleanwaterforUSkids.org/carolina using the PIN and complete the enrollment surveys for three program sections: 1) lead in water, 2) lead-based paint, and 3) asbestos. 3. Evaluate Hazards - The program will ship your facility a water sample kit and may coordinate an on-site visit by a professional to assess for lead-based paint and asbestos hazards, if needed. 4. Receive Results – Receive your results, recommendations, and water mitigation support, if needed. 5. Request Reimbursement - If you choose to conduct lead-based paint or asbestos mitigation, you can request reimbursement from NC DHHS. Visit the web site at: https://www.ncdhhs.gov/divisions/public-health/asbestos-and-lead-based-paint-reimbursement-program-arpa You may also refer to the June 6, 2024 email blast for more information. At the end of this visit, documentation was completed electronically, printed and reviewed with you. Please remember it is your responsibility to comply with all child care rules and requirements at all times. If you have questions or need assistance please feel free to contact me at 910-338-7038 or amy.wangler@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

10A NCAC 09.0901 · Violation

Name of Operation: ALL ANNIE'S CHILDREN Facility ID: 24000165 Consultant: AMY WANGLER Operation Type: Center Case Number: Visit Date: 8/1/2024 Number Present: 37 Completed Date: 8/1/2024 Age: From 0 To 5 Total Minutes: 140 Time In: 12:10 PM Time Out: 02:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance with applicable child care requirements pertinent to this visit type. This facility currently operates with a Three Star issued February 17, 2023. Restrictions include: a first shift capacity of 57 children 0-12 years of age, meets enhanced space, and children under 2 ½ years old in rooms with direct exits only. Restrictions were in compliance today. The last annual compliance visit was conducted January 11, 2024. A Superior sanitation rating was earned January 11, 2024, and a fire inspection was conducted June 12, 2024; the facility was approved for day time care only. Prior to the visit, the facility had an eighteen-month compliance history score of 87%. Owner/Administrator Linda Pollard was present and available for consultation today. Three indoor spaces and two outdoor spaces are approved for use; Indoor Space #2 is separated into two distinct spaces using furniture. Infants and children one and two years of age in Space #1 were observed in individual feeding and sleeping routines as well as play activities. Four children slept in cribs, two children ate snacks in high chairs, and the other two children were being rocked by staff members or playing freely in the carpeted areas. Safe sleep practices including documentation were monitored and appeared in compliance today based on staff reports of the infant’s nap times. Children two and three years of age in Spaces #2a and #2b participated in rest time routines. They rested on cots with individual linens, lights were dimmed and soft music played. Staff members comforted and assisted children who were not yet asleep in settling down. In Space #3, preschool children had just finished lunch and were transitioning to rest time routines as well. After rest time, a snack of Goldfish crackers and apples was planned. One new staff member has been hired since the Annual Compliance visit. Child Care programs are expected to always achieve and maintain compliance with child care rules, and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The following violations were observed today and must be corrected immediately: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The facility's last fire inspection was conducted June 1, 2023, and the next inspection was not conducted until June 12, 2024. 10A NCAC 09 .0304(a) 316 Children under one year of age were not kept separate from children two years and older. An infant was observed and reported as routinely being cared for with a child who had turned two years of age. 10A NCAC 09 .0713(a)(5) 853 Incident logs were not completed and maintained as required. The incident log observed today was incomplete. .0802(g)(1-6) 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 who began employment in April 2024 has not complete First Aid certification from an approved agency. .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 who began employment in April 2024 has not completed CPR training from an approved agency. .1102(d) A compliance letter including detailed information about how all violations have been corrected must be received by August 15, 2024. Include any supporting documentation with your response (if applicable). Your letter will be used as verification that violations have been corrected and compliance is maintained; your written response is considered a legal document so must be accurate and truthful. If you email the compliance letter, it must be sent using the email address registered with DCDEE and include your facility name and ID number. If sufficient information is not received by the due date, a follow-up visit will be conducted. Technical Assistance Regarding Violations Cited For the safety of the children and staff, Child Care Rules require operators to schedule and obtain a fire inspection within 12 months of the facility’s previous fire inspection. Today you stated you called early to request your inspection, but the Fire Marshal could not get you scheduled until after 12 months had passed. Moving forward, I suggest noting the date of your most recent inspection on a calendar and setting a reminder for yourself to call and request your inspection at least two to three months in advance of the deadline. The original approved annual fire inspection report should be submitted to me within one week of the inspection visit on the form provided by the Division; you submitted a copy of the inspection conducted June 12, 2024 today. Regarding keeping children of different age groups separate, I reminded you today that unless it is the first and last operating hour of the day, infants may not be grouped with children two years of age and older, and children one year of age may not be grouped with older children unless all children are under three years of age. Today you stated you did not have room on your roll to move the child in Space #1 up to Space #2b when she turned two years of age, however I shared with you that this child could not remain in Space #1 when the newly enrolled infant is present. I advised you to move the two-year-old to Space #2b today as only six children were present, and ratios could be maintained. You stated on the days when the infant is present, you will care for the two-year-old in Space #2a or 2b as long as ratios and group sizes may be maintained. Otherwise, you may need to tell her parents she cannot stay if there is no room for her in one of those classes. Keep in mind, you also have the option of moving a three-year-old from Space #2a to Space #3 if it will help create room. You stated you will follow this plan until school starts at the end of August, when you know you will have room to move several children on your rolls. As discussed, CPR and First Aid training must be an approved course taught by an approved agency. You must also ensure new staff members obtain certification within 90 days and current staff members never let their certifications expire. Today I emailed you the list of approved course and agencies. You stated you have invited a trainer from an approved agency to conduct training at the center next week and you will ensure everyone who needs it takes it. Technical assistance was also provided today regarding Incident Logs. As discussed, each time a child is injured at the center an Incident Report must be written, a copy must be offered to the parent and signed or refused, and the report must be logged on the Incident Log. Today you completed your Incident Log during the visit and stated you will check it once a week moving forward to ensure completion. Remember, you must also submit any incident reports which resulted in medical treatment to me via email or mail. Technical Assistance Violations of nutrition rules were not cited due to the visit type, however the following technical assistance was provided: Child Care Rule 10A NCAC 09 .0901(j) GENERAL NUTRITION REQUIREMENTS states that staff shall role model appropriate eating behaviors by consuming only food or beverages that meet the nutritional requirements specified in this Rule in the presence of children in care. Unhealthy snacks or soft drinks that staff might consume do not follow these requirements and should not be consumed in the classroom or in the presence of children. In addition, Child Care Rule 10A NCAC 09.0901 requires meals and snacks served to children in a child care center to comply with the USDA meal patterns for children in child care. The meal patterns require a specific number and type of components for each meal or snack; as discussed today, your afternoon snack must include at least two different components from the list, and water does not count as a component. The meal patterns were also emailed to you today. Rated License Information The “hold harmless” state of rated license reassessments has been extended until the new Quality Rating Improvement System standards are put in place. This means that you will not be required to have a reassessment according to timelines discussed previously, however you may request one voluntarily. Today I encouraged you to review information about the new standards as it becomes available and to plan on training your staff on the new assessment tools if you are interested in Environment Rating Scales assessments. I will share more information as I am able. As a reminder, to maintain Education points, all lead teachers must have the NCECC and 50% of lead teachers must have an Associate’s Degree in Early Childhood Education (ECE) or related field with 12 semester hours (SH) ECE coursework and one year of experience. Today I verified that C. Monroe’s evaluation is complete showing her two-year degree, but I. Hampton still needs to register for a WORKS account, apply for a lead teacher position and mail her official transcript for evaluation. Please let me know if you need assistance with DCDEE WORKS or education evaluation. Reminders As discussed, due to the nature of violations cited, a follow-up visit may be conducted in the near future to verify compliance. It’s time to enroll your facility in the Clean Classrooms for Carolina Kids program to identify and eliminate exposure to lead and asbestos hazards in building infrastructure. This program is an expansion of Clean Water for Carolina Kids, which previously tested all child care centers in the state for lead in water at drinking and food preparation taps. As this is a legislatively mandated effort, facilities are required to meet rule requirements to have tap water tested every three years and to have inspections for lead paint and asbestos if applicable. Please see steps below: 1. Sign Up – Pre-enrollment webinars are available at cleanwaterforUSkids.org/carolina or paste https://bit.ly/3CK-webinar into your web browser to see available dates and times for the next month. 2. Enroll – At www.cleanwaterforUSkids.org/carolina using the PIN and complete the enrollment surveys for three program sections: 1) lead in water, 2) lead-based paint, and 3) asbestos. 3. Evaluate Hazards - The program will ship your facility a water sample kit and may coordinate an on-site visit by a professional to assess for lead-based paint and asbestos hazards, if needed. 4. Receive Results – Receive your results, recommendations, and water mitigation support, if needed. 5. Request Reimbursement - If you choose to conduct lead-based paint or asbestos mitigation, you can request reimbursement from NC DHHS. Visit the web site at: https://www.ncdhhs.gov/divisions/public-health/asbestos-and-lead-based-paint-reimbursement-program-arpa You may also refer to the June 6, 2024 email blast for more information. At the end of this visit, documentation was completed electronically, printed and reviewed with you. Please remember it is your responsibility to comply with all child care rules and requirements at all times. If you have questions or need assistance please feel free to contact me at 910-338-7038 or amy.wangler@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: ALL ANNIE'S CHILDREN Facility ID: 24000165 Consultant: AMY WANGLER Operation Type: Center Case Number: Visit Date: 8/1/2024 Number Present: 37 Completed Date: 8/1/2024 Age: From 0 To 5 Total Minutes: 140 Time In: 12:10 PM Time Out: 02:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance with applicable child care requirements pertinent to this visit type. This facility currently operates with a Three Star issued February 17, 2023. Restrictions include: a first shift capacity of 57 children 0-12 years of age, meets enhanced space, and children under 2 ½ years old in rooms with direct exits only. Restrictions were in compliance today. The last annual compliance visit was conducted January 11, 2024. A Superior sanitation rating was earned January 11, 2024, and a fire inspection was conducted June 12, 2024; the facility was approved for day time care only. Prior to the visit, the facility had an eighteen-month compliance history score of 87%. Owner/Administrator Linda Pollard was present and available for consultation today. Three indoor spaces and two outdoor spaces are approved for use; Indoor Space #2 is separated into two distinct spaces using furniture. Infants and children one and two years of age in Space #1 were observed in individual feeding and sleeping routines as well as play activities. Four children slept in cribs, two children ate snacks in high chairs, and the other two children were being rocked by staff members or playing freely in the carpeted areas. Safe sleep practices including documentation were monitored and appeared in compliance today based on staff reports of the infant’s nap times. Children two and three years of age in Spaces #2a and #2b participated in rest time routines. They rested on cots with individual linens, lights were dimmed and soft music played. Staff members comforted and assisted children who were not yet asleep in settling down. In Space #3, preschool children had just finished lunch and were transitioning to rest time routines as well. After rest time, a snack of Goldfish crackers and apples was planned. One new staff member has been hired since the Annual Compliance visit. Child Care programs are expected to always achieve and maintain compliance with child care rules, and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The following violations were observed today and must be corrected immediately: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The facility's last fire inspection was conducted June 1, 2023, and the next inspection was not conducted until June 12, 2024. 10A NCAC 09 .0304(a) 316 Children under one year of age were not kept separate from children two years and older. An infant was observed and reported as routinely being cared for with a child who had turned two years of age. 10A NCAC 09 .0713(a)(5) 853 Incident logs were not completed and maintained as required. The incident log observed today was incomplete. .0802(g)(1-6) 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 who began employment in April 2024 has not complete First Aid certification from an approved agency. .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 who began employment in April 2024 has not completed CPR training from an approved agency. .1102(d) A compliance letter including detailed information about how all violations have been corrected must be received by August 15, 2024. Include any supporting documentation with your response (if applicable). Your letter will be used as verification that violations have been corrected and compliance is maintained; your written response is considered a legal document so must be accurate and truthful. If you email the compliance letter, it must be sent using the email address registered with DCDEE and include your facility name and ID number. If sufficient information is not received by the due date, a follow-up visit will be conducted. Technical Assistance Regarding Violations Cited For the safety of the children and staff, Child Care Rules require operators to schedule and obtain a fire inspection within 12 months of the facility’s previous fire inspection. Today you stated you called early to request your inspection, but the Fire Marshal could not get you scheduled until after 12 months had passed. Moving forward, I suggest noting the date of your most recent inspection on a calendar and setting a reminder for yourself to call and request your inspection at least two to three months in advance of the deadline. The original approved annual fire inspection report should be submitted to me within one week of the inspection visit on the form provided by the Division; you submitted a copy of the inspection conducted June 12, 2024 today. Regarding keeping children of different age groups separate, I reminded you today that unless it is the first and last operating hour of the day, infants may not be grouped with children two years of age and older, and children one year of age may not be grouped with older children unless all children are under three years of age. Today you stated you did not have room on your roll to move the child in Space #1 up to Space #2b when she turned two years of age, however I shared with you that this child could not remain in Space #1 when the newly enrolled infant is present. I advised you to move the two-year-old to Space #2b today as only six children were present, and ratios could be maintained. You stated on the days when the infant is present, you will care for the two-year-old in Space #2a or 2b as long as ratios and group sizes may be maintained. Otherwise, you may need to tell her parents she cannot stay if there is no room for her in one of those classes. Keep in mind, you also have the option of moving a three-year-old from Space #2a to Space #3 if it will help create room. You stated you will follow this plan until school starts at the end of August, when you know you will have room to move several children on your rolls. As discussed, CPR and First Aid training must be an approved course taught by an approved agency. You must also ensure new staff members obtain certification within 90 days and current staff members never let their certifications expire. Today I emailed you the list of approved course and agencies. You stated you have invited a trainer from an approved agency to conduct training at the center next week and you will ensure everyone who needs it takes it. Technical assistance was also provided today regarding Incident Logs. As discussed, each time a child is injured at the center an Incident Report must be written, a copy must be offered to the parent and signed or refused, and the report must be logged on the Incident Log. Today you completed your Incident Log during the visit and stated you will check it once a week moving forward to ensure completion. Remember, you must also submit any incident reports which resulted in medical treatment to me via email or mail. Technical Assistance Violations of nutrition rules were not cited due to the visit type, however the following technical assistance was provided: Child Care Rule 10A NCAC 09 .0901(j) GENERAL NUTRITION REQUIREMENTS states that staff shall role model appropriate eating behaviors by consuming only food or beverages that meet the nutritional requirements specified in this Rule in the presence of children in care. Unhealthy snacks or soft drinks that staff might consume do not follow these requirements and should not be consumed in the classroom or in the presence of children. In addition, Child Care Rule 10A NCAC 09.0901 requires meals and snacks served to children in a child care center to comply with the USDA meal patterns for children in child care. The meal patterns require a specific number and type of components for each meal or snack; as discussed today, your afternoon snack must include at least two different components from the list, and water does not count as a component. The meal patterns were also emailed to you today. Rated License Information The “hold harmless” state of rated license reassessments has been extended until the new Quality Rating Improvement System standards are put in place. This means that you will not be required to have a reassessment according to timelines discussed previously, however you may request one voluntarily. Today I encouraged you to review information about the new standards as it becomes available and to plan on training your staff on the new assessment tools if you are interested in Environment Rating Scales assessments. I will share more information as I am able. As a reminder, to maintain Education points, all lead teachers must have the NCECC and 50% of lead teachers must have an Associate’s Degree in Early Childhood Education (ECE) or related field with 12 semester hours (SH) ECE coursework and one year of experience. Today I verified that C. Monroe’s evaluation is complete showing her two-year degree, but I. Hampton still needs to register for a WORKS account, apply for a lead teacher position and mail her official transcript for evaluation. Please let me know if you need assistance with DCDEE WORKS or education evaluation. Reminders As discussed, due to the nature of violations cited, a follow-up visit may be conducted in the near future to verify compliance. It’s time to enroll your facility in the Clean Classrooms for Carolina Kids program to identify and eliminate exposure to lead and asbestos hazards in building infrastructure. This program is an expansion of Clean Water for Carolina Kids, which previously tested all child care centers in the state for lead in water at drinking and food preparation taps. As this is a legislatively mandated effort, facilities are required to meet rule requirements to have tap water tested every three years and to have inspections for lead paint and asbestos if applicable. Please see steps below: 1. Sign Up – Pre-enrollment webinars are available at cleanwaterforUSkids.org/carolina or paste https://bit.ly/3CK-webinar into your web browser to see available dates and times for the next month. 