Small Hands - BIG Future Child Care

NC GS 110-90 · Violation

Name of Operation: SMALL HANDS - BIG FUTURE CHILD CARE Facility ID: 53000299 Consultant: TURKESHIA MCCORMICK Operation Type: Center Case Number: 1025-394L Visit Date: 11/7/2025 Number Present: 19 Completed Date: 11/7/2025 Age: From 0 To 5 Total Minutes: 140 Time In: 12:00 PM Time Out: 02:20 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 obtain information regarding alleged violations of child care requirements. The allegations are as follows: There are concerns that there are violations of child care requirements regarding staff/child ratio and supervision. Staff/child ratio, group size, supervision, use of licensed space, space capacity, license restrictions, and the outdoor environment were monitored. The license and emergency care plan were posted. Fire drills, medication administration, and storage of hazardous products were also monitored. Files for new staff were reviewed. Additionally, I observed the indoor and outdoor spaces used by the children. I observed the teachers supervising the children during naptime. I observed the children napping and resting. Today’s menu consisted of turkey cheese sandwiches, sliced tomatoes, apples and milk. Based on information provided, on October 29, 2025, a three-year old child was playing with a mat during naptime and had their finger caught on string which caused the child’s finger to become swollen. I interviewed two caregivers for the older children that were present during my visit. Teacher A stated they were responsible for the classrooms of the younger and older preschool aged children typically from 12:00pm-1:00pm during their naptime. She stated that she will sit in between the two classes and constantly monitors the children until the other teacher returns from their break. During my interview with Teacher B, they stated that once they return from lunch, they go back into their class or go into another class if needed to relieve other staff for lunch or if the kitchen staff is available before then, they will step into the classroom that needs assistance. Upon my arrival during naptime for the children, Teacher A was supervising both the classes used for the younger older preschool aged children. At that time, they were able to hear the children in both spaces. Based on information received from interviewed staff and my observations, the finding regarding the allegation of inadequate supervision was unsubstantiated. Regarding the allegation that staff/child ratio were not in compliance, upon my arrival I observed one staff member responsible for the care of a total of eleven children upon which one two-year old, five three-year olds, four four-year olds and one five-year old were present. I also reviewed the children’s attendance and incident notifications in Bright Wheel for the month of October. Based on the above information the allegation regarding staff/child ratio not being maintained was substantiated. The following violations were observed: Violation Number Comment Rule 317 The staff/child ratios for children, two years and older, during naptime were not maintained by having at least one person in each room, visually supervising all children and the total number of required staff on the premises within calling distance of each room occupied by children. Upon my arrival, one staff member was responsible for supervising two adjacent classrooms with a total of eleven (11) children present and the youngest child present was two years old. .1801(b) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report was not available for a child who injured their finger during naptime on 10/14/2025. .0802 (e) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before November 24, 2025 (an extra day was given due to the upcoming Holiday), 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 considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Turkeshia McCormick PO Box 411, Lillington, NC turkeshia.mccormick@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 was offered on ensuring that proper coverage for things such as lunch breaks and restroom breaks is available. Since there is an extra staff member that works in the kitchen, consider coming up with a staffing schedule or pattern that incorporates that person being available to give lunch breaks when needed. Also work on a notification system in which the staff will notify the administrator or person in charge for the day of the current ratios are at the children’s meal times so that modifications to staffing can take place during staff lunch breaks if needed. For instance, if the youngest child in a classroom can be moved to a younger classroom in order to maintain ratios for both classrooms then go ahead and transition that child to the younger classroom during nap time for that day. A violation was documented for failure to maintain compliance with staff/child ratio requirements. Violations of this nature directly impact the safety of the children while in your care. In addition, these types of violations have the greatest negative impact on your compliance history. During the visit, we discussed that repeated violations of this nature during consecutive visits may lead to an administrative action against your license. A follow up visit may be conducted in the near future to monitor compliance with child care requirements. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. Contact me at Turkeshia McCormick at Turkeshia.mccormick@dhhs.nc.gov or (910) 308-0895 if you have questions. 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: SMALL HANDS - BIG FUTURE CHILD CARE Facility ID: 53000299 Consultant: TURKESHIA MCCORMICK Operation Type: Center Case Number: Visit Date: 11/4/2025 Number Present: 21 Completed Date: 11/4/2025 Age: From 0 To 5 Total Minutes: 210 Time In: 09:20 AM Time Out: 12:50 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. The facility operated with a Four-Star License, issued May 22, 2019, earning four points in the education component, six points in the program component and one quality point for complying with the education option. License restrictions include first and second shift, meets enhanced ratios, meets enhanced space and children under 2 ½ years old in classrooms with direct exits only. Cynthia Galyean, administrator/owner, assisted me with the visit. The last annual compliance visit was conducted on December 5, 2025. The last sanitation inspection was conducted on December 30, 2024, and a superior rating was received. The last fire inspection was conducted on June 30, 2025. The program’s compliance history was ninety-seven (97) percent as of 11/3/2025. I visited each indoor and outdoor space. Children enrolled were observed during free play, teacher directed activities, outdoor play, nap/quiet activities, personal care routines and transitioning to lunch and nap. Two infants present were observed during free play. Lunch today consisted of chicken fajitas, grilled vegetables, mangos and milk. The following violations were observed during the Violation Number Comment Rule 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. R. Morrison, who began employment on 9/2/2025, had a medical report on file dated 10/8/2025. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. R. Morrison, who began employment on 9/2/2025, had a medical TB test on file dated 10/8/2025. .0701(a) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. K. Cameron, who began employment on 9/15/2025 had not been added on the roster in the ABCMS portal as of today's visit. G.S. 110-90.2 & .2703(r) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The last recorded shelter-in-place drill was dated on 5/28/2025. .0604(u);.0302(d)(8) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. K. Cameron and R. Morrison who were hired during the month of September did not have signed statements on file .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Permission to administer forms for Do. Blake and Dr. Blake for albuterol were not on file. