10A NCAC 09 .0514 · Violation

Name of Operation: BRI'S CARING HEART CHILD CARE Facility ID: 24000158 Consultant: AMY WANGLER Operation Type: Center Case Number: Visit Date: 12/3/2024 Number Present: 61 Completed Date: 12/3/2024 Age: From 0 To 3 Total Minutes: 235 Time In: 10:20 AM Time Out: 02:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of my visit was to monitor compliance with applicable child care requirements pertinent to this visit type. This facility currently operates with a Four Star license issued June 26, 2024, earning 4 points in Education, 5 points in Program Standards, and 1 Quality Point. Restrictions on the permit include: a first shift capacity of 86 children 0-12 years of age and meets enhanced ratios and space. Restrictions were in compliance today. The last annual compliance visit was conducted December 12, 2023. A Superior sanitation rating was earned January 17, 2024, and a fire inspection was conducted January 24, 2024; the facility was approved for day time care only. Prior to the visit, the facility had an eighteen-month compliance history score of 95%. Owner/Administrator, M. Spivey, was present and available for consultation today. Due to the proximity of a program needing an afternoon visit, this visit began after 9:00 A.M. Six indoor and three outdoor spaces are approved for use by children. Upon arrival, infants were observed in individual sleeping and feeding routines as well as play activities. Safe sleep practices including documentation were monitored and in compliance today. Children one year of age were observed playing with blocks, using push toys and relaxing in cozy areas. Children two years of age participated in hand washing routines and transition activities as they waited for lunch to be served. Children three years of age were also observed in toileting and hand washing routines as well as a music and movement activity as they waited for lunch to be served. Lunch consisted of whole grain-breaded chicken tenders, green beans, tropical fruit salad and milk. After lunch, children one through three years of age transitioned to rest time routines. They rested on cots which were appropriately spaced or separated by dividers. Lights were dimmed and soft music played. All staff members employed more than one year have completed the Health and Safety trainings as outlined in Child Care Rule 10A NCAC 09 .1102, and staff members employed at least five years have now repeated all topics as required. Child Care programs are expected to always achieve and maintain compliance with child care rules, and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The following violations were observed today and must be corrected immediately: Violation Number Comment Rule 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. Two staff members had medical reports which were older than 12 months when they were re-hired after a period of unemployment. 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. Two staff members had TB test results older than 12 months when they were re-hired after a period of unemployment. .0701(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. A staff member who began employment on November 6, 2023 did not have an annual staff evaluation or development plan on file. 10A NCAC 09 .0514(f) 1419 All commercially manufactured equipment and furnishings were not assembled and installed according to procedures specified by the manufacturer and/or the manufacturer's instructions were not kept on file or electronically accessible, if available. A piece of playground equipment labeled "for domestic use only" was observed on the playground used by children one and two years of age. .0601(b) 1757 A valid qualification letter was not on file and available to review at the facility. A valid qualification letter was not on file for a staff member who began employment in April 2022. G.S. 110-90.2(b) & (d) & .2703(e) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. Staff members were observed drinking soft drinks in classrooms with children during rest time. .0901(i) A compliance letter including detailed information about how all violations have been corrected must be received by December 17, 2024. Include any supporting documentation with your response (if applicable). Your letter will be used as verification that violations have been corrected and compliance is maintained; your written response is considered a legal document so must be accurate and truthful. If you email the compliance letter, it must be sent using the email address registered with DCDEE and include your facility name and ID number. If sufficient information is not received by the due date, a follow-up visit will be conducted. Technical Assistance Regarding Violations Cited The qualification letter on file today for Riley Cox was a provisional qualification which expired in October 2022. You stated you must not have realized you never filed her final determination letter because you listed it as valid for five years on your Staff and Training Worksheet instead of six months. The ABCMS database was reviewed during the visit and it was determined that Ms. Cox is qualified through August 2027, however she was not able to log in and print her letter due to an issue with the account. I provided the number for the criminal records unit help desk today and suggested she call and explain that she can’t access the application she submitted in 2022. Once she is given access to her letter, she must print it for her file. Remember to send a copy to verify compliance. Today we reviewed requirements for staff members who leave employment and then return later. As discussed, you must ensure qualification letters are still valid and TB test results and medical reports are not older than 12 months at the time of rehire (if they are, they must be redone prior to rehire). I also strongly urged you to ensure that you only write dates on the Staff and Training Worksheet when you have matching documentation in files, rather than copying over from previous versions. Remember to send copies of new TB test results and medical reports as discussed to verify compliance. Technical assistance was provided today regarding the assembly and installation of equipment and furnishings. As discussed, manufacturer’s instructions should not only be followed but kept on file for all equipment installed after 2017. The warning label on the Simplay3 climber placed on the playground used by children one and two years of age stated “for domestic use only,” therefore it is not approved for child care use. You removed it from the playground today to correct the violation. Moving forward, I urged you to read all instructions and warning labels prior to purchasing new equipment to ensure it is safe for commercial use and installed correctly. Child Care Rule 10A NCAC 09 .0901(j) states that staff shall role model appropriate eating behaviors by consuming only food or beverages that meet the nutritional requirements specified in this Rule in the presence of children in care. Soft drinks or fast food meals that staff might consume do not follow these requirements and should not be consumed in the classroom or in the presence of children. Today you stated you would remind staff to eat or drink these items on breaks outside of the classrooms only moving forward. Technical Assistance Technical assistance was also provided today regarding posting infant feeding plans for easy reference in Spaces #1 and 2. I suggested you hang sheet protectors on the wall in such a way that the second page of each child’s plan may be easily seen by all caregivers. This will assist staff in being able to quickly determine what types of foods should be served to each child. Today I also gave some suggestions for the transition between play time and lunch. As discussed in Space #2, if children appear to be falling asleep prior to lunch, it is best practice to try to put them down and let them sleep. You can always feed them lunch after they wake up, and it is sometimes unsafe to allow children who are sleepy to eat as it may be a choking hazard. In Space #4 I also suggested waiting until the food is ready to be served before asking children to wash their hands. This will cut down on wait time and the possibility of children recontaminating hands by touching classroom materials. Rated License Information As shared with you during the September 19, 2024 visit, the “hold harmless” state of rated license reassessments has been extended until the new Quality Rating Improvement System (QRIS) standards are put in place. This means that you will not be required to have a reassessment according to timelines previously discussed, and when your reassessment is due you will have options to choose from regarding how your star level is earned. When more information becomes available about the new QRIS standards, I may assist you in determining which option is best for your program. Please note any Infant Toddler Environment Rating Scales (ITERS) or Early Childhood Environment Rating Scales (ECERS) assessments conducted after February 1, 2025 will be the third editions, or the “3s.” You may find more information regarding the third editions including training materials and how to purchase at https://ncrlap.org/Resources/pages/get-ready-for-3s/. Regarding education standards, when new QRIS rules are implemented, education requirements will be different, but it is still critical that all staff in key positions have complete WORKS evaluations to assist with the rated license reassessment process. Information from DCDEE WORKS was reviewed with you today. It appears you are maintaining compliance pending complete evaluation of new staff members. As discussed, now that the evaluation for Q. Baldwin is complete, you may be eligible for seven points at the lead teacher position, however to increase Education points you must also earn seven points at the teacher position. Today we reviewed requirements and I encouraged you to ensure new assistant teachers complete the WORKS evaluation process. Please let me know if you need assistance with the WORKS portal. Reminders You must schedule and obtain an approved fire inspection by January 24, 2025, and submit a copy within one week as required. You must also ensure a sanitation inspection is conducted by January 17, 2025. Remember to also update staff records in December and January as necessary, as well as complete your annual Emergency Medical Care Plan reviews. North Carolina child care administrators can now view and edit their facility’s staff roster in ABCMS, the DCDEE’s criminal background check system. Provider Access to ABCMS allows administrators to: • See the real-time background check status of staff members. • Run a printable report of the staff roster to assist with compliance visits. • See new background check applicants and add to staff roster. To get started, complete the ABCMS Child Care Provider Portal Training in Moodle—a video tutorial followed by a few questions. The reporting period for child care immunizations is now open. Reporting for 2024-2025 has been extended due to Hurricane Helene. Children have a grace period from requirements until November 30, 2024, and reports will be accepted until January 15, 2025. Use this link to submit your report: https://survey.alchemer.com/s3/7955242/2024-2025-Child-Care-Immunization-Report. Send any questions regarding child care immunization reporting to immunization.reports@dhhs.nc.gov. Keep an eye on your inbox for the 2024 annual license fee invoice. Online payments will be due by December 31, 2024. The amount of your annual license fee is based on the licensed capacity printed on your license as of October 1, 2024, not the number of children enrolled at your facility. At the end of this visit, documentation was completed electronically, printed and reviewed with you. Please remember it is your responsibility to comply with all child care rules and requirements at all times. If you have questions or need assistance please feel free to contact me at 910-338-7038 or amy.wangler@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