2. Enroll – At www.cleanwaterforUSkids.org/carolina using the PIN and complete the enrollment surveys for three program sections: 1) lead in water, 2) lead-based paint, and 3) asbestos. 3. Evaluate Hazards - The program will ship your facility a water sample kit and may coordinate an on-site visit by a professional to assess for lead-based paint and asbestos hazards, if needed. 4. Receive Results – Receive your results, recommendations, and water mitigation support, if needed. 5. Request Reimbursement - If you choose to conduct lead-based paint or asbestos mitigation, you can request reimbursement from NC DHHS. Visit the web site at: https://www.ncdhhs.gov/divisions/public-health/asbestos-and-lead-based-paint-reimbursement-program-arpa You may also refer to the June 6, 2024 email blast for more information. At the end of this visit, documentation was completed electronically, printed and reviewed with you. Please remember it is your responsibility to comply with all child care rules and requirements at all times. If you have questions or need assistance please feel free to contact me at 910-338-7038 or amy.wangler@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: ALL ANNIE'S CHILDREN Facility ID: 24000165 Consultant: AMY WANGLER Operation Type: Center Case Number: Visit Date: 8/1/2024 Number Present: 37 Completed Date: 8/1/2024 Age: From 0 To 5 Total Minutes: 140 Time In: 12:10 PM Time Out: 02:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance with applicable child care requirements pertinent to this visit type. This facility currently operates with a Three Star issued February 17, 2023. Restrictions include: a first shift capacity of 57 children 0-12 years of age, meets enhanced space, and children under 2 ½ years old in rooms with direct exits only. Restrictions were in compliance today. The last annual compliance visit was conducted January 11, 2024. A Superior sanitation rating was earned January 11, 2024, and a fire inspection was conducted June 12, 2024; the facility was approved for day time care only. Prior to the visit, the facility had an eighteen-month compliance history score of 87%. Owner/Administrator Linda Pollard was present and available for consultation today. Three indoor spaces and two outdoor spaces are approved for use; Indoor Space #2 is separated into two distinct spaces using furniture. Infants and children one and two years of age in Space #1 were observed in individual feeding and sleeping routines as well as play activities. Four children slept in cribs, two children ate snacks in high chairs, and the other two children were being rocked by staff members or playing freely in the carpeted areas. Safe sleep practices including documentation were monitored and appeared in compliance today based on staff reports of the infant’s nap times. Children two and three years of age in Spaces #2a and #2b participated in rest time routines. They rested on cots with individual linens, lights were dimmed and soft music played. Staff members comforted and assisted children who were not yet asleep in settling down. In Space #3, preschool children had just finished lunch and were transitioning to rest time routines as well. After rest time, a snack of Goldfish crackers and apples was planned. One new staff member has been hired since the Annual Compliance visit. Child Care programs are expected to always achieve and maintain compliance with child care rules, and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The following violations were observed today and must be corrected immediately: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The facility's last fire inspection was conducted June 1, 2023, and the next inspection was not conducted until June 12, 2024. 10A NCAC 09 .0304(a) 316 Children under one year of age were not kept separate from children two years and older. An infant was observed and reported as routinely being cared for with a child who had turned two years of age. 10A NCAC 09 .0713(a)(5) 853 Incident logs were not completed and maintained as required. The incident log observed today was incomplete. .0802(g)(1-6) 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 who began employment in April 2024 has not complete First Aid certification from an approved agency. .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 who began employment in April 2024 has not completed CPR training from an approved agency. .1102(d) A compliance letter including detailed information about how all violations have been corrected must be received by August 15, 2024. Include any supporting documentation with your response (if applicable). Your letter will be used as verification that violations have been corrected and compliance is maintained; your written response is considered a legal document so must be accurate and truthful. If you email the compliance letter, it must be sent using the email address registered with DCDEE and include your facility name and ID number. If sufficient information is not received by the due date, a follow-up visit will be conducted. Technical Assistance Regarding Violations Cited For the safety of the children and staff, Child Care Rules require operators to schedule and obtain a fire inspection within 12 months of the facility’s previous fire inspection. Today you stated you called early to request your inspection, but the Fire Marshal could not get you scheduled until after 12 months had passed. Moving forward, I suggest noting the date of your most recent inspection on a calendar and setting a reminder for yourself to call and request your inspection at least two to three months in advance of the deadline. The original approved annual fire inspection report should be submitted to me within one week of the inspection visit on the form provided by the Division; you submitted a copy of the inspection conducted June 12, 2024 today. Regarding keeping children of different age groups separate, I reminded you today that unless it is the first and last operating hour of the day, infants may not be grouped with children two years of age and older, and children one year of age may not be grouped with older children unless all children are under three years of age. Today you stated you did not have room on your roll to move the child in Space #1 up to Space #2b when she turned two years of age, however I shared with you that this child could not remain in Space #1 when the newly enrolled infant is present. I advised you to move the two-year-old to Space #2b today as only six children were present, and ratios could be maintained. You stated on the days when the infant is present, you will care for the two-year-old in Space #2a or 2b as long as ratios and group sizes may be maintained. Otherwise, you may need to tell her parents she cannot stay if there is no room for her in one of those classes. Keep in mind, you also have the option of moving a three-year-old from Space #2a to Space #3 if it will help create room. You stated you will follow this plan until school starts at the end of August, when you know you will have room to move several children on your rolls. As discussed, CPR and First Aid training must be an approved course taught by an approved agency. You must also ensure new staff members obtain certification within 90 days and current staff members never let their certifications expire. Today I emailed you the list of approved course and agencies. You stated you have invited a trainer from an approved agency to conduct training at the center next week and you will ensure everyone who needs it takes it. Technical assistance was also provided today regarding Incident Logs. As discussed, each time a child is injured at the center an Incident Report must be written, a copy must be offered to the parent and signed or refused, and the report must be logged on the Incident Log. Today you completed your Incident Log during the visit and stated you will check it once a week moving forward to ensure completion. Remember, you must also submit any incident reports which resulted in medical treatment to me via email or mail. Technical Assistance Violations of nutrition rules were not cited due to the visit type, however the following technical assistance was provided: Child Care Rule 10A NCAC 09 .0901(j) GENERAL NUTRITION REQUIREMENTS states that staff shall role model appropriate eating behaviors by consuming only food or beverages that meet the nutritional requirements specified in this Rule in the presence of children in care. Unhealthy snacks or soft drinks that staff might consume do not follow these requirements and should not be consumed in the classroom or in the presence of children. In addition, Child Care Rule 10A NCAC 09.0901 requires meals and snacks served to children in a child care center to comply with the USDA meal patterns for children in child care. The meal patterns require a specific number and type of components for each meal or snack; as discussed today, your afternoon snack must include at least two different components from the list, and water does not count as a component. The meal patterns were also emailed to you today. Rated License Information The “hold harmless” state of rated license reassessments has been extended until the new Quality Rating Improvement System standards are put in place. This means that you will not be required to have a reassessment according to timelines discussed previously, however you may request one voluntarily. Today I encouraged you to review information about the new standards as it becomes available and to plan on training your staff on the new assessment tools if you are interested in Environment Rating Scales assessments. I will share more information as I am able. As a reminder, to maintain Education points, all lead teachers must have the NCECC and 50% of lead teachers must have an Associate’s Degree in Early Childhood Education (ECE) or related field with 12 semester hours (SH) ECE coursework and one year of experience. Today I verified that C. Monroe’s evaluation is complete showing her two-year degree, but I. Hampton still needs to register for a WORKS account, apply for a lead teacher position and mail her official transcript for evaluation. Please let me know if you need assistance with DCDEE WORKS or education evaluation. Reminders As discussed, due to the nature of violations cited, a follow-up visit may be conducted in the near future to verify compliance. It’s time to enroll your facility in the Clean Classrooms for Carolina Kids program to identify and eliminate exposure to lead and asbestos hazards in building infrastructure. This program is an expansion of Clean Water for Carolina Kids, which previously tested all child care centers in the state for lead in water at drinking and food preparation taps. As this is a legislatively mandated effort, facilities are required to meet rule requirements to have tap water tested every three years and to have inspections for lead paint and asbestos if applicable. Please see steps below: 1. Sign Up – Pre-enrollment webinars are available at cleanwaterforUSkids.org/carolina or paste https://bit.ly/3CK-webinar into your web browser to see available dates and times for the next month. 2. Enroll – At www.cleanwaterforUSkids.org/carolina using the PIN and complete the enrollment surveys for three program sections: 1) lead in water, 2) lead-based paint, and 3) asbestos. 3. Evaluate Hazards - The program will ship your facility a water sample kit and may coordinate an on-site visit by a professional to assess for lead-based paint and asbestos hazards, if needed. 4. Receive Results – Receive your results, recommendations, and water mitigation support, if needed. 5. Request Reimbursement - If you choose to conduct lead-based paint or asbestos mitigation, you can request reimbursement from NC DHHS. Visit the web site at: https://www.ncdhhs.gov/divisions/public-health/asbestos-and-lead-based-paint-reimbursement-program-arpa You may also refer to the June 6, 2024 email blast for more information. At the end of this visit, documentation was completed electronically, printed and reviewed with you. Please remember it is your responsibility to comply with all child care rules and requirements at all times. If you have questions or need assistance please feel free to contact me at 910-338-7038 or amy.wangler@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0713 · Violation

Name of Operation: ALL ANNIE'S CHILDREN Facility ID: 24000165 Consultant: AMY WANGLER Operation Type: Center Case Number: Visit Date: 8/1/2024 Number Present: 37 Completed Date: 8/1/2024 Age: From 0 To 5 Total Minutes: 140 Time In: 12:10 PM Time Out: 02:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance with applicable child care requirements pertinent to this visit type. This facility currently operates with a Three Star issued February 17, 2023. Restrictions include: a first shift capacity of 57 children 0-12 years of age, meets enhanced space, and children under 2 ½ years old in rooms with direct exits only. Restrictions were in compliance today. The last annual compliance visit was conducted January 11, 2024. A Superior sanitation rating was earned January 11, 2024, and a fire inspection was conducted June 12, 2024; the facility was approved for day time care only. Prior to the visit, the facility had an eighteen-month compliance history score of 87%. Owner/Administrator Linda Pollard was present and available for consultation today. Three indoor spaces and two outdoor spaces are approved for use; Indoor Space #2 is separated into two distinct spaces using furniture. Infants and children one and two years of age in Space #1 were observed in individual feeding and sleeping routines as well as play activities. Four children slept in cribs, two children ate snacks in high chairs, and the other two children were being rocked by staff members or playing freely in the carpeted areas. Safe sleep practices including documentation were monitored and appeared in compliance today based on staff reports of the infant’s nap times. Children two and three years of age in Spaces #2a and #2b participated in rest time routines. They rested on cots with individual linens, lights were dimmed and soft music played. Staff members comforted and assisted children who were not yet asleep in settling down. In Space #3, preschool children had just finished lunch and were transitioning to rest time routines as well. After rest time, a snack of Goldfish crackers and apples was planned. One new staff member has been hired since the Annual Compliance visit. Child Care programs are expected to always achieve and maintain compliance with child care rules, and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The following violations were observed today and must be corrected immediately: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The facility's last fire inspection was conducted June 1, 2023, and the next inspection was not conducted until June 12, 2024. 10A NCAC 09 .0304(a) 316 Children under one year of age were not kept separate from children two years and older. An infant was observed and reported as routinely being cared for with a child who had turned two years of age. 10A NCAC 09 .0713(a)(5) 853 Incident logs were not completed and maintained as required. The incident log observed today was incomplete. .0802(g)(1-6) 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 who began employment in April 2024 has not complete First Aid certification from an approved agency. .