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before November 20, 2025 (an extra day was given due to the upcoming Holiday), I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Turkeshia McCormick, Child Care Consultant, PO Box 411, Lillington NC 27546. 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 was also offered on reviewing both staff and children’s records to ensure that all required documentation is on complete and on file. I recommend both the administrator and staff review their individually periodically to keep up with deadlines for trainings and any other pertinent information. During this visit we discussed the QRIS Modernization Pathways to the Stars. At this time, Mrs. Gaylean has not decided which Pathway option to choose. She has been given information on both Pathway #1 and #2 and also has an outreach assessment scheduled with NCRLAP coming up in December. Once the results of that assessment are received, Mrs. Gaylean will contact me to discuss the option that she will choose. The following information for pathway options #1 and 2 for Centers and Centers Located in a Residence (CLIAR) were discussed with Mrs. Gaylean includes the following: •Enhanced Ratio and Reduced Enhanced Ratios and/or Enhanced Space • 50% of all Lead Teachers and 50% other educators meet 4 & 5 Star Education Standards • Family and Community Engagement Foundational Practices AND 3 additional choices • CQI Plan for Facility and Individuals • Approved curriculum for all ages served • Child Observations and assessments • Coaching/training options for administrators and lead teachers. • NCRLAP Self Study and assessments I also left copies of the Continuous Quality Improvement and Professional Development Plan, work experience form, Pathway #1 & 2 -Classroom and Instructional Quality for Child Care Centers and Centers Located in a Residence (keep those copies and continue working on completing them prior to your next visit). You stated that you will review the approved curricula and assessment tools at a later date and decide if you are going to continue using your current curriculum or go with another option. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with Mrs. Gaylean. Contact me at Turkeshia McCormick, Child Care Consultant, 910-308-0895, Turkeshia.mccormick@dhhs.nc.gov if you have questions. 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. 110-90 · Violation

Name of Operation: SMALL HANDS - BIG FUTURE CHILD CARE Facility ID: 53000299 Consultant: TURKESHIA MCCORMICK Operation Type: Center Case Number: Visit Date: 11/4/2025 Number Present: 21 Completed Date: 11/4/2025 Age: From 0 To 5 Total Minutes: 210 Time In: 09:20 AM Time Out: 12:50 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. The facility operated with a Four-Star License, issued May 22, 2019, earning four points in the education component, six points in the program component and one quality point for complying with the education option. License restrictions include first and second shift, meets enhanced ratios, meets enhanced space and children under 2 ½ years old in classrooms with direct exits only. Cynthia Galyean, administrator/owner, assisted me with the visit. The last annual compliance visit was conducted on December 5, 2025. The last sanitation inspection was conducted on December 30, 2024, and a superior rating was received. The last fire inspection was conducted on June 30, 2025. The program’s compliance history was ninety-seven (97) percent as of 11/3/2025. I visited each indoor and outdoor space. Children enrolled were observed during free play, teacher directed activities, outdoor play, nap/quiet activities, personal care routines and transitioning to lunch and nap. Two infants present were observed during free play. Lunch today consisted of chicken fajitas, grilled vegetables, mangos and milk. The following violations were observed during the Violation Number Comment Rule 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. R. Morrison, who began employment on 9/2/2025, had a medical report on file dated 10/8/2025. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. R. Morrison, who began employment on 9/2/2025, had a medical TB test on file dated 10/8/2025. .0701(a) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. K. Cameron, who began employment on 9/15/2025 had not been added on the roster in the ABCMS portal as of today's visit. G.S. 110-90.2 & .2703(r) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The last recorded shelter-in-place drill was dated on 5/28/2025. .0604(u);.0302(d)(8) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. K. Cameron and R. Morrison who were hired during the month of September did not have signed statements on file .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Permission to administer forms for Do. Blake and Dr. Blake for albuterol were not on file. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before November 20, 2025 (an extra day was given due to the upcoming Holiday), I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Turkeshia McCormick, Child Care Consultant, PO Box 411, Lillington NC 27546. 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 was also offered on reviewing both staff and children’s records to ensure that all required documentation is on complete and on file. I recommend both the administrator and staff review their individually periodically to keep up with deadlines for trainings and any other pertinent information. During this visit we discussed the QRIS Modernization Pathways to the Stars. At this time, Mrs. Gaylean has not decided which Pathway option to choose. She has been given information on both Pathway #1 and #2 and also has an outreach assessment scheduled with NCRLAP coming up in December. Once the results of that assessment are received, Mrs. Gaylean will contact me to discuss the option that she will choose. The following information for pathway options #1 and 2 for Centers and Centers Located in a Residence (CLIAR) were discussed with Mrs. Gaylean includes the following: •Enhanced Ratio and Reduced Enhanced Ratios and/or Enhanced Space • 50% of all Lead Teachers and 50% other educators meet 4 & 5 Star Education Standards • Family and Community Engagement Foundational Practices AND 3 additional choices • CQI Plan for Facility and Individuals • Approved curriculum for all ages served • Child Observations and assessments • Coaching/training options for administrators and lead teachers. • NCRLAP Self Study and assessments I also left copies of the Continuous Quality Improvement and Professional Development Plan, work experience form, Pathway #1 & 2 -Classroom and Instructional Quality for Child Care Centers and Centers Located in a Residence (keep those copies and continue working on completing them prior to your next visit). You stated that you will review the approved curricula and assessment tools at a later date and decide if you are going to continue using your current curriculum or go with another option. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with Mrs. Gaylean. Contact me at Turkeshia McCormick, Child Care Consultant, 910-308-0895, Turkeshia.mccormick@dhhs.nc.gov if you have questions. 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: SMALL HANDS - BIG FUTURE CHILD CARE Facility ID: 53000299 Consultant: TURKESHIA MCCORMICK Operation Type: Center Case Number: Visit Date: 11/4/2025 Number Present: 21 Completed Date: 11/4/2025 Age: From 0 To 5 Total Minutes: 210 Time In: 09:20 AM Time Out: 12:50 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. The facility operated with a Four-Star License, issued May 22, 2019, earning four points in the education component, six points in the program component and one quality point for complying with the education option. License restrictions include first and second shift, meets enhanced ratios, meets enhanced space and children under 2 ½ years old in classrooms with direct exits only. Cynthia Galyean, administrator/owner, assisted me with the visit. The last annual compliance visit was conducted on December 5, 2025. The last sanitation inspection was conducted on December 30, 2024, and a superior rating was received. The last fire inspection was conducted on June 30, 2025. The program’s compliance history was ninety-seven (97) percent as of 11/3/2025. I visited each indoor and outdoor space. Children enrolled were observed during free play, teacher directed activities, outdoor play, nap/quiet activities, personal care routines and transitioning to lunch and nap. Two infants present were observed during free play. Lunch today consisted of chicken fajitas, grilled vegetables, mangos and milk. The following violations were observed during the Violation Number Comment Rule 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. R. Morrison, who began employment on 9/2/2025, had a medical report on file dated 10/8/2025. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. R. Morrison, who began employment on 9/2/2025, had a medical TB test on file dated 10/8/2025. .0701(a) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. K. Cameron, who began employment on 9/15/2025 had not been added on the roster in the ABCMS portal as of today's visit. G.S. 110-90.2 & .2703(r) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The last recorded shelter-in-place drill was dated on 5/28/2025. .0604(u);.0302(d)(8) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. K. Cameron and R. Morrison who were hired during the month of September did not have signed statements on file .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Permission to administer forms for Do. Blake and Dr. Blake for albuterol were not on file. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before November 20, 2025 (an extra day was given due to the upcoming Holiday), I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Turkeshia McCormick, Child Care Consultant, PO Box 411, Lillington NC 27546. 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 was also offered on reviewing both staff and children’s records to ensure that all required documentation is on complete and on file. I recommend both the administrator and staff review their individually periodically to keep up with deadlines for trainings and any other pertinent information. During this visit we discussed the QRIS Modernization Pathways to the Stars. At this time, Mrs. Gaylean has not decided which Pathway option to choose. She has been given information on both Pathway #1 and #2 and also has an outreach assessment scheduled with NCRLAP coming up in December. Once the results of that assessment are received, Mrs. Gaylean will contact me to discuss the option that she will choose. The following information for pathway options #1 and 2 for Centers and Centers Located in a Residence (CLIAR) were discussed with Mrs. Gaylean includes the following: •Enhanced Ratio and Reduced Enhanced Ratios and/or Enhanced Space • 50% of all Lead Teachers and 50% other educators meet 4 & 5 Star Education Standards • Family and Community Engagement Foundational Practices AND 3 additional choices • CQI Plan for Facility and Individuals • Approved curriculum for all ages served • Child Observations and assessments • Coaching/training options for administrators and lead teachers. • NCRLAP Self Study and assessments I also left copies of the Continuous Quality Improvement and Professional Development Plan, work experience form, Pathway #1 & 2 -Classroom and Instructional Quality for Child Care Centers and Centers Located in a Residence (keep those copies and continue working on completing them prior to your next visit). You stated that you will review the approved curricula and assessment tools at a later date and decide if you are going to continue using your current curriculum or go with another option. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with Mrs. Gaylean. Contact me at Turkeshia McCormick, Child Care Consultant, 910-308-0895, Turkeshia.mccormick@dhhs.nc.gov if you have questions. 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: SMALL HANDS - BIG FUTURE CHILD CARE Facility ID: 53000299 Consultant: TURKESHIA MCCORMICK Operation Type: Center Case Number: 0125-079L Visit Date: 1/14/2025 Number Present: 25 Completed Date: 1/14/2025 Age: From 0 To 5 Total Minutes: 155 Time In: 10:00 AM Time Out: 12:35 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 obtain information regarding alleged violations of child care requirements. I reviewed the allegation with the administrator/owner, Cynthia Galyean and she was given the opportunity to respond. The allegations are as follows: There is a concern that staff/child ratios are not being followed. There is a concern that sanitation guidelines are not being followed. There is a concern that children are being cared for in an unsafe environment. Staff/child ratio, group size, supervision, use of licensed space, space capacity, license restrictions, the license and emergency care plan were posted. Fire drills, medication administration, and storage of hazardous products were also monitored. No new staff have been employed since my last visit. I observed the indoor and outdoor spaces used by the children, A total of twenty-five (25) children were present. I observed the educators and children enrolled in free play, group activities and transitioning to lunch including handwashing and toileting routines. The infant enrolled was observed during naptime. Lunch consisted of ground beef, tomatoes and lettuce, whole wheat tortillas, sliced bananas and milk. Based on information provided, January 8, 2025, I interviewed the administrator and two staff members. During my interview with the administrator, Cynthia Galyean, she stated that the front door to the facility is open from about 6:00am-9:00am, at that at 9:00am the door is closed and locked until around 2:30pm each day. She stated that the door is left open and unlocked for morning arrivals and afternoon departures. The screen door kept closed all day. She stated that in the mornings, it is usually herself and Teacher A who are present when the facility opens until about 7:00am-7:30am when the teacher in the classroom for the young preschoolers arrive. She stated that there are some mornings when an additional teacher may come in a little earlier or later but that the center is in ratio until that time and afterwards. During my interview with Teacher A, she stated that she along with the administrator are present most mornings when the center opens. She stated that she will supervises the older children and that the administrator will take the younger children to another classroom until the next staff member arrives between 7:00am-8:00am. She also stated that the front door to the facility remains open and unlocked from 6:00am-9:00am. The screen door is kept closed all day. She stated that there have been no issues or concerns that the children who are present during that time may leave the classrooms or the facility. During my interview with Teacher B, she stated that she typically does not store items in a crib or on top of a cot that a child will use for the day. She stated that if she places something in a crib then it is a crib that is not in use. She also stated that if an item or toy has been stored in a crib then once she removes it, she will sanitize that mattress before placing a clean crib sheet on the mattress. I was also able review the attendance records documented in Brightwheel and written sign in sheets located in each classroom. I visually inspected the floors, doors and baseboards in each space. Upon my arrival to the center, in the space used by the preschoolers, an infant who had just been dropped off to the facility was in that space with one teacher and eight (8) other children ranging in ages from three to five. Based on the above information, the allegation regarding a concern that staff/child ratios not being met was substantiated. The allegations regarding concerns that sanitation guidelines are not being followed and that children are being cared for in an unsafe environment were unsubstantiated. The following violation was observed during today’s visit: Violation Number Comment Rule 316 Children under one year of age were not kept separate from children two years and older. Upon my arrival to the center, a six week old infant was in the space used by the preschoolers which had eight (8) children ranging in ages from three to four present. 