G.S. 110-91 · Violation

Name of Operation: FIRST ENVIRONMENTS EARLY LEARNING CENTER Facility ID: 32001514 Consultant: SHANNEL HALL Operation Type: Center Case Number: 0724-254L Visit Date: 8/7/2024 Number Present: 142 Completed Date: 8/8/2024 Age: From 0 To 5 Total Minutes: 120 Time In: 11:30 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to investigate an allegation of non-compliance with the NC Child Care Licensing Requirements received by The Division of Child Development and Early Education on 7/23/24 and revised on 7/31/24. Upon arrival I was greeted by the receptionist and then one of the coordinators. I explained the reason for today’s visit and Ms. Beth was notified that I was at the facility. I was greeted by the director, Ms. Beth shortly after I arrived. MONITORING A partial assessment of the child care requirements was conducted during today’s visit. I observed children from fifteen (15) different classrooms having story time, getting changed, eating lunch, and preparing for nap time. ALLEGATION: There are concerns regarding safe environment; employee medications may not have been stored appropriately and safe sleep practices might not have been followed. I did a walk-through of the fifteen (15) classrooms. I observed the children having free play in their indoor learning environment, medications and potentially hazardous items were being properly stored and all teachers’ supplies were locked and out of the reach of children. When speaking with the director, she stated that only children’s medication is stored in the classroom. I reviewed the staff policy, and it states that medication and personal items are not allowed in classrooms. If any staff needs to take medication, they can call for someone to step into the classroom for them. When interviewing the two staff members and the director, the staff members stated that medications are not allowed in the classroom. The two staff members stated that personal items are not allowed in the classroom when caring for the children. A staff member also stated that she had no concerns when it came to any other teachers ensuring that they provide a safe friendly environment for the children they care for on a daily basis. ALLEGATION: There are concerns regarding Nurture and Care; infants might have been lifted by their arms When speaking with the director and the infant coordinator they explain that a previous teacher did come to them regarding a teacher lifting a child out of the crib without using the proper lifting techniques. They brought the teacher in and explain what was brought to their attention. During this time the infant coordinator explain the correct lifting techniques that should be always implemented. The director and infant coordinator implemented a policy on the correct techniques of handle infants/children. The infant coordinator stated that a parent called around the same time this incident occurred as a courtesy, to inform them that they observed the same teacher trying to pick up three children at one time. The infant coordinator has implemented the policy where they are observing the teacher at least once a week. I observed the children having free play in their indoor learning environment. I observed the children in space #120 for forty minutes which included them eating lunch, washing hands, listening to the teacher read a story, and preparing for nap time. I observed the children being busy and I asked the teacher how are they throughout the day are? She mentioned that it can be very busy in the morning between morning bottles and some of the children needing their morning naps. The teacher stated that they do have a fifth teacher to help depending on what is going on the teacher will move around throughout the infant wing which consists of four classrooms. While talking with one of the teachers in the classroom for infants, she was asked about how she and other staff handle the non-walking children when they need to be moved from one location to another and whether she recalled any situation when that might not have happened appropriately. She stated that she had once lifted a child by the arm to move them the crib to the floor and had received additional training from management. During my observations, all non-walking children were handled appropriately and there were no concerns with their care. The following violations were observed and recorded during today 's visit. Violation Number Comment Rule 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. A teacher in space #120 did not use proper lifting techniques when moving a child from the crib to floor. G.S. 110-91(10) In order to comply with the NC Laws & Rules, any violations cited today must be corrected immediately. A compliance letter should be sent to me by August 21, 2024. The letter should address each violation, and explain how and when it has been corrected. Please send the letter to shannel.hall@dhhs.nc.gov and include the following: -Facility name -Facility ID number -Each item number COMPLIANCE HISTORY: Prior to today’s visit your compliance history was 96%. It will be updated after today's visit, and you will be informed of the new score. ALLEGATION RESOLUTIONS Additional monitoring and a return visit will be necessary to further investigate the allegation related to safe environment. Once that occurs, you will be informed of the status of that allegation. Based on the interviews with the Teaching Staff, Director, and Infant Coordinator, it was determined that a teacher had lifted a child by the arm, therefore the allegation related to Nurture and Care is SUBSTANTIATED. TECHNICAL ASSISTANCE It's crucial to avoid picking up babies by their hands or arms. This practice can lead to a common injury called nursemaid's elbow, where the elbow joint partially dislocates. Although you have spoken with the teacher involved, you will want to increase your observations of her to ensure that children are always handled appropriately. You may also want to share proper handling techniques with all staff working with small children as this is not a concern for just infants. Make sure all staff know how to Safely Pick Up babies by following these guidelines: -Support the Head and Neck: Always support baby’s head and neck with one hand until baby develops enough neck strength to support their head with confidence. -Lift from the Torso: Place your other hand under their bottom or back to lift them gently. Don’t lift from their armpits until baby’s core muscles are more developed. -Support Baby Against Your Own Body: Cradle baby close to your torso, chest, or shoulder for added support and security. AGENCY UPDATES Please remember to check the Division of Child Development and Early Education website: ncchildcare.ncdhhs.gov frequently to stay updated on rule requirements. CONTACT INFORMATION Please contact me if you need any assistance at shannel.hall@dhhs.nc.gov or by phone at (919) 703-5003. 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