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 who began employment in April 2024 has not completed CPR training from an approved agency. .1102(d) A compliance letter including detailed information about how all violations have been corrected must be received by August 15, 2024. Include any supporting documentation with your response (if applicable). Your letter will be used as verification that violations have been corrected and compliance is maintained; your written response is considered a legal document so must be accurate and truthful. If you email the compliance letter, it must be sent using the email address registered with DCDEE and include your facility name and ID number. If sufficient information is not received by the due date, a follow-up visit will be conducted. Technical Assistance Regarding Violations Cited For the safety of the children and staff, Child Care Rules require operators to schedule and obtain a fire inspection within 12 months of the facility’s previous fire inspection. Today you stated you called early to request your inspection, but the Fire Marshal could not get you scheduled until after 12 months had passed. Moving forward, I suggest noting the date of your most recent inspection on a calendar and setting a reminder for yourself to call and request your inspection at least two to three months in advance of the deadline. The original approved annual fire inspection report should be submitted to me within one week of the inspection visit on the form provided by the Division; you submitted a copy of the inspection conducted June 12, 2024 today. Regarding keeping children of different age groups separate, I reminded you today that unless it is the first and last operating hour of the day, infants may not be grouped with children two years of age and older, and children one year of age may not be grouped with older children unless all children are under three years of age. Today you stated you did not have room on your roll to move the child in Space #1 up to Space #2b when she turned two years of age, however I shared with you that this child could not remain in Space #1 when the newly enrolled infant is present. I advised you to move the two-year-old to Space #2b today as only six children were present, and ratios could be maintained. You stated on the days when the infant is present, you will care for the two-year-old in Space #2a or 2b as long as ratios and group sizes may be maintained. Otherwise, you may need to tell her parents she cannot stay if there is no room for her in one of those classes. Keep in mind, you also have the option of moving a three-year-old from Space #2a to Space #3 if it will help create room. You stated you will follow this plan until school starts at the end of August, when you know you will have room to move several children on your rolls. As discussed, CPR and First Aid training must be an approved course taught by an approved agency. You must also ensure new staff members obtain certification within 90 days and current staff members never let their certifications expire. Today I emailed you the list of approved course and agencies. You stated you have invited a trainer from an approved agency to conduct training at the center next week and you will ensure everyone who needs it takes it. Technical assistance was also provided today regarding Incident Logs. As discussed, each time a child is injured at the center an Incident Report must be written, a copy must be offered to the parent and signed or refused, and the report must be logged on the Incident Log. Today you completed your Incident Log during the visit and stated you will check it once a week moving forward to ensure completion. Remember, you must also submit any incident reports which resulted in medical treatment to me via email or mail. Technical Assistance Violations of nutrition rules were not cited due to the visit type, however the following technical assistance was provided: Child Care Rule 10A NCAC 09 .0901(j) GENERAL NUTRITION REQUIREMENTS states that staff shall role model appropriate eating behaviors by consuming only food or beverages that meet the nutritional requirements specified in this Rule in the presence of children in care. Unhealthy snacks or soft drinks that staff might consume do not follow these requirements and should not be consumed in the classroom or in the presence of children. In addition, Child Care Rule 10A NCAC 09.0901 requires meals and snacks served to children in a child care center to comply with the USDA meal patterns for children in child care. The meal patterns require a specific number and type of components for each meal or snack; as discussed today, your afternoon snack must include at least two different components from the list, and water does not count as a component. The meal patterns were also emailed to you today. Rated License Information The “hold harmless” state of rated license reassessments has been extended until the new Quality Rating Improvement System standards are put in place. This means that you will not be required to have a reassessment according to timelines discussed previously, however you may request one voluntarily. Today I encouraged you to review information about the new standards as it becomes available and to plan on training your staff on the new assessment tools if you are interested in Environment Rating Scales assessments. I will share more information as I am able. As a reminder, to maintain Education points, all lead teachers must have the NCECC and 50% of lead teachers must have an Associate’s Degree in Early Childhood Education (ECE) or related field with 12 semester hours (SH) ECE coursework and one year of experience. Today I verified that C. Monroe’s evaluation is complete showing her two-year degree, but I. Hampton still needs to register for a WORKS account, apply for a lead teacher position and mail her official transcript for evaluation. Please let me know if you need assistance with DCDEE WORKS or education evaluation. Reminders As discussed, due to the nature of violations cited, a follow-up visit may be conducted in the near future to verify compliance. It’s time to enroll your facility in the Clean Classrooms for Carolina Kids program to identify and eliminate exposure to lead and asbestos hazards in building infrastructure. This program is an expansion of Clean Water for Carolina Kids, which previously tested all child care centers in the state for lead in water at drinking and food preparation taps. As this is a legislatively mandated effort, facilities are required to meet rule requirements to have tap water tested every three years and to have inspections for lead paint and asbestos if applicable. Please see steps below: 1. Sign Up – Pre-enrollment webinars are available at cleanwaterforUSkids.org/carolina or paste https://bit.ly/3CK-webinar into your web browser to see available dates and times for the next month. 2. Enroll – At www.cleanwaterforUSkids.org/carolina using the PIN and complete the enrollment surveys for three program sections: 1) lead in water, 2) lead-based paint, and 3) asbestos. 3. Evaluate Hazards - The program will ship your facility a water sample kit and may coordinate an on-site visit by a professional to assess for lead-based paint and asbestos hazards, if needed. 4. Receive Results – Receive your results, recommendations, and water mitigation support, if needed. 5. Request Reimbursement - If you choose to conduct lead-based paint or asbestos mitigation, you can request reimbursement from NC DHHS. Visit the web site at: https://www.ncdhhs.gov/divisions/public-health/asbestos-and-lead-based-paint-reimbursement-program-arpa You may also refer to the June 6, 2024 email blast for more information. At the end of this visit, documentation was completed electronically, printed and reviewed with you. Please remember it is your responsibility to comply with all child care rules and requirements at all times. If you have questions or need assistance please feel free to contact me at 910-338-7038 or amy.wangler@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0604 · Violation

Name of Operation: ALL ANNIE'S CHILDREN Facility ID: 24000165 Consultant: AMY WANGLER Operation Type: Center Case Number: Visit Date: 1/11/2024 Number Present: 39 Completed Date: 1/11/2024 Age: From 0 To 4 Total Minutes: 300 Time In: 08:30 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance with applicable child care requirements pertinent to this visit type. This facility currently operates with a Three Star issued February 17, 2023. Restrictions include: a first shift capacity of 57 children 0-12 years of age, meets enhanced space, and children under 2 ½ years old in rooms with direct exits only. Restrictions were in compliance today. The last annual compliance visit was conducted January 24, 2023. A Superior sanitation rating was earned September 14, 2023, and a fire inspection was conducted June 1, 2023; the facility was approved for day time care only. Prior to the visit, the facility had an eighteen-month compliance history score of 94%. Owner/Administrator Linda Pollard was present and available for consultation today. Three indoor spaces and two outdoor spaces are approved for use; Indoor Space #2 is separated into two distinct spaces using furniture. Infants and children one year of age in Space #1 were observed in individual feeding and sleeping routines as well as play activities. Three children ate a breakfast of grits, eggs, mandarin oranges and milk while the other two played freely in the carpeted areas. Later, an infant was observed asleep on his back in his crib; safe sleep practices including documentation were monitored and in compliance today. Children one and two years of age in Space #2b participated in free choice activities including building with blocks and pretending to vacuum. Children two and three years of age in Space #2a were observed coloring on white paper plates with crayons. In Space #3, preschool children participated in a large group activity during which they danced and sang songs. Lunch served consisted of spaghetti with meat sauce, corn, mixed fruit and milk. After lunch, children transitioned to rest time routines. They rested on appropriately spaced cots with individual linens. Today it was observed that the large climber with a slide, ladder and two swings observed in Outdoor Space #1b on August 30, 2023 was removed per my guidance as it was not approved for commercial use. A movable piece of equipment with a small climber and slide was observed in its place. Health and Safety training requirements as outlined in Child Care Rule 10A NCAC 09 .1102 were monitored today. Child Care programs are expected to always achieve and maintain compliance with child care rules, and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The following violations were observed today and must be corrected immediately: 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. Several bottles observed in Space #1 were not labeled with dates. 15A NCAC 18A .2804(d) 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. A written feeding plan was not observed for one child under fifteen months of age. 10A NCAC 09 .0902(a) 620 All walls and ceilings including doors and windows were not kept clean and in good repair. One of the bathroom stall doors in the bathroom used by children was observed off of its hinges. 15A NCAC 18A .2825(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. One outlet in Space #3 and two outlets in the bathrooms used by children were observed uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. An aerosol can of disinfectant was observed unlocked in Space #3. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A tube of prescription diaper cream was observed unlocked in Space #1. 15A NCAC 18A .2820(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. Written authorizations for topical ointments reported in use by staff members in Spaces #1 and 2b were not observed on file. 10A NCAC 09 .0803(1)(a & b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Several topical ointments reported by Ms. Pollard as no longer in use were observed in Space #2b. .0803(12) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic trash bags, grocery bags and storage bags were observed accessible to children under three years of age in Spaces #1, 2a and 2b. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. A playground inspection has not been documented since March 8, 2023. .0605(q) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A staff member hired October 9, 2023 does not have a medical report on file. 10A NCAC 09 .0701(a) 1043 All staff records, except financial records, were not made available for review. Staff records reviewed today were incomplete, most of them missing annual health questionnaires, emergency information forms, professional development plans, evaluations, and documentation of review of the facility's Emergency Preparedness and Response (EPR) and Emergency Medical Care (EMC) plans. G.S. 110-91( 9) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Two new staff members, who began employment in August and October 2023, have not yet completed at least 16 hours of orientation. .1101(a) 1320 Children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care was not on file for each child. A health assessment was not on file for one of the four children's files reviewed today. GS 110-91(1);.0302(d)(2); .0304(g) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. A signed and dated statement of receipt of the facility's discipline policy was not on file for one of the four children's files reviewed. .1804(b) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. A shelter-in-place or lockdown drill has not been conducted since March 8, 2023. .0604(u);.0302(d)(8) 1898 Staff did not complete the health and safety training within one year of employment. Completion of health and safety training topics could not be verified for three staff members today. .1102(a) A compliance letter including detailed information about how all violations have been corrected must be received by January 25, 2024. Include any supporting documentation with your response (if applicable). Your letter will be used as verification that violations have been corrected and compliance is maintained; your written response is considered a legal document so must be accurate and truthful. If you email the compliance letter, it must be sent using the email address registered with DCDEE and include your facility name and ID number. If sufficient information is not received by the due date, a follow-up visit will be conducted. Technical Assistance Regarding Violations Cited Technical assistance was provided during the last Annual Compliance visit regarding using staff file checklists to organize staff files and ensure all required documentation is in place by appropriate deadlines. Today I demonstrated how to use the checklist with a new staff member’s file. I also went through the Staff and Training Worksheet line by line with you and showed you how to complete it accurately using your staff records. As discussed, items such as staff health questionnaires, emergency information, professional development plans and evaluations must be updated annually. In addition, you must conduct an annual review of the Emergency Medical Care Plan and Emergency Preparedness and Response Plan and document these on the worksheet. To correct violations, you must audit all staff files using the checklist and complete all annual updates as noted today. I gave you a list of staff members who need to complete forms, orientation and/or training topics to correct violations, and a follow-up visit will be conducted to confirm this. Moving forward, I suggested you select a certain month each year to complete annual updates and set a reminder on your calendar so records will always be current. You must also revise your Staff and Training Worksheet and ensure you keep it updated as needed. This document should serve as a tracking tool for required paperwork and deadlines and will help you avoid recordkeeping violations in the future if you review it frequently. Regarding children’s records, I also urged you to audit files using the Child File Checklist to ensure all documentation is on file. You may wish to delegate some recordkeeping responsibilities to another staff member who has good organizational skills and is able to assist. This will allow you to trust that accurate records are being kept while you focus on other aspects of managing your facility. Today I also strongly urged you to conduct frequent “spot checks” in the classrooms for potential safety hazards such as uncovered outlets, improper storage of hazardous items, required postings, etc. It may be helpful for you to “pretend” you are a Child Care Consultant or inspector and look for violations yourself so you can correct them and hold staff accountable for non-compliance. Regarding the broken bathroom door, you stated you have asked the owners of the adjacent community center to fix it but they have not. Since you are responsible for the safety of the child care spaces, I urged you to make this area inaccessible to children until a repair can be made. Technical assistance was also provided today regarding medication requirements. I strongly encouraged you to review the Child Care Rules regarding medication and share them with staff, as they should never administer medication without written authorization. I reminded you that you can print permission forms from Provider Documents and Forms on the DCDEE website and ensure they are filled out accurately by parents prior to putting medications in the classrooms. Medications no longer in use should be returned to the parent or discarded, and you must ensure all medications are kept in locked storage except for topical ointments and emergency medications. These items must be stored at least five feet from the floor but do not have to be locked. I suggest you develop a plan to check the classrooms for compliance with medication requirements on a regular basis as well. Technical Assistance Technical assistance was also provided today on the service of juice. As discussed, even if parents provide juice, nutrition rules do not allow you to serve more than 6 ounces to each child per day. It is also prohibited to serve juice in a bottle. In Space #2b, I also suggested the lead teacher go through the books in the reading area and discard any which are in poor repair. Rated License Information Your facility’s three-year rated license reassessment is due in 2025, therefore you have been placed in “Cohort 3” of the cohort model of resuming rated license reassessments. This means your planning/preparation year will be 7/1/25-6/30/26, and your next reassessment will be due between 7/1/26 and 6/30/27. As discussed, if you are interested in having the Environment Rating Scales (ERS) conducted to try to increase points in Program Standards, you will have the option to request ERS assessments during your planning year if you wish. Planning year assessments will be free and will only count towards your star rating if you choose. If interested, I encourage you to use resources such as the NCRLAP website, Columbus County Partnership for Children, and Region 4 CCR&R to prepare for assessments. I will be in touch regarding timelines as your planning year approaches. Information from DCDEE WORKS was reviewed with you and noted on the Staff and Training Worksheet today. Regarding Education standards, compliance could not be verified due to pending WORKS evaluations of two new staff members. Today you stated one of them is enrolled in the NCECC coursework and the other will mail an official transcript for evaluation. You must ensure all staff in key positions including lead teacher and teacher have registered for WORKS accounts, applied for appropriate positions and submitted official transcripts as required for evaluation. Please let me know if you need assistance with the WORKS portal. Reminders As discussed, a follow-up visit may be conducted in the near future to verify corrections of violations cited. Please be aware the violations cited may result in Administrative Action being issued against your license. Additional on-going training hours are needed as follows by January 24, 2024 to avoid another violation: Felicia Waddell- 17 hours Doreathea McNeil- 12 hours Stella Munn- 6 hours You must schedule and obtain an approved fire inspection by June 1, 2024. Remember to submit a copy within one week as required. Save the date for a Zoom Provider Meeting! The meeting for center owners and directors will be held February 7, 2024 at 10am. Keep an eye out for an email invitation with Zoom link soon! Child Care Rules were revised July 1, 2023, and a new rule book was posted to the DCDEE website. As discussed, you should discard any old versions of the rules and ensure you are referring to the most current rule book when reviewing or researching requirements. Sanitation rules were also readopted July 1, 2023. I strongly urge you to review the training information at https://ehs.dph.ncdhhs.gov/hhccehb/cehu/ccs/op-training.htm, and contact Children’s Environmental Health Services with any questions. For more information regarding the “cohort model” of resuming rated license reassessments, and opportunities for training and technical assistance as you prepare for a reassessment, you may visit https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-Star-Rated-License. At the end of this visit, documentation was completed electronically, printed and reviewed with you. Please remember it is your responsibility to comply with all child care rules and requirements at all times. If you have questions or need assistance please feel free to contact me at 910-338-7038 or amy.wangler@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