10A NCAC 09 .0713(a)(5) 1756 Enhanced staff/child ratios and group sizes were not met. A teacher in the space used for the preschoolers had nine children with the youngest being a six week old. 10A NCAC 09 .2818 Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. Your compliance history was ninety-four (94%) prior to today’s visit. The violation(s) documented must be corrected immediately. On or before January 29, 2025 (an extra day given due to the upcoming Holiday), I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Turkeshia McCormick, Child Care Consultant, PO Box 411, Lillington NC 27546. 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 Please note that because the allegation was substantiated, an Administrative Action may be issued and a follow-up visit will be conducted within two weeks from today’s visit. Technical assistance was also offer on maintaining the required staff/child ratio. Maintaining the required staff/child ratio at all times is key in ensuring the safety of the children who are present for the day. This can ensure that there are no lapses in supervision as well as avoiding accidents or mishaps that could have been preventable had the required amount of staff been in place with the children. Younger children should not be placed with older children unless it is the opening hour or the last hour of the day. Ensure that your families are aware of what enhanced ratios mean as well as that they are leaving their children in the appropriate classrooms during arrivals. You stated that the facility has walkie talkies. I recommend having a staff meeting and review the appropriate times to use them when calling for help or additional assistance in the classrooms. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with the administrator, Cynthia Galyean. Contact me at Turkeshia McCormick, Child Care Consultant, @ (910) 308-0895 or Turkeshia.mccormick@dhhs.nc.gov or Janet Edwards at, Janet Edwards, Licensing Supervisor, 910-709-4160, janet.edwards@dhhs.nc.gov if you have questions. 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 .2818 · Violation

Name of Operation: SMALL HANDS - BIG FUTURE CHILD CARE Facility ID: 53000299 Consultant: TURKESHIA MCCORMICK Operation Type: Center Case Number: 0125-079L Visit Date: 1/14/2025 Number Present: 25 Completed Date: 1/14/2025 Age: From 0 To 5 Total Minutes: 155 Time In: 10:00 AM Time Out: 12:35 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 obtain information regarding alleged violations of child care requirements. I reviewed the allegation with the administrator/owner, Cynthia Galyean and she was given the opportunity to respond. The allegations are as follows: There is a concern that staff/child ratios are not being followed. There is a concern that sanitation guidelines are not being followed. There is a concern that children are being cared for in an unsafe environment. Staff/child ratio, group size, supervision, use of licensed space, space capacity, license restrictions, the license and emergency care plan were posted. Fire drills, medication administration, and storage of hazardous products were also monitored. No new staff have been employed since my last visit. I observed the indoor and outdoor spaces used by the children, A total of twenty-five (25) children were present. I observed the educators and children enrolled in free play, group activities and transitioning to lunch including handwashing and toileting routines. The infant enrolled was observed during naptime. Lunch consisted of ground beef, tomatoes and lettuce, whole wheat tortillas, sliced bananas and milk. Based on information provided, January 8, 2025, I interviewed the administrator and two staff members. During my interview with the administrator, Cynthia Galyean, she stated that the front door to the facility is open from about 6:00am-9:00am, at that at 9:00am the door is closed and locked until around 2:30pm each day. She stated that the door is left open and unlocked for morning arrivals and afternoon departures. The screen door kept closed all day. She stated that in the mornings, it is usually herself and Teacher A who are present when the facility opens until about 7:00am-7:30am when the teacher in the classroom for the young preschoolers arrive. She stated that there are some mornings when an additional teacher may come in a little earlier or later but that the center is in ratio until that time and afterwards. During my interview with Teacher A, she stated that she along with the administrator are present most mornings when the center opens. She stated that she will supervises the older children and that the administrator will take the younger children to another classroom until the next staff member arrives between 7:00am-8:00am. She also stated that the front door to the facility remains open and unlocked from 6:00am-9:00am. The screen door is kept closed all day. She stated that there have been no issues or concerns that the children who are present during that time may leave the classrooms or the facility. During my interview with Teacher B, she stated that she typically does not store items in a crib or on top of a cot that a child will use for the day. She stated that if she places something in a crib then it is a crib that is not in use. She also stated that if an item or toy has been stored in a crib then once she removes it, she will sanitize that mattress before placing a clean crib sheet on the mattress. I was also able review the attendance records documented in Brightwheel and written sign in sheets located in each classroom. I visually inspected the floors, doors and baseboards in each space. Upon my arrival to the center, in the space used by the preschoolers, an infant who had just been dropped off to the facility was in that space with one teacher and eight (8) other children ranging in ages from three to five. Based on the above information, the allegation regarding a concern that staff/child ratios not being met was substantiated. The allegations regarding concerns that sanitation guidelines are not being followed and that children are being cared for in an unsafe environment were unsubstantiated. The following violation was observed during today’s visit: Violation Number Comment Rule 316 Children under one year of age were not kept separate from children two years and older. Upon my arrival to the center, a six week old infant was in the space used by the preschoolers which had eight (8) children ranging in ages from three to four present. 10A NCAC 09 .0713(a)(5) 1756 Enhanced staff/child ratios and group sizes were not met. A teacher in the space used for the preschoolers had nine children with the youngest being a six week old. 10A NCAC 09 .2818 Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. Your compliance history was ninety-four (94%) prior to today’s visit. The violation(s) documented must be corrected immediately. On or before January 29, 2025 (an extra day given due to the upcoming Holiday), I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Turkeshia McCormick, Child Care Consultant, PO Box 411, Lillington NC 27546. 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 Please note that because the allegation was substantiated, an Administrative Action may be issued and a follow-up visit will be conducted within two weeks from today’s visit. Technical assistance was also offer on maintaining the required staff/child ratio. Maintaining the required staff/child ratio at all times is key in ensuring the safety of the children who are present for the day. This can ensure that there are no lapses in supervision as well as avoiding accidents or mishaps that could have been preventable had the required amount of staff been in place with the children. Younger children should not be placed with older children unless it is the opening hour or the last hour of the day. Ensure that your families are aware of what enhanced ratios mean as well as that they are leaving their children in the appropriate classrooms during arrivals. You stated that the facility has walkie talkies. I recommend having a staff meeting and review the appropriate times to use them when calling for help or additional assistance in the classrooms. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with the administrator, Cynthia Galyean. Contact me at Turkeshia McCormick, Child Care Consultant, @ (910) 308-0895 or Turkeshia.mccormick@dhhs.nc.gov or Janet Edwards at, Janet Edwards, Licensing Supervisor, 910-709-4160, janet.edwards@dhhs.nc.gov if you have questions. 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: SMALL HANDS - BIG FUTURE CHILD CARE Facility ID: 53000299 Consultant: TURKESHIA MCCORMICK Operation Type: Center Case Number: 0125-079L Visit Date: 1/14/2025 Number Present: 25 Completed Date: 1/14/2025 Age: From 0 To 5 Total Minutes: 155 Time In: 10:00 AM Time Out: 12:35 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 obtain information regarding alleged violations of child care requirements. I reviewed the allegation with the administrator/owner, Cynthia Galyean and she was given the opportunity to respond. The allegations are as follows: There is a concern that staff/child ratios are not being followed. There is a concern that sanitation guidelines are not being followed. There is a concern that children are being cared for in an unsafe environment. Staff/child ratio, group size, supervision, use of licensed space, space capacity, license restrictions, the license and emergency care plan were posted. Fire drills, medication administration, and storage of hazardous products were also monitored. No new staff have been employed since my last visit. I observed the indoor and outdoor spaces used by the children, A total of twenty-five (25) children were present. I observed the educators and children enrolled in free play, group activities and transitioning to lunch including handwashing and toileting routines. The infant enrolled was observed during naptime. Lunch consisted of ground beef, tomatoes and lettuce, whole wheat tortillas, sliced bananas and milk. Based on information provided, January 8, 2025, I interviewed the administrator and two staff members. During my interview with the administrator, Cynthia Galyean, she stated that the front door to the facility is open from about 6:00am-9:00am, at that at 9:00am the door is closed and locked until around 2:30pm each day. She stated that the door is left open and unlocked for morning arrivals and afternoon departures. The screen door kept closed all day. She stated that in the mornings, it is usually herself and Teacher A who are present when the facility opens until about 7:00am-7:30am when the teacher in the classroom for the young preschoolers arrive. She stated that there are some mornings when an additional teacher may come in a little earlier or later but that the center is in ratio until that time and afterwards. During my interview with Teacher A, she stated that she along with the administrator are present most mornings when the center opens. She stated that she will supervises the older children and that the administrator will take the younger children to another classroom until the next staff member arrives between 7:00am-8:00am. She also stated that the front door to the facility remains open and unlocked from 6:00am-9:00am. The screen door is kept closed all day. She stated that there have been no issues or concerns that the children who are present during that time may leave the classrooms or the facility. During my interview with Teacher B, she stated that she typically does not store items in a crib or on top of a cot that a child will use for the day. She stated that if she places something in a crib then it is a crib that is not in use. She also stated that if an item or toy has been stored in a crib then once she removes it, she will sanitize that mattress before placing a clean crib sheet on the mattress. I was also able review the attendance records documented in Brightwheel and written sign in sheets located in each classroom. I visually inspected the floors, doors and baseboards in each space. Upon my arrival to the center, in the space used by the preschoolers, an infant who had just been dropped off to the facility was in that space with one teacher and eight (8) other children ranging in ages from three to five. Based on the above information, the allegation regarding a concern that staff/child ratios not being met was substantiated. The allegations regarding concerns that sanitation guidelines are not being followed and that children are being cared for in an unsafe environment were unsubstantiated. The following violation was observed during today’s visit: Violation Number Comment Rule 316 Children under one year of age were not kept separate from children two years and older. Upon my arrival to the center, a six week old infant was in the space used by the preschoolers which had eight (8) children ranging in ages from three to four present. 10A NCAC 09 .0713(a)(5) 1756 Enhanced staff/child ratios and group sizes were not met. A teacher in the space used for the preschoolers had nine children with the youngest being a six week old. 10A NCAC 09 .2818 Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. Your compliance history was ninety-four (94%) prior to today’s visit. The violation(s) documented must be corrected immediately. On or before January 29, 2025 (an extra day given due to the upcoming Holiday), I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Turkeshia McCormick, Child Care Consultant, PO Box 411, Lillington NC 27546. 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 Please note that because the allegation was substantiated, an Administrative Action may be issued and a follow-up visit will be conducted within two weeks from today’s visit. Technical assistance was also offer on maintaining the required staff/child ratio. Maintaining the required staff/child ratio at all times is key in ensuring the safety of the children who are present for the day. This can ensure that there are no lapses in supervision as well as avoiding accidents or mishaps that could have been preventable had the required amount of staff been in place with the children. Younger children should not be placed with older children unless it is the opening hour or the last hour of the day. Ensure that your families are aware of what enhanced ratios mean as well as that they are leaving their children in the appropriate classrooms during arrivals. You stated that the facility has walkie talkies. I recommend having a staff meeting and review the appropriate times to use them when calling for help or additional assistance in the classrooms. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with the administrator, Cynthia Galyean. Contact me at Turkeshia McCormick, Child Care Consultant, @ (910) 308-0895 or Turkeshia.mccormick@dhhs.nc.gov or Janet Edwards at, Janet Edwards, Licensing Supervisor, 910-709-4160, janet.edwards@dhhs.nc.gov if you have questions. 