10A NCAC 09 .0902 · Violation

Name of Operation: ALL ANNIE'S CHILDREN Facility ID: 24000165 Consultant: AMY WANGLER Operation Type: Center Case Number: Visit Date: 1/11/2024 Number Present: 39 Completed Date: 1/11/2024 Age: From 0 To 4 Total Minutes: 300 Time In: 08:30 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance with applicable child care requirements pertinent to this visit type. This facility currently operates with a Three Star issued February 17, 2023. Restrictions include: a first shift capacity of 57 children 0-12 years of age, meets enhanced space, and children under 2 ½ years old in rooms with direct exits only. Restrictions were in compliance today. The last annual compliance visit was conducted January 24, 2023. A Superior sanitation rating was earned September 14, 2023, and a fire inspection was conducted June 1, 2023; the facility was approved for day time care only. Prior to the visit, the facility had an eighteen-month compliance history score of 94%. Owner/Administrator Linda Pollard was present and available for consultation today. Three indoor spaces and two outdoor spaces are approved for use; Indoor Space #2 is separated into two distinct spaces using furniture. Infants and children one year of age in Space #1 were observed in individual feeding and sleeping routines as well as play activities. Three children ate a breakfast of grits, eggs, mandarin oranges and milk while the other two played freely in the carpeted areas. Later, an infant was observed asleep on his back in his crib; safe sleep practices including documentation were monitored and in compliance today. Children one and two years of age in Space #2b participated in free choice activities including building with blocks and pretending to vacuum. Children two and three years of age in Space #2a were observed coloring on white paper plates with crayons. In Space #3, preschool children participated in a large group activity during which they danced and sang songs. Lunch served consisted of spaghetti with meat sauce, corn, mixed fruit and milk. After lunch, children transitioned to rest time routines. They rested on appropriately spaced cots with individual linens. Today it was observed that the large climber with a slide, ladder and two swings observed in Outdoor Space #1b on August 30, 2023 was removed per my guidance as it was not approved for commercial use. A movable piece of equipment with a small climber and slide was observed in its place. Health and Safety training requirements as outlined in Child Care Rule 10A NCAC 09 .1102 were monitored today. Child Care programs are expected to always achieve and maintain compliance with child care rules, and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The following violations were observed today and must be corrected immediately: 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. Several bottles observed in Space #1 were not labeled with dates. 15A NCAC 18A .2804(d) 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. A written feeding plan was not observed for one child under fifteen months of age. 10A NCAC 09 .0902(a) 620 All walls and ceilings including doors and windows were not kept clean and in good repair. One of the bathroom stall doors in the bathroom used by children was observed off of its hinges. 15A NCAC 18A .2825(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. One outlet in Space #3 and two outlets in the bathrooms used by children were observed uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. An aerosol can of disinfectant was observed unlocked in Space #3. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A tube of prescription diaper cream was observed unlocked in Space #1. 15A NCAC 18A .2820(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. Written authorizations for topical ointments reported in use by staff members in Spaces #1 and 2b were not observed on file. 10A NCAC 09 .0803(1)(a & b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Several topical ointments reported by Ms. Pollard as no longer in use were observed in Space #2b. .0803(12) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic trash bags, grocery bags and storage bags were observed accessible to children under three years of age in Spaces #1, 2a and 2b. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. A playground inspection has not been documented since March 8, 2023. .0605(q) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A staff member hired October 9, 2023 does not have a medical report on file. 10A NCAC 09 .0701(a) 1043 All staff records, except financial records, were not made available for review. Staff records reviewed today were incomplete, most of them missing annual health questionnaires, emergency information forms, professional development plans, evaluations, and documentation of review of the facility's Emergency Preparedness and Response (EPR) and Emergency Medical Care (EMC) plans. G.S. 110-91( 9) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Two new staff members, who began employment in August and October 2023, have not yet completed at least 16 hours of orientation. .1101(a) 1320 Children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care was not on file for each child. A health assessment was not on file for one of the four children's files reviewed today. GS 110-91(1);.0302(d)(2); .0304(g) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. A signed and dated statement of receipt of the facility's discipline policy was not on file for one of the four children's files reviewed. .1804(b) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. A shelter-in-place or lockdown drill has not been conducted since March 8, 2023. .0604(u);.0302(d)(8) 1898 Staff did not complete the health and safety training within one year of employment. Completion of health and safety training topics could not be verified for three staff members today. .1102(a) A compliance letter including detailed information about how all violations have been corrected must be received by January 25, 2024. Include any supporting documentation with your response (if applicable). Your letter will be used as verification that violations have been corrected and compliance is maintained; your written response is considered a legal document so must be accurate and truthful. If you email the compliance letter, it must be sent using the email address registered with DCDEE and include your facility name and ID number. If sufficient information is not received by the due date, a follow-up visit will be conducted. Technical Assistance Regarding Violations Cited Technical assistance was provided during the last Annual Compliance visit regarding using staff file checklists to organize staff files and ensure all required documentation is in place by appropriate deadlines. Today I demonstrated how to use the checklist with a new staff member’s file. I also went through the Staff and Training Worksheet line by line with you and showed you how to complete it accurately using your staff records. As discussed, items such as staff health questionnaires, emergency information, professional development plans and evaluations must be updated annually. In addition, you must conduct an annual review of the Emergency Medical Care Plan and Emergency Preparedness and Response Plan and document these on the worksheet. To correct violations, you must audit all staff files using the checklist and complete all annual updates as noted today. I gave you a list of staff members who need to complete forms, orientation and/or training topics to correct violations, and a follow-up visit will be conducted to confirm this. Moving forward, I suggested you select a certain month each year to complete annual updates and set a reminder on your calendar so records will always be current. You must also revise your Staff and Training Worksheet and ensure you keep it updated as needed. This document should serve as a tracking tool for required paperwork and deadlines and will help you avoid recordkeeping violations in the future if you review it frequently. Regarding children’s records, I also urged you to audit files using the Child File Checklist to ensure all documentation is on file. You may wish to delegate some recordkeeping responsibilities to another staff member who has good organizational skills and is able to assist. This will allow you to trust that accurate records are being kept while you focus on other aspects of managing your facility. Today I also strongly urged you to conduct frequent “spot checks” in the classrooms for potential safety hazards such as uncovered outlets, improper storage of hazardous items, required postings, etc. It may be helpful for you to “pretend” you are a Child Care Consultant or inspector and look for violations yourself so you can correct them and hold staff accountable for non-compliance. Regarding the broken bathroom door, you stated you have asked the owners of the adjacent community center to fix it but they have not. Since you are responsible for the safety of the child care spaces, I urged you to make this area inaccessible to children until a repair can be made. Technical assistance was also provided today regarding medication requirements. I strongly encouraged you to review the Child Care Rules regarding medication and share them with staff, as they should never administer medication without written authorization. I reminded you that you can print permission forms from Provider Documents and Forms on the DCDEE website and ensure they are filled out accurately by parents prior to putting medications in the classrooms. Medications no longer in use should be returned to the parent or discarded, and you must ensure all medications are kept in locked storage except for topical ointments and emergency medications. These items must be stored at least five feet from the floor but do not have to be locked. I suggest you develop a plan to check the classrooms for compliance with medication requirements on a regular basis as well. Technical Assistance Technical assistance was also provided today on the service of juice. As discussed, even if parents provide juice, nutrition rules do not allow you to serve more than 6 ounces to each child per day. It is also prohibited to serve juice in a bottle. In Space #2b, I also suggested the lead teacher go through the books in the reading area and discard any which are in poor repair. Rated License Information Your facility’s three-year rated license reassessment is due in 2025, therefore you have been placed in “Cohort 3” of the cohort model of resuming rated license reassessments. This means your planning/preparation year will be 7/1/25-6/30/26, and your next reassessment will be due between 7/1/26 and 6/30/27. As discussed, if you are interested in having the Environment Rating Scales (ERS) conducted to try to increase points in Program Standards, you will have the option to request ERS assessments during your planning year if you wish. Planning year assessments will be free and will only count towards your star rating if you choose. If interested, I encourage you to use resources such as the NCRLAP website, Columbus County Partnership for Children, and Region 4 CCR&R to prepare for assessments. I will be in touch regarding timelines as your planning year approaches. Information from DCDEE WORKS was reviewed with you and noted on the Staff and Training Worksheet today. Regarding Education standards, compliance could not be verified due to pending WORKS evaluations of two new staff members. Today you stated one of them is enrolled in the NCECC coursework and the other will mail an official transcript for evaluation. You must ensure all staff in key positions including lead teacher and teacher have registered for WORKS accounts, applied for appropriate positions and submitted official transcripts as required for evaluation. Please let me know if you need assistance with the WORKS portal. Reminders As discussed, a follow-up visit may be conducted in the near future to verify corrections of violations cited. Please be aware the violations cited may result in Administrative Action being issued against your license. Additional on-going training hours are needed as follows by January 24, 2024 to avoid another violation: Felicia Waddell- 17 hours Doreathea McNeil- 12 hours Stella Munn- 6 hours You must schedule and obtain an approved fire inspection by June 1, 2024. Remember to submit a copy within one week as required. Save the date for a Zoom Provider Meeting! The meeting for center owners and directors will be held February 7, 2024 at 10am. Keep an eye out for an email invitation with Zoom link soon! Child Care Rules were revised July 1, 2023, and a new rule book was posted to the DCDEE website. As discussed, you should discard any old versions of the rules and ensure you are referring to the most current rule book when reviewing or researching requirements. Sanitation rules were also readopted July 1, 2023. I strongly urge you to review the training information at https://ehs.dph.ncdhhs.gov/hhccehb/cehu/ccs/op-training.htm, and contact Children’s Environmental Health Services with any questions. For more information regarding the “cohort model” of resuming rated license reassessments, and opportunities for training and technical assistance as you prepare for a reassessment, you may visit https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-Star-Rated-License. At the end of this visit, documentation was completed electronically, printed and reviewed with you. Please remember it is your responsibility to comply with all child care rules and requirements at all times. If you have questions or need assistance please feel free to contact me at 910-338-7038 or amy.wangler@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0701 · Violation

Name of Operation: ALL ANNIE'S CHILDREN Facility ID: 24000165 Consultant: AMY WANGLER Operation Type: Center Case Number: Visit Date: 1/11/2024 Number Present: 39 Completed Date: 1/11/2024 Age: From 0 To 4 Total Minutes: 300 Time In: 08:30 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance with applicable child care requirements pertinent to this visit type. This facility currently operates with a Three Star issued February 17, 2023. Restrictions include: a first shift capacity of 57 children 0-12 years of age, meets enhanced space, and children under 2 ½ years old in rooms with direct exits only. Restrictions were in compliance today. The last annual compliance visit was conducted January 24, 2023. A Superior sanitation rating was earned September 14, 2023, and a fire inspection was conducted June 1, 2023; the facility was approved for day time care only. Prior to the visit, the facility had an eighteen-month compliance history score of 94%. Owner/Administrator Linda Pollard was present and available for consultation today. Three indoor spaces and two outdoor spaces are approved for use; Indoor Space #2 is separated into two distinct spaces using furniture. Infants and children one year of age in Space #1 were observed in individual feeding and sleeping routines as well as play activities. Three children ate a breakfast of grits, eggs, mandarin oranges and milk while the other two played freely in the carpeted areas. Later, an infant was observed asleep on his back in his crib; safe sleep practices including documentation were monitored and in compliance today. Children one and two years of age in Space #2b participated in free choice activities including building with blocks and pretending to vacuum. Children two and three years of age in Space #2a were observed coloring on white paper plates with crayons. In Space #3, preschool children participated in a large group activity during which they danced and sang songs. Lunch served consisted of spaghetti with meat sauce, corn, mixed fruit and milk. After lunch, children transitioned to rest time routines. They rested on appropriately spaced cots with individual linens. Today it was observed that the large climber with a slide, ladder and two swings observed in Outdoor Space #1b on August 30, 2023 was removed per my guidance as it was not approved for commercial use. A movable piece of equipment with a small climber and slide was observed in its place. Health and Safety training requirements as outlined in Child Care Rule 10A NCAC 09 .1102 were monitored today. Child Care programs are expected to always achieve and maintain compliance with child care rules, and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The following violations were observed today and must be corrected immediately: 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. Several bottles observed in Space #1 were not labeled with dates. 15A NCAC 18A .2804(d) 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. A written feeding plan was not observed for one child under fifteen months of age. 10A NCAC 09 .0902(a) 620 All walls and ceilings including doors and windows were not kept clean and in good repair. One of the bathroom stall doors in the bathroom used by children was observed off of its hinges. 15A NCAC 18A .2825(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. One outlet in Space #3 and two outlets in the bathrooms used by children were observed uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. An aerosol can of disinfectant was observed unlocked in Space #3. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A tube of prescription diaper cream was observed unlocked in Space #1. 15A NCAC 18A .2820(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. Written authorizations for topical ointments reported in use by staff members in Spaces #1 and 2b were not observed on file. 10A NCAC 09 .0803(1)(a & b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Several topical ointments reported by Ms. Pollard as no longer in use were observed in Space #2b. .0803(12) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic trash bags, grocery bags and storage bags were observed accessible to children under three years of age in Spaces #1, 2a and 2b. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. A playground inspection has not been documented since March 8, 2023. .0605(q) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A staff member hired October 9, 2023 does not have a medical report on file. 10A NCAC 09 .0701(a) 1043 All staff records, except financial records, were not made available for review. Staff records reviewed today were incomplete, most of them missing annual health questionnaires, emergency information forms, professional development plans, evaluations, and documentation of review of the facility's Emergency Preparedness and Response (EPR) and Emergency Medical Care (EMC) plans. G.S. 110-91( 9) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Two new staff members, who began employment in August and October 2023, have not yet completed at least 16 hours of orientation. .1101(a) 1320 Children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care was not on file for each child. A health assessment was not on file for one of the four children's files reviewed today. GS 110-91(1);.0302(d)(2); .0304(g) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. A signed and dated statement of receipt of the facility's discipline policy was not on file for one of the four children's files reviewed. .1804(b) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. A shelter-in-place or lockdown drill has not been conducted since March 8, 2023. .0604(u);.0302(d)(8) 1898 Staff did not complete the health and safety training within one year of employment. Completion of health and safety training topics could not be verified for three staff members today. .1102(a) A compliance letter including detailed information about how all violations have been corrected must be received by January 25, 2024. Include any supporting documentation with your response (if applicable). Your letter will be used as verification that violations have been corrected and compliance is maintained; your written response is considered a legal document so must be accurate and truthful. If you email the compliance letter, it must be sent using the email address registered with DCDEE and include your facility name and ID number. If sufficient information is not received by the due date, a follow-up visit will be conducted. Technical Assistance Regarding Violations Cited Technical assistance was provided during the last Annual Compliance visit regarding using staff file checklists to organize staff files and ensure all required documentation is in place by appropriate deadlines. Today I demonstrated how to use the checklist with a new staff member’s file. I also went through the Staff and Training Worksheet line by line with you and showed you how to complete it accurately using your staff records. As discussed, items such as staff health questionnaires, emergency information, professional development plans and evaluations must be updated annually. In addition, you must conduct an annual review of the Emergency Medical Care Plan and Emergency Preparedness and Response Plan and document these on the worksheet. To correct violations, you must audit all staff files using the checklist and complete all annual updates as noted today. I gave you a list of staff members who need to complete forms, orientation and/or training topics to correct violations, and a follow-up visit will be conducted to confirm this. Moving forward, I suggested you select a certain month each year to complete annual updates and set a reminder on your calendar so records will always be current. You must also revise your Staff and Training Worksheet and ensure you keep it updated as needed. This document should serve as a tracking tool for required paperwork and deadlines and will help you avoid recordkeeping violations in the future if you review it frequently. Regarding children’s records, I also urged you to audit files using the Child File Checklist to ensure all documentation is on file. You may wish to delegate some recordkeeping responsibilities to another staff member who has good organizational skills and is able to assist. This will allow you to trust that accurate records are being kept while you focus on other aspects of managing your facility. Today I also strongly urged you to conduct frequent “spot checks” in the classrooms for potential safety hazards such as uncovered outlets, improper storage of hazardous items, required postings, etc. It may be helpful for you to “pretend” you are a Child Care Consultant or inspector and look for violations yourself so you can correct them and hold staff accountable for non-compliance. Regarding the broken bathroom door, you stated you have asked the owners of the adjacent community center to fix it but they have not. Since you are responsible for the safety of the child care spaces, I urged you to make this area inaccessible to children until a repair can be made. Technical assistance was also provided today regarding medication requirements. I strongly encouraged you to review the Child Care Rules regarding medication and share them with staff, as they should never administer medication without written authorization. I reminded you that you can print permission forms from Provider Documents and Forms on the DCDEE website and ensure they are filled out accurately by parents prior to putting medications in the classrooms. Medications no longer in use should be returned to the parent or discarded, and you must ensure all medications are kept in locked storage except for topical ointments and emergency medications. These items must be stored at least five feet from the floor but do not have to be locked. I suggest you develop a plan to check the classrooms for compliance with medication requirements on a regular basis as well. Technical Assistance Technical assistance was also provided today on the service of juice. As discussed, even if parents provide juice, nutrition rules do not allow you to serve more than 6 ounces to each child per day. It is also prohibited to serve juice in a bottle. In Space #2b, I also suggested the lead teacher go through the books in the reading area and discard any which are in poor repair. Rated License Information Your facility’s three-year rated license reassessment is due in 2025, therefore you have been placed in “Cohort 3” of the cohort model of resuming rated license reassessments. This means your planning/preparation year will be 7/1/25-6/30/26, and your next reassessment will be due between 7/1/26 and 6/30/27. As discussed, if you are interested in having the Environment Rating Scales (ERS) conducted to try to increase points in Program Standards, you will have the option to request ERS assessments during your planning year if you wish. Planning year assessments will be free and will only count towards your star rating if you choose. If interested, I encourage you to use resources such as the NCRLAP website, Columbus County Partnership for Children, and Region 4 CCR&R to prepare for assessments. I will be in touch regarding timelines as your planning year approaches. Information from DCDEE WORKS was reviewed with you and noted on the Staff and Training Worksheet today. Regarding Education standards, compliance could not be verified due to pending WORKS evaluations of two new staff members. Today you stated one of them is enrolled in the NCECC coursework and the other will mail an official transcript for evaluation. You must ensure all staff in key positions including lead teacher and teacher have registered for WORKS accounts, applied for appropriate positions and submitted official transcripts as required for evaluation. Please let me know if you need assistance with the WORKS portal. Reminders As discussed, a follow-up visit may be conducted in the near future to verify corrections of violations cited. Please be aware the violations cited may result in Administrative Action being issued against your license. Additional on-going training hours are needed as follows by January 24, 2024 to avoid another violation: Felicia Waddell- 17 hours Doreathea McNeil- 12 hours Stella Munn- 6 hours You must schedule and obtain an approved fire inspection by June 1, 2024. Remember to submit a copy within one week as required. Save the date for a Zoom Provider Meeting! The meeting for center owners and directors will be held February 7, 2024 at 10am. Keep an eye out for an email invitation with Zoom link soon! Child Care Rules were revised July 1, 2023, and a new rule book was posted to the DCDEE website. As discussed, you should discard any old versions of the rules and ensure you are referring to the most current rule book when reviewing or researching requirements. Sanitation rules were also readopted July 1, 2023. I strongly urge you to review the training information at https://ehs.dph.ncdhhs.gov/hhccehb/cehu/ccs/op-training.htm, and contact Children’s Environmental Health Services with any questions. For more information regarding the “cohort model” of resuming rated license reassessments, and opportunities for training and technical assistance as you prepare for a reassessment, you may visit https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-Star-Rated-License. At the end of this visit, documentation was completed electronically, printed and reviewed with you. Please remember it is your responsibility to comply with all child care rules and requirements at all times. If you have questions or need assistance please feel free to contact me at 910-338-7038 or amy.wangler@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0803 · Violation

Name of Operation: ALL ANNIE'S CHILDREN Facility ID: 24000165 Consultant: AMY WANGLER Operation Type: Center Case Number: Visit Date: 1/11/2024 Number Present: 39 Completed Date: 1/11/2024 Age: From 0 To 4 Total Minutes: 300 Time In: 08:30 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance with applicable child care requirements pertinent to this visit type. This facility currently operates with a Three Star issued February 17, 2023. Restrictions include: a first shift capacity of 57 children 0-12 years of age, meets enhanced space, and children under 2 ½ years old in rooms with direct exits only. Restrictions were in compliance today. The last annual compliance visit was conducted January 24, 2023. A Superior sanitation rating was earned September 14, 2023, and a fire inspection was conducted June 1, 2023; the facility was approved for day time care only. Prior to the visit, the facility had an eighteen-month compliance history score of 94%. Owner/Administrator Linda Pollard was present and available for consultation today. Three indoor spaces and two outdoor spaces are approved for use; Indoor Space #2 is separated into two distinct spaces using furniture. Infants and children one year of age in Space #1 were observed in individual feeding and sleeping routines as well as play activities. Three children ate a breakfast of grits, eggs, mandarin oranges and milk while the other two played freely in the carpeted areas. Later, an infant was observed asleep on his back in his crib; safe sleep practices including documentation were monitored and in compliance today. Children one and two years of age in Space #2b participated in free choice activities including building with blocks and pretending to vacuum. Children two and three years of age in Space #2a were observed coloring on white paper plates with crayons. In Space #3, preschool children participated in a large group activity during which they danced and sang songs. Lunch served consisted of spaghetti with meat sauce, corn, mixed fruit and milk. After lunch, children transitioned to rest time routines. They rested on appropriately spaced cots with individual linens. Today it was observed that the large climber with a slide, ladder and two swings observed in Outdoor Space #1b on August 30, 2023 was removed per my guidance as it was not approved for commercial use. A movable piece of equipment with a small climber and slide was observed in its place. Health and Safety training requirements as outlined in Child Care Rule 10A NCAC 09 .1102 were monitored today. Child Care programs are expected to always achieve and maintain compliance with child care rules, and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The following violations were observed today and must be corrected immediately: 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. Several bottles observed in Space #1 were not labeled with dates. 15A NCAC 18A .2804(d) 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. A written feeding plan was not observed for one child under fifteen months of age. 10A NCAC 09 .0902(a) 620 All walls and ceilings including doors and windows were not kept clean and in good repair. One of the bathroom stall doors in the bathroom used by children was observed off of its hinges. 15A NCAC 18A .2825(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. One outlet in Space #3 and two outlets in the bathrooms used by children were observed uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. An aerosol can of disinfectant was observed unlocked in Space #3. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A tube of prescription diaper cream was observed unlocked in Space #1. 15A NCAC 18A .2820(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. Written authorizations for topical ointments reported in use by staff members in Spaces #1 and 2b were not observed on file. 10A NCAC 09 .0803(1)(a & b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Several topical ointments reported by Ms. Pollard as no longer in use were observed in Space #2b. .0803(12) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic trash bags, grocery bags and storage bags were observed accessible to children under three years of age in Spaces #1, 2a and 2b. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. A playground inspection has not been documented since March 8, 2023. .0605(q) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A staff member hired October 9, 2023 does not have a medical report on file. 10A NCAC 09 .0701(a) 1043 All staff records, except financial records, were not made available for review. Staff records reviewed today were incomplete, most of them missing annual health questionnaires, emergency information forms, professional development plans, evaluations, and documentation of review of the facility's Emergency Preparedness and Response (EPR) and Emergency Medical Care (EMC) plans. G.S. 110-91( 9) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Two new staff members, who began employment in August and October 2023, have not yet completed at least 16 hours of orientation. .1101(a) 1320 Children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care was not on file for each child. A health assessment was not on file for one of the four children's files reviewed today. GS 110-91(1);.0302(d)(2); .0304(g) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. A signed and dated statement of receipt of the facility's discipline policy was not on file for one of the four children's files reviewed. .1804(b) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. A shelter-in-place or lockdown drill has not been conducted since March 8, 2023. .0604(u);.0302(d)(8) 1898 Staff did not complete the health and safety training within one year of employment. Completion of health and safety training topics could not be verified for three staff members today. .1102(a) A compliance letter including detailed information about how all violations have been corrected must be received by January 25, 2024. Include any supporting documentation with your response (if applicable). Your letter will be used as verification that violations have been corrected and compliance is maintained; your written response is considered a legal document so must be accurate and truthful. If you email the compliance letter, it must be sent using the email address registered with DCDEE and include your facility name and ID number. If sufficient information is not received by the due date, a follow-up visit will be conducted. Technical Assistance Regarding Violations Cited Technical assistance was provided during the last Annual Compliance visit regarding using staff file checklists to organize staff files and ensure all required documentation is in place by appropriate deadlines. Today I demonstrated how to use the checklist with a new staff member’s file. I also went through the Staff and Training Worksheet line by line with you and showed you how to complete it accurately using your staff records. As discussed, items such as staff health questionnaires, emergency information, professional development plans and evaluations must be updated annually. In addition, you must conduct an annual review of the Emergency Medical Care Plan and Emergency Preparedness and Response Plan and document these on the worksheet. To correct violations, you must audit all staff files using the checklist and complete all annual updates as noted today. I gave you a list of staff members who need to complete forms, orientation and/or training topics to correct violations, and a follow-up visit will be conducted to confirm this. Moving forward, I suggested you select a certain month each year to complete annual updates and set a reminder on your calendar so records will always be current. You must also revise your Staff and Training Worksheet and ensure you keep it updated as needed. This document should serve as a tracking tool for required paperwork and deadlines and will help you avoid recordkeeping violations in the future if you review it frequently. Regarding children’s records, I also urged you to audit files using the Child File Checklist to ensure all documentation is on file. You may wish to delegate some recordkeeping responsibilities to another staff member who has good organizational skills and is able to assist. This will allow you to trust that accurate records are being kept while you focus on other aspects of managing your facility. Today I also strongly urged you to conduct frequent “spot checks” in the classrooms for potential safety hazards such as uncovered outlets, improper storage of hazardous items, required postings, etc. It may be helpful for you to “pretend” you are a Child Care Consultant or inspector and look for violations yourself so you can correct them and hold staff accountable for non-compliance. Regarding the broken bathroom door, you stated you have asked the owners of the adjacent community center to fix it but they have not. Since you are responsible for the safety of the child care spaces, I urged you to make this area inaccessible to children until a repair can be made. Technical assistance was also provided today regarding medication requirements. I strongly encouraged you to review the Child Care Rules regarding medication and share them with staff, as they should never administer medication without written authorization. I reminded you that you can print permission forms from Provider Documents and Forms on the DCDEE website and ensure they are filled out accurately by parents prior to putting medications in the classrooms. Medications no longer in use should be returned to the parent or discarded, and you must ensure all medications are kept in locked storage except for topical ointments and emergency medications. These items must be stored at least five feet from the floor but do not have to be locked. I suggest you develop a plan to check the classrooms for compliance with medication requirements on a regular basis as well. Technical Assistance Technical assistance was also provided today on the service of juice. As discussed, even if parents provide juice, nutrition rules do not allow you to serve more than 6 ounces to each child per day. It is also prohibited to serve juice in a bottle. In Space #2b, I also suggested the lead teacher go through the books in the reading area and discard any which are in poor repair. Rated License Information Your facility’s three-year rated license reassessment is due in 2025, therefore you have been placed in “Cohort 3” of the cohort model of resuming rated license reassessments. This means your planning/preparation year will be 7/1/25-6/30/26, and your next reassessment will be due between 7/1/26 and 6/30/27. As discussed, if you are interested in having the Environment Rating Scales (ERS) conducted to try to increase points in Program Standards, you will have the option to request ERS assessments during your planning year if you wish. Planning year assessments will be free and will only count towards your star rating if you choose. If interested, I encourage you to use resources such as the NCRLAP website, Columbus County Partnership for Children, and Region 4 CCR&R to prepare for assessments. I will be in touch regarding timelines as your planning year approaches. Information from DCDEE WORKS was reviewed with you and noted on the Staff and Training Worksheet today. Regarding Education standards, compliance could not be verified due to pending WORKS evaluations of two new staff members. Today you stated one of them is enrolled in the NCECC coursework and the other will mail an official transcript for evaluation. You must ensure all staff in key positions including lead teacher and teacher have registered for WORKS accounts, applied for appropriate positions and submitted official transcripts as required for evaluation. Please let me know if you need assistance with the WORKS portal. Reminders As discussed, a follow-up visit may be conducted in the near future to verify corrections of violations cited. Please be aware the violations cited may result in Administrative Action being issued against your license. Additional on-going training hours are needed as follows by January 24, 2024 to avoid another violation: Felicia Waddell- 17 hours Doreathea McNeil- 12 hours Stella Munn- 6 hours You must schedule and obtain an approved fire inspection by June 1, 2024. Remember to submit a copy within one week as required. Save the date for a Zoom Provider Meeting! The meeting for center owners and directors will be held February 7, 2024 at 10am. Keep an eye out for an email invitation with Zoom link soon! Child Care Rules were revised July 1, 2023, and a new rule book was posted to the DCDEE website. As discussed, you should discard any old versions of the rules and ensure you are referring to the most current rule book when reviewing or researching requirements. Sanitation rules were also readopted July 1, 2023. I strongly urge you to review the training information at https://ehs.dph.ncdhhs.gov/hhccehb/cehu/ccs/op-training.htm, and contact Children’s Environmental Health Services with any questions. For more information regarding the “cohort model” of resuming rated license reassessments, and opportunities for training and technical assistance as you prepare for a reassessment, you may visit https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-Star-Rated-License. At the end of this visit, documentation was completed electronically, printed and reviewed with you. Please remember it is your responsibility to comply with all child care rules and requirements at all times. If you have questions or need assistance please feel free to contact me at 910-338-7038 or amy.wangler@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: ALL ANNIE'S CHILDREN Facility ID: 24000165 Consultant: AMY WANGLER Operation Type: Center Case Number: Visit Date: 1/11/2024 Number Present: 39 Completed Date: 1/11/2024 Age: From 0 To 4 Total Minutes: 300 Time In: 08:30 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance with applicable child care requirements pertinent to this visit type. This facility currently operates with a Three Star issued February 17, 2023. Restrictions include: a first shift capacity of 57 children 0-12 years of age, meets enhanced space, and children under 2 ½ years old in rooms with direct exits only. Restrictions were in compliance today. The last annual compliance visit was conducted January 24, 2023. A Superior sanitation rating was earned September 14, 2023, and a fire inspection was conducted June 1, 2023; the facility was approved for day time care only. Prior to the visit, the facility had an eighteen-month compliance history score of 94%. Owner/Administrator Linda Pollard was present and available for consultation today. Three indoor spaces and two outdoor spaces are approved for use; Indoor Space #2 is separated into two distinct spaces using furniture. Infants and children one year of age in Space #1 were observed in individual feeding and sleeping routines as well as play activities. Three children ate a breakfast of grits, eggs, mandarin oranges and milk while the other two played freely in the carpeted areas. Later, an infant was observed asleep on his back in his crib; safe sleep practices including documentation were monitored and in compliance today. Children one and two years of age in Space #2b participated in free choice activities including building with blocks and pretending to vacuum. Children two and three years of age in Space #2a were observed coloring on white paper plates with crayons. In Space #3, preschool children participated in a large group activity during which they danced and sang songs. Lunch served consisted of spaghetti with meat sauce, corn, mixed fruit and milk. After lunch, children transitioned to rest time routines. They rested on appropriately spaced cots with individual linens. Today it was observed that the large climber with a slide, ladder and two swings observed in Outdoor Space #1b on August 30, 2023 was removed per my guidance as it was not approved for commercial use. A movable piece of equipment with a small climber and slide was observed in its place. Health and Safety training requirements as outlined in Child Care Rule 10A NCAC 09 .1102 were monitored today. Child Care programs are expected to always achieve and maintain compliance with child care rules, and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The following violations were observed today and must be corrected immediately: 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. Several bottles observed in Space #1 were not labeled with dates. 15A NCAC 18A .2804(d) 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. A written feeding plan was not observed for one child under fifteen months of age. 10A NCAC 09 .0902(a) 620 All walls and ceilings including doors and windows were not kept clean and in good repair. One of the bathroom stall doors in the bathroom used by children was observed off of its hinges. 15A NCAC 18A .2825(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. One outlet in Space #3 and two outlets in the bathrooms used by children were observed uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. An aerosol can of disinfectant was observed unlocked in Space #3. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A tube of prescription diaper cream was observed unlocked in Space #1. 15A NCAC 18A .2820(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. Written authorizations for topical ointments reported in use by staff members in Spaces #1 and 2b were not observed on file. 10A NCAC 09 .0803(1)(a & b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Several topical ointments reported by Ms. Pollard as no longer in use were observed in Space #2b. .0803(12) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic trash bags, grocery bags and storage bags were observed accessible to children under three years of age in Spaces #1, 2a and 2b. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. A playground inspection has not been documented since March 8, 2023. .0605(q) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A staff member hired October 9, 2023 does not have a medical report on file. 10A NCAC 09 .0701(a) 1043 All staff records, except financial records, were not made available for review. Staff records reviewed today were incomplete, most of them missing annual health questionnaires, emergency information forms, professional development plans, evaluations, and documentation of review of the facility's Emergency Preparedness and Response (EPR) and Emergency Medical Care (EMC) plans. G.S. 110-91( 9) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Two new staff members, who began employment in August and October 2023, have not yet completed at least 16 hours of orientation. .1101(a) 1320 Children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care was not on file for each child. A health assessment was not on file for one of the four children's files reviewed today. GS 110-91(1);.0302(d)(2); .0304(g) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. A signed and dated statement of receipt of the facility's discipline policy was not on file for one of the four children's files reviewed. .1804(b) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. A shelter-in-place or lockdown drill has not been conducted since March 8, 2023. .0604(u);.0302(d)(8) 1898 Staff did not complete the health and safety training within one year of employment. Completion of health and safety training topics could not be verified for three staff members today. .1102(a) A compliance letter including detailed information about how all violations have been corrected must be received by January 25, 2024. Include any supporting documentation with your response (if applicable). Your letter will be used as verification that violations have been corrected and compliance is maintained; your written response is considered a legal document so must be accurate and truthful. If you email the compliance letter, it must be sent using the email address registered with DCDEE and include your facility name and ID number. If sufficient information is not received by the due date, a follow-up visit will be conducted. Technical Assistance Regarding Violations Cited Technical assistance was provided during the last Annual Compliance visit regarding using staff file checklists to organize staff files and ensure all required documentation is in place by appropriate deadlines. Today I demonstrated how to use the checklist with a new staff member’s file. I also went through the Staff and Training Worksheet line by line with you and showed you how to complete it accurately using your staff records. As discussed, items such as staff health questionnaires, emergency information, professional development plans and evaluations must be updated annually. In addition, you must conduct an annual review of the Emergency Medical Care Plan and Emergency Preparedness and Response Plan and document these on the worksheet. To correct violations, you must audit all staff files using the checklist and complete all annual updates as noted today. I gave you a list of staff members who need to complete forms, orientation and/or training topics to correct violations, and a follow-up visit will be conducted to confirm this. Moving forward, I suggested you select a certain month each year to complete annual updates and set a reminder on your calendar so records will always be current. You must also revise your Staff and Training Worksheet and ensure you keep it updated as needed. This document should serve as a tracking tool for required paperwork and deadlines and will help you avoid recordkeeping violations in the future if you review it frequently. Regarding children’s records, I also urged you to audit files using the Child File Checklist to ensure all documentation is on file. You may wish to delegate some recordkeeping responsibilities to another staff member who has good organizational skills and is able to assist. This will allow you to trust that accurate records are being kept while you focus on other aspects of managing your facility. Today I also strongly urged you to conduct frequent “spot checks” in the classrooms for potential safety hazards such as uncovered outlets, improper storage of hazardous items, required postings, etc. It may be helpful for you to “pretend” you are a Child Care Consultant or inspector and look for violations yourself so you can correct them and hold staff accountable for non-compliance. Regarding the broken bathroom door, you stated you have asked the owners of the adjacent community center to fix it but they have not. Since you are responsible for the safety of the child care spaces, I urged you to make this area inaccessible to children until a repair can be made. Technical assistance was also provided today regarding medication requirements. I strongly encouraged you to review the Child Care Rules regarding medication and share them with staff, as they should never administer medication without written authorization. I reminded you that you can print permission forms from Provider Documents and Forms on the DCDEE website and ensure they are filled out accurately by parents prior to putting medications in the classrooms. Medications no longer in use should be returned to the parent or discarded, and you must ensure all medications are kept in locked storage except for topical ointments and emergency medications. These items must be stored at least five feet from the floor but do not have to be locked. I suggest you develop a plan to check the classrooms for compliance with medication requirements on a regular basis as well. Technical Assistance Technical assistance was also provided today on the service of juice. As discussed, even if parents provide juice, nutrition rules do not allow you to serve more than 6 ounces to each child per day. It is also prohibited to serve juice in a bottle. In Space #2b, I also suggested the lead teacher go through the books in the reading area and discard any which are in poor repair. Rated License Information Your facility’s three-year rated license reassessment is due in 2025, therefore you have been placed in “Cohort 3” of the cohort model of resuming rated license reassessments. This means your planning/preparation year will be 7/1/25-6/30/26, and your next reassessment will be due between 7/1/26 and 6/30/27. As discussed, if you are interested in having the Environment Rating Scales (ERS) conducted to try to increase points in Program Standards, you will have the option to request ERS assessments during your planning year if you wish. Planning year assessments will be free and will only count towards your star rating if you choose. If interested, I encourage you to use resources such as the NCRLAP website, Columbus County Partnership for Children, and Region 4 CCR&R to prepare for assessments. I will be in touch regarding timelines as your planning year approaches. Information from DCDEE WORKS was reviewed with you and noted on the Staff and Training Worksheet today. Regarding Education standards, compliance could not be verified due to pending WORKS evaluations of two new staff members. Today you stated one of them is enrolled in the NCECC coursework and the other will mail an official transcript for evaluation. You must ensure all staff in key positions including lead teacher and teacher have registered for WORKS accounts, applied for appropriate positions and submitted official transcripts as required for evaluation. Please let me know if you need assistance with the WORKS portal. Reminders As discussed, a follow-up visit may be conducted in the near future to verify corrections of violations cited. Please be aware the violations cited may result in Administrative Action being issued against your license. Additional on-going training hours are needed as follows by January 24, 2024 to avoid another violation: Felicia Waddell- 17 hours Doreathea McNeil- 12 hours Stella Munn- 6 hours You must schedule and obtain an approved fire inspection by June 1, 2024. Remember to submit a copy within one week as required. Save the date for a Zoom Provider Meeting! The meeting for center owners and directors will be held February 7, 2024 at 10am. Keep an eye out for an email invitation with Zoom link soon! Child Care Rules were revised July 1, 2023, and a new rule book was posted to the DCDEE website. As discussed, you should discard any old versions of the rules and ensure you are referring to the most current rule book when reviewing or researching requirements. Sanitation rules were also readopted July 1, 2023. I strongly urge you to review the training information at https://ehs.dph.ncdhhs.gov/hhccehb/cehu/ccs/op-training.htm, and contact Children’s Environmental Health Services with any questions. For more information regarding the “cohort model” of resuming rated license reassessments, and opportunities for training and technical assistance as you prepare for a reassessment, you may visit https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-Star-Rated-License. At the end of this visit, documentation was completed electronically, printed and reviewed with you. Please remember it is your responsibility to comply with all child care rules and requirements at all times. If you have questions or need assistance please feel free to contact me at 910-338-7038 or amy.wangler@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-91 · Violation