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: SMALL HANDS - BIG FUTURE CHILD CARE Facility ID: 53000299 Consultant: TURKESHIA MCCORMICK Operation Type: Center Case Number: Visit Date: 12/11/2023 Number Present: 21 Completed Date: 12/11/2023 Age: From 0 To 5 Total Minutes: 275 Time In: 09:45 AM Time Out: 02:20 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. The facility operated with a Four-Star License, issued May 22, 2019, earning four points in the education component, six points in the program component and one quality point for complying with the education option. License restrictions include first and second shift, meets enhanced ratios, meets enhanced space and children under 2 ½ years old in classrooms with direct exits only. Cynthia Galyean, administrator/owner, assisted me with the visit. The last annual compliance visit was conducted January 11, 2023. The last sanitation inspection was conducted on August 22, 2023 earning a superior rating. The last fire inspection was conducted on July 22, 2023. The program compliance history was ninety-five (95) percent as of 12/10/2023. The NC Secretary of State website was reviewed on December 11, 2023 and Small Hands-Big Future Childcare, LLC. was listed as current- active. I visited each indoor and outdoor space. Children enrolled were observed in free play in the centers, outdoor play, participating in teacher directed activities and routines such as diapering, toileting and handwashing and eating lunch. Lunch was observed and consisted of ground beef with beef and cheese rolls, corn, strawberries and milk. The following violations were observed during the visit: Violation Number Comment Rule 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A packet of Advil pills was stored in an unlocked cabinet above the sink in the space used by the toddlers. 15A NCAC 18A .2820(d) 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. An employee who began employment on 6/25/2023 had a medical statement on file dated 7/22/2023. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. An employee who began employment on 6/25/2023 had a TB test on file dated for 7/20/2023 .0701(a) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The last lockdown drill was documented on 8/1/2023. .0604(u);.0302(d)(8) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. The training was not on file for two employees who began employment in April and June 2023. .1102(g) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately on or before December 26, 2023, (an extra day given due to holiday on the 25th) I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Turkeshia McCormick, Child Care Consultant, PO Box 411, Lillington NC 27546. 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 was offered on creating a system for the administrator and staff that allows them to periodically check required documentation to ensure that the dates are valid and that all necessary information is included as well as ensuring that compliance is maintained throughout the facility. Utilize the staff file checklist and staff training worksheets that are available on the DCDEE website to assist with keeping track of the required documentation and the timelines. We discussed requesting Environment Rating Scale (ERS) assessments in an effort to maintain the program's star rating. Resources such as Child Care Resource and Referral and Smart Start can be valuable when preparing for the ERS. “All about ECERS-R” and the NCRLAP website (www.ncrlap.org) can also be helpful as staff prepare for the ERS. On the NCRLAP website, there are training videos, sample questions and clarifying information regarding the assessments you may find helpful. As a reminder, S. Lefancheck has Recognizing and Responding to Suspicions of Child Abuse and Neglect training that is due today. Your facility is in Cohort 2 of the rated license process. Your prep year will begin 7/1/2024-6/30/2025 Please consider contacting the Partners for Families and Children of Lee County for help with technical assistance, room arrangements, mock observations, self observations and in any other areas that will help prepare you for the assessments as well as increase/maintain the quality level of care that your staff provide. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with Cynthia Gaylean. Contact me at Turkeshia McCormick, Child Care Consultant, 910-308-0895, Turkeshia.mccormick@dhhs.nc.gov or Janet Edwards, Licensing Supervisor, 910-709-4160, janet.edwards@dhhs.nc.gov if you have questions. 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: SMALL HANDS - BIG FUTURE CHILD CARE Facility ID: 53000299 Consultant: TURKESHIA MCCORMICK Operation Type: Center Case Number: Visit Date: 12/11/2023 Number Present: 21 Completed Date: 12/11/2023 Age: From 0 To 5 Total Minutes: 275 Time In: 09:45 AM Time Out: 02:20 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. The facility operated with a Four-Star License, issued May 22, 2019, earning four points in the education component, six points in the program component and one quality point for complying with the education option. License restrictions include first and second shift, meets enhanced ratios, meets enhanced space and children under 2 ½ years old in classrooms with direct exits only. Cynthia Galyean, administrator/owner, assisted me with the visit. The last annual compliance visit was conducted January 11, 2023. The last sanitation inspection was conducted on August 22, 2023 earning a superior rating. The last fire inspection was conducted on July 22, 2023. The program compliance history was ninety-five (95) percent as of 12/10/2023. The NC Secretary of State website was reviewed on December 11, 2023 and Small Hands-Big Future Childcare, LLC. was listed as current- active. I visited each indoor and outdoor space. Children enrolled were observed in free play in the centers, outdoor play, participating in teacher directed activities and routines such as diapering, toileting and handwashing and eating lunch. Lunch was observed and consisted of ground beef with beef and cheese rolls, corn, strawberries and milk. The following violations were observed during the visit: Violation Number Comment Rule 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A packet of Advil pills was stored in an unlocked cabinet above the sink in the space used by the toddlers. 15A NCAC 18A .2820(d) 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. An employee who began employment on 6/25/2023 had a medical statement on file dated 7/22/2023. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. An employee who began employment on 6/25/2023 had a TB test on file dated for 7/20/2023 .0701(a) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The last lockdown drill was documented on 8/1/2023. .0604(u);.0302(d)(8) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. The training was not on file for two employees who began employment in April and June 2023. .1102(g) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately on or before December 26, 2023, (an extra day given due to holiday on the 25th) I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Turkeshia McCormick, Child Care Consultant, PO Box 411, Lillington NC 27546. 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 was offered on creating a system for the administrator and staff that allows them to periodically check required documentation to ensure that the dates are valid and that all necessary information is included as well as ensuring that compliance is maintained throughout the facility. Utilize the staff file checklist and staff training worksheets that are available on the DCDEE website to assist with keeping track of the required documentation and the timelines. We discussed requesting Environment Rating Scale (ERS) assessments in an effort to maintain the program's star rating. Resources such as Child Care Resource and Referral and Smart Start can be valuable when preparing for the ERS. “All about ECERS-R” and the NCRLAP website (www.ncrlap.org) can also be helpful as staff prepare for the ERS. On the NCRLAP website, there are training videos, sample questions and clarifying information regarding the assessments you may find helpful. As a reminder, S. Lefancheck has Recognizing and Responding to Suspicions of Child Abuse and Neglect training that is due today. Your facility is in Cohort 2 of the rated license process. Your prep year will begin 7/1/2024-6/30/2025 Please consider contacting the Partners for Families and Children of Lee County for help with technical assistance, room arrangements, mock observations, self observations and in any other areas that will help prepare you for the assessments as well as increase/maintain the quality level of care that your staff provide. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with Cynthia Gaylean. Contact me at Turkeshia McCormick, Child Care Consultant, 910-308-0895, Turkeshia.mccormick@dhhs.nc.gov or Janet Edwards, Licensing Supervisor, 910-709-4160, janet.edwards@dhhs.nc.gov if you have questions. 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: SMALL HANDS - BIG FUTURE CHILD CARE Facility ID: 53000299 Consultant: ALECIA PASCHAL Operation Type: Center Case Number: Visit Date: 7/17/2023 Number Present: 21 Completed Date: 7/17/2023 Age: From 0 To 8 Total Minutes: 175 Time In: 09:05 AM Time Out: 12:00 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 your program for compliance with applicable child care requirements for a routine unannounced visit. The facility operates with a Four-Star License, issued May 22, 2019, earning four points in the education component, six points in the program component and one quality point for complying with the education option. License restrictions include first and second shift, meets enhanced ratios, meets enhanced space and children under 2 ½ years old in classrooms with direct exits only. Cynthia Gaylean, owner/director, assisted me with the visit. The last annual compliance visit was conducted January 11, 2023. The last sanitation inspection was conducted on February 15, 2022 earning a superior rating. The last fire inspection was conducted on July 14, 2023. The program’s compliance history was ninety-five (95) percent as of 7/14/2023. The NC Secretary of State website was reviewed on July 14, 2023 and Small Hands-Big Future Childcare, LLC was listed as current- active. New staff files were reviewed and the Staff and Training Worksheet was completed. I visited each indoor and outdoor space. Children enrolled were observed in outdoor play, transitions and eating lunch. Lunch was observed and consisted of hot dogs, buns, baked beans, pears and milk. The following violations were observed during the visit: Violation Number Comment Rule 104 Center has not passed required sanitation inspection and received an approved or superior rating. The last sanitation inspection was February 15, 2022. 10A NCAC 09 .0304(b) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Three new staff files did not have emergency information on file on or before the first day of work. .0701(a) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before July 31, 2023, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Alecia Paschal, Child Care Consultant, 509 Pilot Ave., Fayetteville, NC 28303. 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: There is a new resource available through the Healthy Social Behaviors (HSB) Project that supports teachers to promote healthy social-emotional development and reduce the expulsion rate among young children in licensed child care centers across North Carolina. It is titled, Challenging Behaviors Helpline and I provided the handout to you. You will need to access the online version to use the links that are provided. For your convenience, I am also including the web address and phone number below: Speak to a Behavior Support Advisor for advice and resources specific to the challenging behaviors in your classroom. 1-888-600-1685 Option 1 Submit your questions to a Behavior Support Advisor online and receive a call or email in response here: https://docs.google.com/forms/d/e/1FAIpQLSc-4ADUCpoHc9MrxFvD15H12AwsNWbUtWEJRXW38q_41Y3hzA/viewform Post your questions in the ‘Talk to the Expert’ Group on our online network, Social Emotional Connections, for early childhood educators. There will also be opportunities to join free webinars on challenging topics or classroom activities here: https://nc-childcare-community-connections.mn.co/sign_in?from=https%3A%2F%2Fnc-childcare-community-connections.mn.co%2Fsettings%2Flanding-page Today we discussed how children develop. You were also concerned about how to help parents track their own child’s development. I suggested a free resource through the Center for Disease Prevention to explain to parents how to track their own child’s milestones. Here is the address: https://www.cdc.gov/ncbddd/wicguide/pdf/WIC-Implementation-Guide-Full-2021-P.pdf There is also a milestone app for parents to use on their smartphone. This will make it easier to partner with parents to provide children with additional help when they are not meeting milestones. They should be referred to their pediatrician or other professional to determine of additional services are needed. It is essential for teachers and parents of children to be purposeful in the way they interact with children in order to promote brain development. We discussed a simple term that can help you with parent engagement opportunities. Today we discussed serve and return and why making this connection with others is the “secret sauce” that encourages children to grow and develop. Teachers should plan activities that help the children through the zone of proximal development. NC Foundations for Early Learning and Development is a free resource tool for early educators to begin the process of assessing the developmental goals for their classroom lesson plan. Here is the link: https://ncchildcare.ncdhhs.gov/Foundations-for-Early-Learning-and-Development I provided you a reproduceable hand-out from the Center on the Developing Child at Harvard University because “Child-adult relationships that are responsive and attentive—with lots of back-and-forth interactions—build a strong foundation in a child’s brain for all future learning and development. This is called “serve and return,” and it take two to play” (5 steps for brain-building serve and return. Center on the Developing Child at Harvard University. (2020, October 29).) There are many songs and fingerplays available to use in the classroom setting. Time honored favorites include pat-a-cake, this little piggy and peek-a-boo. The game of peek-a-boo is all about serve and return. “Molly Wright, one of the youngest-ever TED Talk speakers breaks down the research-backed ways parents and caregivers can support children's healthy brain development. In this TED Talk, Wright highlights the benefits of play on lifelong learning, behavior, and well-being, sharing effective strategies to help all kids thrive by the age of five.” (Wright, M. (n.d.). How every child can thrive by five. Molly Wright: How every child can thrive by five | TED Talk). When you are having a parent or staff meeting, this TED Talk can assist you in illustrating this brain building concept. “The earliest years are all about relationships. Infants and toddlers crave and develop attachments to the special people in their lives. Depending on how parents, early childhood educators, and others treat them, babies also develop expectations about people and themselves. •Young infants (0 to 9 months) seek security. •Mobile infants (8 to 18 months) are eager to explore. •Toddlers (16 to 36 months) are working on their identity; they want to know who they are and who’s in charge. In childcare programs, relationships with families are critical. Caring teachers and caregivers learn from the experiences, knowledge, culture, and childrearing beliefs of family members.” (DAP with infants and toddlers. NAEYC. (n.d.). DAP with infants and toddlers. NAEYC. (n.d.).) Resources: 5 steps for brain-building serve and return. Center on the Developing Child at Harvard University. (2020, October 29). Retrieved February 27, 2023, from https://developingchild.harvard.edu/resources/5-steps-for-brain-building-serve-and-return/ Wright, M. (n.d.). How every child can thrive by five. Molly Wright: How every child can thrive by five | TED Talk. Retrieved February 27, 2023, from https://www.ted.com/talks/molly_wright_how_every_child_can_thrive_by_five?fbclid=IwAR3jB-arYAdkPkaeAiKSfwD9G4OAS9D0Xwm-DMLaeoL9-p-5XQ4eU-m9XZA#t-48744 DAP with infants and toddlers. NAEYC. (n.d.). Retrieved February 27, 2023, from https://www.naeyc.org/resources/topics/dap/infants-and-toddlers For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ Contact me at Alecia Paschal, Child Care Consultant, 910-489-0413, alecia.paschal@dhhs.nc.gov or Janet Edwards, Licensing Supervisor, 910-709-4160, janet.edwards@dhhs.nc.gov if you have questions. 