Name of Operation: ALL ANNIE'S CHILDREN Facility ID: 24000165 Consultant: AMY WANGLER Operation Type: Center Case Number: Visit Date: 1/11/2024 Number Present: 39 Completed Date: 1/11/2024 Age: From 0 To 4 Total Minutes: 300 Time In: 08:30 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance with applicable child care requirements pertinent to this visit type. This facility currently operates with a Three Star issued February 17, 2023. Restrictions include: a first shift capacity of 57 children 0-12 years of age, meets enhanced space, and children under 2 ½ years old in rooms with direct exits only. Restrictions were in compliance today. The last annual compliance visit was conducted January 24, 2023. A Superior sanitation rating was earned September 14, 2023, and a fire inspection was conducted June 1, 2023; the facility was approved for day time care only. Prior to the visit, the facility had an eighteen-month compliance history score of 94%. Owner/Administrator Linda Pollard was present and available for consultation today. Three indoor spaces and two outdoor spaces are approved for use; Indoor Space #2 is separated into two distinct spaces using furniture. Infants and children one year of age in Space #1 were observed in individual feeding and sleeping routines as well as play activities. Three children ate a breakfast of grits, eggs, mandarin oranges and milk while the other two played freely in the carpeted areas. Later, an infant was observed asleep on his back in his crib; safe sleep practices including documentation were monitored and in compliance today. Children one and two years of age in Space #2b participated in free choice activities including building with blocks and pretending to vacuum. Children two and three years of age in Space #2a were observed coloring on white paper plates with crayons. In Space #3, preschool children participated in a large group activity during which they danced and sang songs. Lunch served consisted of spaghetti with meat sauce, corn, mixed fruit and milk. After lunch, children transitioned to rest time routines. They rested on appropriately spaced cots with individual linens. Today it was observed that the large climber with a slide, ladder and two swings observed in Outdoor Space #1b on August 30, 2023 was removed per my guidance as it was not approved for commercial use. A movable piece of equipment with a small climber and slide was observed in its place. Health and Safety training requirements as outlined in Child Care Rule 10A NCAC 09 .1102 were monitored today. Child Care programs are expected to always achieve and maintain compliance with child care rules, and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The following violations were observed today and must be corrected immediately: 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. Several bottles observed in Space #1 were not labeled with dates. 15A NCAC 18A .2804(d) 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. A written feeding plan was not observed for one child under fifteen months of age. 10A NCAC 09 .0902(a) 620 All walls and ceilings including doors and windows were not kept clean and in good repair. One of the bathroom stall doors in the bathroom used by children was observed off of its hinges. 15A NCAC 18A .2825(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. One outlet in Space #3 and two outlets in the bathrooms used by children were observed uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. An aerosol can of disinfectant was observed unlocked in Space #3. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A tube of prescription diaper cream was observed unlocked in Space #1. 15A NCAC 18A .2820(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. Written authorizations for topical ointments reported in use by staff members in Spaces #1 and 2b were not observed on file. 10A NCAC 09 .0803(1)(a & b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Several topical ointments reported by Ms. Pollard as no longer in use were observed in Space #2b. .0803(12) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic trash bags, grocery bags and storage bags were observed accessible to children under three years of age in Spaces #1, 2a and 2b. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. A playground inspection has not been documented since March 8, 2023. .0605(q) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A staff member hired October 9, 2023 does not have a medical report on file. 10A NCAC 09 .0701(a) 1043 All staff records, except financial records, were not made available for review. Staff records reviewed today were incomplete, most of them missing annual health questionnaires, emergency information forms, professional development plans, evaluations, and documentation of review of the facility's Emergency Preparedness and Response (EPR) and Emergency Medical Care (EMC) plans. G.S. 110-91( 9) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Two new staff members, who began employment in August and October 2023, have not yet completed at least 16 hours of orientation. .1101(a) 1320 Children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care was not on file for each child. A health assessment was not on file for one of the four children's files reviewed today. GS 110-91(1);.0302(d)(2); .0304(g) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. A signed and dated statement of receipt of the facility's discipline policy was not on file for one of the four children's files reviewed. .1804(b) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. A shelter-in-place or lockdown drill has not been conducted since March 8, 2023. .0604(u);.0302(d)(8) 1898 Staff did not complete the health and safety training within one year of employment. Completion of health and safety training topics could not be verified for three staff members today. .1102(a) A compliance letter including detailed information about how all violations have been corrected must be received by January 25, 2024. Include any supporting documentation with your response (if applicable). Your letter will be used as verification that violations have been corrected and compliance is maintained; your written response is considered a legal document so must be accurate and truthful. If you email the compliance letter, it must be sent using the email address registered with DCDEE and include your facility name and ID number. If sufficient information is not received by the due date, a follow-up visit will be conducted. Technical Assistance Regarding Violations Cited Technical assistance was provided during the last Annual Compliance visit regarding using staff file checklists to organize staff files and ensure all required documentation is in place by appropriate deadlines. Today I demonstrated how to use the checklist with a new staff member’s file. I also went through the Staff and Training Worksheet line by line with you and showed you how to complete it accurately using your staff records. As discussed, items such as staff health questionnaires, emergency information, professional development plans and evaluations must be updated annually. In addition, you must conduct an annual review of the Emergency Medical Care Plan and Emergency Preparedness and Response Plan and document these on the worksheet. To correct violations, you must audit all staff files using the checklist and complete all annual updates as noted today. I gave you a list of staff members who need to complete forms, orientation and/or training topics to correct violations, and a follow-up visit will be conducted to confirm this. Moving forward, I suggested you select a certain month each year to complete annual updates and set a reminder on your calendar so records will always be current. You must also revise your Staff and Training Worksheet and ensure you keep it updated as needed. This document should serve as a tracking tool for required paperwork and deadlines and will help you avoid recordkeeping violations in the future if you review it frequently. Regarding children’s records, I also urged you to audit files using the Child File Checklist to ensure all documentation is on file. You may wish to delegate some recordkeeping responsibilities to another staff member who has good organizational skills and is able to assist. This will allow you to trust that accurate records are being kept while you focus on other aspects of managing your facility. Today I also strongly urged you to conduct frequent “spot checks” in the classrooms for potential safety hazards such as uncovered outlets, improper storage of hazardous items, required postings, etc. It may be helpful for you to “pretend” you are a Child Care Consultant or inspector and look for violations yourself so you can correct them and hold staff accountable for non-compliance. Regarding the broken bathroom door, you stated you have asked the owners of the adjacent community center to fix it but they have not. Since you are responsible for the safety of the child care spaces, I urged you to make this area inaccessible to children until a repair can be made. Technical assistance was also provided today regarding medication requirements. I strongly encouraged you to review the Child Care Rules regarding medication and share them with staff, as they should never administer medication without written authorization. I reminded you that you can print permission forms from Provider Documents and Forms on the DCDEE website and ensure they are filled out accurately by parents prior to putting medications in the classrooms. Medications no longer in use should be returned to the parent or discarded, and you must ensure all medications are kept in locked storage except for topical ointments and emergency medications. These items must be stored at least five feet from the floor but do not have to be locked. I suggest you develop a plan to check the classrooms for compliance with medication requirements on a regular basis as well. Technical Assistance Technical assistance was also provided today on the service of juice. As discussed, even if parents provide juice, nutrition rules do not allow you to serve more than 6 ounces to each child per day. It is also prohibited to serve juice in a bottle. In Space #2b, I also suggested the lead teacher go through the books in the reading area and discard any which are in poor repair. Rated License Information Your facility’s three-year rated license reassessment is due in 2025, therefore you have been placed in “Cohort 3” of the cohort model of resuming rated license reassessments. This means your planning/preparation year will be 7/1/25-6/30/26, and your next reassessment will be due between 7/1/26 and 6/30/27. As discussed, if you are interested in having the Environment Rating Scales (ERS) conducted to try to increase points in Program Standards, you will have the option to request ERS assessments during your planning year if you wish. Planning year assessments will be free and will only count towards your star rating if you choose. If interested, I encourage you to use resources such as the NCRLAP website, Columbus County Partnership for Children, and Region 4 CCR&R to prepare for assessments. I will be in touch regarding timelines as your planning year approaches. Information from DCDEE WORKS was reviewed with you and noted on the Staff and Training Worksheet today. Regarding Education standards, compliance could not be verified due to pending WORKS evaluations of two new staff members. Today you stated one of them is enrolled in the NCECC coursework and the other will mail an official transcript for evaluation. You must ensure all staff in key positions including lead teacher and teacher have registered for WORKS accounts, applied for appropriate positions and submitted official transcripts as required for evaluation. Please let me know if you need assistance with the WORKS portal. Reminders As discussed, a follow-up visit may be conducted in the near future to verify corrections of violations cited. Please be aware the violations cited may result in Administrative Action being issued against your license. Additional on-going training hours are needed as follows by January 24, 2024 to avoid another violation: Felicia Waddell- 17 hours Doreathea McNeil- 12 hours Stella Munn- 6 hours You must schedule and obtain an approved fire inspection by June 1, 2024. Remember to submit a copy within one week as required. Save the date for a Zoom Provider Meeting! The meeting for center owners and directors will be held February 7, 2024 at 10am. Keep an eye out for an email invitation with Zoom link soon! Child Care Rules were revised July 1, 2023, and a new rule book was posted to the DCDEE website. As discussed, you should discard any old versions of the rules and ensure you are referring to the most current rule book when reviewing or researching requirements. Sanitation rules were also readopted July 1, 2023. I strongly urge you to review the training information at https://ehs.dph.ncdhhs.gov/hhccehb/cehu/ccs/op-training.htm, and contact Children’s Environmental Health Services with any questions. For more information regarding the “cohort model” of resuming rated license reassessments, and opportunities for training and technical assistance as you prepare for a reassessment, you may visit https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-Star-Rated-License. At the end of this visit, documentation was completed electronically, printed and reviewed with you. Please remember it is your responsibility to comply with all child care rules and requirements at all times. If you have questions or need assistance please feel free to contact me at 910-338-7038 or amy.wangler@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-91 · Violation

Name of Operation: ALL ANNIE'S CHILDREN Facility ID: 24000165 Consultant: AMY WANGLER Operation Type: Center Case Number: Visit Date: 1/11/2024 Number Present: 39 Completed Date: 1/11/2024 Age: From 0 To 4 Total Minutes: 300 Time In: 08:30 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance with applicable child care requirements pertinent to this visit type. This facility currently operates with a Three Star issued February 17, 2023. Restrictions include: a first shift capacity of 57 children 0-12 years of age, meets enhanced space, and children under 2 ½ years old in rooms with direct exits only. Restrictions were in compliance today. The last annual compliance visit was conducted January 24, 2023. A Superior sanitation rating was earned September 14, 2023, and a fire inspection was conducted June 1, 2023; the facility was approved for day time care only. Prior to the visit, the facility had an eighteen-month compliance history score of 94%. Owner/Administrator Linda Pollard was present and available for consultation today. Three indoor spaces and two outdoor spaces are approved for use; Indoor Space #2 is separated into two distinct spaces using furniture. Infants and children one year of age in Space #1 were observed in individual feeding and sleeping routines as well as play activities. Three children ate a breakfast of grits, eggs, mandarin oranges and milk while the other two played freely in the carpeted areas. Later, an infant was observed asleep on his back in his crib; safe sleep practices including documentation were monitored and in compliance today. Children one and two years of age in Space #2b participated in free choice activities including building with blocks and pretending to vacuum. Children two and three years of age in Space #2a were observed coloring on white paper plates with crayons. In Space #3, preschool children participated in a large group activity during which they danced and sang songs. Lunch served consisted of spaghetti with meat sauce, corn, mixed fruit and milk. After lunch, children transitioned to rest time routines. They rested on appropriately spaced cots with individual linens. Today it was observed that the large climber with a slide, ladder and two swings observed in Outdoor Space #1b on August 30, 2023 was removed per my guidance as it was not approved for commercial use. A movable piece of equipment with a small climber and slide was observed in its place. Health and Safety training requirements as outlined in Child Care Rule 10A NCAC 09 .1102 were monitored today. Child Care programs are expected to always achieve and maintain compliance with child care rules, and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The following violations were observed today and must be corrected immediately: 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. Several bottles observed in Space #1 were not labeled with dates. 15A NCAC 18A .2804(d) 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. A written feeding plan was not observed for one child under fifteen months of age. 10A NCAC 09 .0902(a) 620 All walls and ceilings including doors and windows were not kept clean and in good repair. One of the bathroom stall doors in the bathroom used by children was observed off of its hinges. 15A NCAC 18A .2825(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. One outlet in Space #3 and two outlets in the bathrooms used by children were observed uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. An aerosol can of disinfectant was observed unlocked in Space #3. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A tube of prescription diaper cream was observed unlocked in Space #1. 15A NCAC 18A .2820(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. Written authorizations for topical ointments reported in use by staff members in Spaces #1 and 2b were not observed on file. 10A NCAC 09 .0803(1)(a & b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Several topical ointments reported by Ms. Pollard as no longer in use were observed in Space #2b. .0803(12) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic trash bags, grocery bags and storage bags were observed accessible to children under three years of age in Spaces #1, 2a and 2b. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. A playground inspection has not been documented since March 8, 2023. .0605(q) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A staff member hired October 9, 2023 does not have a medical report on file. 10A NCAC 09 .0701(a) 1043 All staff records, except financial records, were not made available for review. Staff records reviewed today were incomplete, most of them missing annual health questionnaires, emergency information forms, professional development plans, evaluations, and documentation of review of the facility's Emergency Preparedness and Response (EPR) and Emergency Medical Care (EMC) plans. G.S. 110-91( 9) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Two new staff members, who began employment in August and October 2023, have not yet completed at least 16 hours of orientation. .1101(a) 1320 Children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care was not on file for each child. A health assessment was not on file for one of the four children's files reviewed today. GS 110-91(1);.0302(d)(2); .0304(g) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. A signed and dated statement of receipt of the facility's discipline policy was not on file for one of the four children's files reviewed. .1804(b) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. A shelter-in-place or lockdown drill has not been conducted since March 8, 2023. .0604(u);.0302(d)(8) 1898 Staff did not complete the health and safety training within one year of employment. Completion of health and safety training topics could not be verified for three staff members today. .1102(a) A compliance letter including detailed information about how all violations have been corrected must be received by January 25, 2024. Include any supporting documentation with your response (if applicable). Your letter will be used as verification that violations have been corrected and compliance is maintained; your written response is considered a legal document so must be accurate and truthful. If you email the compliance letter, it must be sent using the email address registered with DCDEE and include your facility name and ID number. If sufficient information is not received by the due date, a follow-up visit will be conducted. Technical Assistance Regarding Violations Cited Technical assistance was provided during the last Annual Compliance visit regarding using staff file checklists to organize staff files and ensure all required documentation is in place by appropriate deadlines. Today I demonstrated how to use the checklist with a new staff member’s file. I also went through the Staff and Training Worksheet line by line with you and showed you how to complete it accurately using your staff records. As discussed, items such as staff health questionnaires, emergency information, professional development plans and evaluations must be updated annually. In addition, you must conduct an annual review of the Emergency Medical Care Plan and Emergency Preparedness and Response Plan and document these on the worksheet. To correct violations, you must audit all staff files using the checklist and complete all annual updates as noted today. I gave you a list of staff members who need to complete forms, orientation and/or training topics to correct violations, and a follow-up visit will be conducted to confirm this. Moving forward, I suggested you select a certain month each year to complete annual updates and set a reminder on your calendar so records will always be current. You must also revise your Staff and Training Worksheet and ensure you keep it updated as needed. This document should serve as a tracking tool for required paperwork and deadlines and will help you avoid recordkeeping violations in the future if you review it frequently. Regarding children’s records, I also urged you to audit files using the Child File Checklist to ensure all documentation is on file. You may wish to delegate some recordkeeping responsibilities to another staff member who has good organizational skills and is able to assist. This will allow you to trust that accurate records are being kept while you focus on other aspects of managing your facility. Today I also strongly urged you to conduct frequent “spot checks” in the classrooms for potential safety hazards such as uncovered outlets, improper storage of hazardous items, required postings, etc. It may be helpful for you to “pretend” you are a Child Care Consultant or inspector and look for violations yourself so you can correct them and hold staff accountable for non-compliance. Regarding the broken bathroom door, you stated you have asked the owners of the adjacent community center to fix it but they have not. Since you are responsible for the safety of the child care spaces, I urged you to make this area inaccessible to children until a repair can be made. Technical assistance was also provided today regarding medication requirements. I strongly encouraged you to review the Child Care Rules regarding medication and share them with staff, as they should never administer medication without written authorization. I reminded you that you can print permission forms from Provider Documents and Forms on the DCDEE website and ensure they are filled out accurately by parents prior to putting medications in the classrooms. Medications no longer in use should be returned to the parent or discarded, and you must ensure all medications are kept in locked storage except for topical ointments and emergency medications. These items must be stored at least five feet from the floor but do not have to be locked. I suggest you develop a plan to check the classrooms for compliance with medication requirements on a regular basis as well. Technical Assistance Technical assistance was also provided today on the service of juice. As discussed, even if parents provide juice, nutrition rules do not allow you to serve more than 6 ounces to each child per day. It is also prohibited to serve juice in a bottle. In Space #2b, I also suggested the lead teacher go through the books in the reading area and discard any which are in poor repair. Rated License Information Your facility’s three-year rated license reassessment is due in 2025, therefore you have been placed in “Cohort 3” of the cohort model of resuming rated license reassessments. This means your planning/preparation year will be 7/1/25-6/30/26, and your next reassessment will be due between 7/1/26 and 6/30/27. As discussed, if you are interested in having the Environment Rating Scales (ERS) conducted to try to increase points in Program Standards, you will have the option to request ERS assessments during your planning year if you wish. Planning year assessments will be free and will only count towards your star rating if you choose. If interested, I encourage you to use resources such as the NCRLAP website, Columbus County Partnership for Children, and Region 4 CCR&R to prepare for assessments. I will be in touch regarding timelines as your planning year approaches. Information from DCDEE WORKS was reviewed with you and noted on the Staff and Training Worksheet today. Regarding Education standards, compliance could not be verified due to pending WORKS evaluations of two new staff members. Today you stated one of them is enrolled in the NCECC coursework and the other will mail an official transcript for evaluation. You must ensure all staff in key positions including lead teacher and teacher have registered for WORKS accounts, applied for appropriate positions and submitted official transcripts as required for evaluation. Please let me know if you need assistance with the WORKS portal. Reminders As discussed, a follow-up visit may be conducted in the near future to verify corrections of violations cited. Please be aware the violations cited may result in Administrative Action being issued against your license. Additional on-going training hours are needed as follows by January 24, 2024 to avoid another violation: Felicia Waddell- 17 hours Doreathea McNeil- 12 hours Stella Munn- 6 hours You must schedule and obtain an approved fire inspection by June 1, 2024. Remember to submit a copy within one week as required. Save the date for a Zoom Provider Meeting! The meeting for center owners and directors will be held February 7, 2024 at 10am. Keep an eye out for an email invitation with Zoom link soon! Child Care Rules were revised July 1, 2023, and a new rule book was posted to the DCDEE website. As discussed, you should discard any old versions of the rules and ensure you are referring to the most current rule book when reviewing or researching requirements. Sanitation rules were also readopted July 1, 2023. I strongly urge you to review the training information at https://ehs.dph.ncdhhs.gov/hhccehb/cehu/ccs/op-training.htm, and contact Children’s Environmental Health Services with any questions. For more information regarding the “cohort model” of resuming rated license reassessments, and opportunities for training and technical assistance as you prepare for a reassessment, you may visit https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-Star-Rated-License. At the end of this visit, documentation was completed electronically, printed and reviewed with you. Please remember it is your responsibility to comply with all child care rules and requirements at all times. If you have questions or need assistance please feel free to contact me at 910-338-7038 or amy.wangler@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: ALL ANNIE'S CHILDREN Facility ID: 24000165 Consultant: AMY WANGLER Operation Type: Center Case Number: Visit Date: 1/11/2024 Number Present: 39 Completed Date: 1/11/2024 Age: From 0 To 4 Total Minutes: 300 Time In: 08:30 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance with applicable child care requirements pertinent to this visit type. This facility currently operates with a Three Star issued February 17, 2023. Restrictions include: a first shift capacity of 57 children 0-12 years of age, meets enhanced space, and children under 2 ½ years old in rooms with direct exits only. Restrictions were in compliance today. The last annual compliance visit was conducted January 24, 2023. A Superior sanitation rating was earned September 14, 2023, and a fire inspection was conducted June 1, 2023; the facility was approved for day time care only. Prior to the visit, the facility had an eighteen-month compliance history score of 94%. Owner/Administrator Linda Pollard was present and available for consultation today. Three indoor spaces and two outdoor spaces are approved for use; Indoor Space #2 is separated into two distinct spaces using furniture. Infants and children one year of age in Space #1 were observed in individual feeding and sleeping routines as well as play activities. Three children ate a breakfast of grits, eggs, mandarin oranges and milk while the other two played freely in the carpeted areas. Later, an infant was observed asleep on his back in his crib; safe sleep practices including documentation were monitored and in compliance today. Children one and two years of age in Space #2b participated in free choice activities including building with blocks and pretending to vacuum. Children two and three years of age in Space #2a were observed coloring on white paper plates with crayons. In Space #3, preschool children participated in a large group activity during which they danced and sang songs. Lunch served consisted of spaghetti with meat sauce, corn, mixed fruit and milk. After lunch, children transitioned to rest time routines. They rested on appropriately spaced cots with individual linens. Today it was observed that the large climber with a slide, ladder and two swings observed in Outdoor Space #1b on August 30, 2023 was removed per my guidance as it was not approved for commercial use. A movable piece of equipment with a small climber and slide was observed in its place. Health and Safety training requirements as outlined in Child Care Rule 10A NCAC 09 .1102 were monitored today. Child Care programs are expected to always achieve and maintain compliance with child care rules, and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The following violations were observed today and must be corrected immediately: 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. Several bottles observed in Space #1 were not labeled with dates. 15A NCAC 18A .2804(d) 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. A written feeding plan was not observed for one child under fifteen months of age. 10A NCAC 09 .0902(a) 620 All walls and ceilings including doors and windows were not kept clean and in good repair. One of the bathroom stall doors in the bathroom used by children was observed off of its hinges. 15A NCAC 18A .2825(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. One outlet in Space #3 and two outlets in the bathrooms used by children were observed uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. An aerosol can of disinfectant was observed unlocked in Space #3. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A tube of prescription diaper cream was observed unlocked in Space #1. 15A NCAC 18A .2820(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. Written authorizations for topical ointments reported in use by staff members in Spaces #1 and 2b were not observed on file. 10A NCAC 09 .0803(1)(a & b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Several topical ointments reported by Ms. Pollard as no longer in use were observed in Space #2b. .0803(12) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic trash bags, grocery bags and storage bags were observed accessible to children under three years of age in Spaces #1, 2a and 2b. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. A playground inspection has not been documented since March 8, 2023. .0605(q) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A staff member hired October 9, 2023 does not have a medical report on file. 10A NCAC 09 .0701(a) 1043 All staff records, except financial records, were not made available for review. Staff records reviewed today were incomplete, most of them missing annual health questionnaires, emergency information forms, professional development plans, evaluations, and documentation of review of the facility's Emergency Preparedness and Response (EPR) and Emergency Medical Care (EMC) plans. G.S. 110-91( 9) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Two new staff members, who began employment in August and October 2023, have not yet completed at least 16 hours of orientation. .1101(a) 1320 Children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care was not on file for each child. A health assessment was not on file for one of the four children's files reviewed today. GS 110-91(1);.0302(d)(2); .0304(g) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. A signed and dated statement of receipt of the facility's discipline policy was not on file for one of the four children's files reviewed. .1804(b) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. A shelter-in-place or lockdown drill has not been conducted since March 8, 2023. .0604(u);.0302(d)(8) 1898 Staff did not complete the health and safety training within one year of employment. Completion of health and safety training topics could not be verified for three staff members today. .1102(a) A compliance letter including detailed information about how all violations have been corrected must be received by January 25, 2024. Include any supporting documentation with your response (if applicable). Your letter will be used as verification that violations have been corrected and compliance is maintained; your written response is considered a legal document so must be accurate and truthful. If you email the compliance letter, it must be sent using the email address registered with DCDEE and include your facility name and ID number. If sufficient information is not received by the due date, a follow-up visit will be conducted. Technical Assistance Regarding Violations Cited Technical assistance was provided during the last Annual Compliance visit regarding using staff file checklists to organize staff files and ensure all required documentation is in place by appropriate deadlines. Today I demonstrated how to use the checklist with a new staff member’s file. I also went through the Staff and Training Worksheet line by line with you and showed you how to complete it accurately using your staff records. As discussed, items such as staff health questionnaires, emergency information, professional development plans and evaluations must be updated annually. In addition, you must conduct an annual review of the Emergency Medical Care Plan and Emergency Preparedness and Response Plan and document these on the worksheet. To correct violations, you must audit all staff files using the checklist and complete all annual updates as noted today. I gave you a list of staff members who need to complete forms, orientation and/or training topics to correct violations, and a follow-up visit will be conducted to confirm this. Moving forward, I suggested you select a certain month each year to complete annual updates and set a reminder on your calendar so records will always be current. You must also revise your Staff and Training Worksheet and ensure you keep it updated as needed. This document should serve as a tracking tool for required paperwork and deadlines and will help you avoid recordkeeping violations in the future if you review it frequently. Regarding children’s records, I also urged you to audit files using the Child File Checklist to ensure all documentation is on file. You may wish to delegate some recordkeeping responsibilities to another staff member who has good organizational skills and is able to assist. This will allow you to trust that accurate records are being kept while you focus on other aspects of managing your facility. Today I also strongly urged you to conduct frequent “spot checks” in the classrooms for potential safety hazards such as uncovered outlets, improper storage of hazardous items, required postings, etc. It may be helpful for you to “pretend” you are a Child Care Consultant or inspector and look for violations yourself so you can correct them and hold staff accountable for non-compliance. Regarding the broken bathroom door, you stated you have asked the owners of the adjacent community center to fix it but they have not. Since you are responsible for the safety of the child care spaces, I urged you to make this area inaccessible to children until a repair can be made. Technical assistance was also provided today regarding medication requirements. I strongly encouraged you to review the Child Care Rules regarding medication and share them with staff, as they should never administer medication without written authorization. I reminded you that you can print permission forms from Provider Documents and Forms on the DCDEE website and ensure they are filled out accurately by parents prior to putting medications in the classrooms. Medications no longer in use should be returned to the parent or discarded, and you must ensure all medications are kept in locked storage except for topical ointments and emergency medications. These items must be stored at least five feet from the floor but do not have to be locked. I suggest you develop a plan to check the classrooms for compliance with medication requirements on a regular basis as well. Technical Assistance Technical assistance was also provided today on the service of juice. As discussed, even if parents provide juice, nutrition rules do not allow you to serve more than 6 ounces to each child per day. It is also prohibited to serve juice in a bottle. In Space #2b, I also suggested the lead teacher go through the books in the reading area and discard any which are in poor repair. Rated License Information Your facility’s three-year rated license reassessment is due in 2025, therefore you have been placed in “Cohort 3” of the cohort model of resuming rated license reassessments. This means your planning/preparation year will be 7/1/25-6/30/26, and your next reassessment will be due between 7/1/26 and 6/30/27. As discussed, if you are interested in having the Environment Rating Scales (ERS) conducted to try to increase points in Program Standards, you will have the option to request ERS assessments during your planning year if you wish. Planning year assessments will be free and will only count towards your star rating if you choose. If interested, I encourage you to use resources such as the NCRLAP website, Columbus County Partnership for Children, and Region 4 CCR&R to prepare for assessments. I will be in touch regarding timelines as your planning year approaches. Information from DCDEE WORKS was reviewed with you and noted on the Staff and Training Worksheet today. Regarding Education standards, compliance could not be verified due to pending WORKS evaluations of two new staff members. Today you stated one of them is enrolled in the NCECC coursework and the other will mail an official transcript for evaluation. You must ensure all staff in key positions including lead teacher and teacher have registered for WORKS accounts, applied for appropriate positions and submitted official transcripts as required for evaluation. Please let me know if you need assistance with the WORKS portal. Reminders As discussed, a follow-up visit may be conducted in the near future to verify corrections of violations cited. Please be aware the violations cited may result in Administrative Action being issued against your license. Additional on-going training hours are needed as follows by January 24, 2024 to avoid another violation: Felicia Waddell- 17 hours Doreathea McNeil- 12 hours Stella Munn- 6 hours You must schedule and obtain an approved fire inspection by June 1, 2024. Remember to submit a copy within one week as required. Save the date for a Zoom Provider Meeting! The meeting for center owners and directors will be held February 7, 2024 at 10am. Keep an eye out for an email invitation with Zoom link soon! Child Care Rules were revised July 1, 2023, and a new rule book was posted to the DCDEE website. As discussed, you should discard any old versions of the rules and ensure you are referring to the most current rule book when reviewing or researching requirements. Sanitation rules were also readopted July 1, 2023. I strongly urge you to review the training information at https://ehs.dph.ncdhhs.gov/hhccehb/cehu/ccs/op-training.htm, and contact Children’s Environmental Health Services with any questions. For more information regarding the “cohort model” of resuming rated license reassessments, and opportunities for training and technical assistance as you prepare for a reassessment, you may visit https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-Star-Rated-License. At the end of this visit, documentation was completed electronically, printed and reviewed with you. Please remember it is your responsibility to comply with all child care rules and requirements at all times. If you have questions or need assistance please feel free to contact me at 910-338-7038 or amy.wangler@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times