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: SMALL HANDS - BIG FUTURE CHILD CARE Facility ID: 53000299 Consultant: ALECIA PASCHAL Operation Type: Center Case Number: Visit Date: 7/17/2023 Number Present: 21 Completed Date: 7/17/2023 Age: From 0 To 8 Total Minutes: 175 Time In: 09:05 AM Time Out: 12:00 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 your program for compliance with applicable child care requirements for a routine unannounced visit. The facility operates with a Four-Star License, issued May 22, 2019, earning four points in the education component, six points in the program component and one quality point for complying with the education option. License restrictions include first and second shift, meets enhanced ratios, meets enhanced space and children under 2 ½ years old in classrooms with direct exits only. Cynthia Gaylean, owner/director, assisted me with the visit. The last annual compliance visit was conducted January 11, 2023. The last sanitation inspection was conducted on February 15, 2022 earning a superior rating. The last fire inspection was conducted on July 14, 2023. The program’s compliance history was ninety-five (95) percent as of 7/14/2023. The NC Secretary of State website was reviewed on July 14, 2023 and Small Hands-Big Future Childcare, LLC was listed as current- active. New staff files were reviewed and the Staff and Training Worksheet was completed. I visited each indoor and outdoor space. Children enrolled were observed in outdoor play, transitions and eating lunch. Lunch was observed and consisted of hot dogs, buns, baked beans, pears and milk. The following violations were observed during the visit: Violation Number Comment Rule 104 Center has not passed required sanitation inspection and received an approved or superior rating. The last sanitation inspection was February 15, 2022. 10A NCAC 09 .0304(b) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Three new staff files did not have emergency information on file on or before the first day of work. .0701(a) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before July 31, 2023, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Alecia Paschal, Child Care Consultant, 509 Pilot Ave., Fayetteville, NC 28303. 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: There is a new resource available through the Healthy Social Behaviors (HSB) Project that supports teachers to promote healthy social-emotional development and reduce the expulsion rate among young children in licensed child care centers across North Carolina. It is titled, Challenging Behaviors Helpline and I provided the handout to you. You will need to access the online version to use the links that are provided. For your convenience, I am also including the web address and phone number below: Speak to a Behavior Support Advisor for advice and resources specific to the challenging behaviors in your classroom. 1-888-600-1685 Option 1 Submit your questions to a Behavior Support Advisor online and receive a call or email in response here: https://docs.google.com/forms/d/e/1FAIpQLSc-4ADUCpoHc9MrxFvD15H12AwsNWbUtWEJRXW38q_41Y3hzA/viewform Post your questions in the ‘Talk to the Expert’ Group on our online network, Social Emotional Connections, for early childhood educators. There will also be opportunities to join free webinars on challenging topics or classroom activities here: https://nc-childcare-community-connections.mn.co/sign_in?from=https%3A%2F%2Fnc-childcare-community-connections.mn.co%2Fsettings%2Flanding-page Today we discussed how children develop. You were also concerned about how to help parents track their own child’s development. I suggested a free resource through the Center for Disease Prevention to explain to parents how to track their own child’s milestones. Here is the address: https://www.cdc.gov/ncbddd/wicguide/pdf/WIC-Implementation-Guide-Full-2021-P.pdf There is also a milestone app for parents to use on their smartphone. This will make it easier to partner with parents to provide children with additional help when they are not meeting milestones. They should be referred to their pediatrician or other professional to determine of additional services are needed. It is essential for teachers and parents of children to be purposeful in the way they interact with children in order to promote brain development. We discussed a simple term that can help you with parent engagement opportunities. Today we discussed serve and return and why making this connection with others is the “secret sauce” that encourages children to grow and develop. Teachers should plan activities that help the children through the zone of proximal development. NC Foundations for Early Learning and Development is a free resource tool for early educators to begin the process of assessing the developmental goals for their classroom lesson plan. Here is the link: https://ncchildcare.ncdhhs.gov/Foundations-for-Early-Learning-and-Development I provided you a reproduceable hand-out from the Center on the Developing Child at Harvard University because “Child-adult relationships that are responsive and attentive—with lots of back-and-forth interactions—build a strong foundation in a child’s brain for all future learning and development. This is called “serve and return,” and it take two to play” (5 steps for brain-building serve and return. Center on the Developing Child at Harvard University. (2020, October 29).) There are many songs and fingerplays available to use in the classroom setting. Time honored favorites include pat-a-cake, this little piggy and peek-a-boo. The game of peek-a-boo is all about serve and return. “Molly Wright, one of the youngest-ever TED Talk speakers breaks down the research-backed ways parents and caregivers can support children's healthy brain development. In this TED Talk, Wright highlights the benefits of play on lifelong learning, behavior, and well-being, sharing effective strategies to help all kids thrive by the age of five.” (Wright, M. (n.d.). How every child can thrive by five. Molly Wright: How every child can thrive by five | TED Talk). When you are having a parent or staff meeting, this TED Talk can assist you in illustrating this brain building concept. “The earliest years are all about relationships. Infants and toddlers crave and develop attachments to the special people in their lives. Depending on how parents, early childhood educators, and others treat them, babies also develop expectations about people and themselves. •Young infants (0 to 9 months) seek security. •Mobile infants (8 to 18 months) are eager to explore. •Toddlers (16 to 36 months) are working on their identity; they want to know who they are and who’s in charge. In childcare programs, relationships with families are critical. Caring teachers and caregivers learn from the experiences, knowledge, culture, and childrearing beliefs of family members.” (DAP with infants and toddlers. NAEYC. (n.d.). DAP with infants and toddlers. NAEYC. (n.d.).) Resources: 5 steps for brain-building serve and return. Center on the Developing Child at Harvard University. (2020, October 29). Retrieved February 27, 2023, from https://developingchild.harvard.edu/resources/5-steps-for-brain-building-serve-and-return/ Wright, M. (n.d.). How every child can thrive by five. Molly Wright: How every child can thrive by five | TED Talk. Retrieved February 27, 2023, from https://www.ted.com/talks/molly_wright_how_every_child_can_thrive_by_five?fbclid=IwAR3jB-arYAdkPkaeAiKSfwD9G4OAS9D0Xwm-DMLaeoL9-p-5XQ4eU-m9XZA#t-48744 DAP with infants and toddlers. NAEYC. (n.d.). Retrieved February 27, 2023, from https://www.naeyc.org/resources/topics/dap/infants-and-toddlers For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ Contact me at Alecia Paschal, Child Care Consultant, 910-489-0413, alecia.paschal@dhhs.nc.gov or Janet Edwards, Licensing Supervisor, 910-709-4160, janet.edwards@dhhs.nc.gov if you have questions. 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