10A NCAC 09 .0701 · Violation

Name of Operation: BRI'S CARING HEART CHILD CARE Facility ID: 24000158 Consultant: AMY WANGLER Operation Type: Center Case Number: Visit Date: 12/3/2024 Number Present: 61 Completed Date: 12/3/2024 Age: From 0 To 3 Total Minutes: 235 Time In: 10:20 AM Time Out: 02:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of my visit was to monitor compliance with applicable child care requirements pertinent to this visit type. This facility currently operates with a Four Star license issued June 26, 2024, earning 4 points in Education, 5 points in Program Standards, and 1 Quality Point. Restrictions on the permit include: a first shift capacity of 86 children 0-12 years of age and meets enhanced ratios and space. Restrictions were in compliance today. The last annual compliance visit was conducted December 12, 2023. A Superior sanitation rating was earned January 17, 2024, and a fire inspection was conducted January 24, 2024; the facility was approved for day time care only. Prior to the visit, the facility had an eighteen-month compliance history score of 95%. Owner/Administrator, M. Spivey, was present and available for consultation today. Due to the proximity of a program needing an afternoon visit, this visit began after 9:00 A.M. Six indoor and three outdoor spaces are approved for use by children. Upon arrival, infants were observed in individual sleeping and feeding routines as well as play activities. Safe sleep practices including documentation were monitored and in compliance today. Children one year of age were observed playing with blocks, using push toys and relaxing in cozy areas. Children two years of age participated in hand washing routines and transition activities as they waited for lunch to be served. Children three years of age were also observed in toileting and hand washing routines as well as a music and movement activity as they waited for lunch to be served. Lunch consisted of whole grain-breaded chicken tenders, green beans, tropical fruit salad and milk. After lunch, children one through three years of age transitioned to rest time routines. They rested on cots which were appropriately spaced or separated by dividers. Lights were dimmed and soft music played. All staff members employed more than one year have completed the Health and Safety trainings as outlined in Child Care Rule 10A NCAC 09 .1102, and staff members employed at least five years have now repeated all topics as required. Child Care programs are expected to always achieve and maintain compliance with child care rules, and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The following violations were observed today and must be corrected immediately: Violation Number Comment Rule 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. Two staff members had medical reports which were older than 12 months when they were re-hired after a period of unemployment. 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. Two staff members had TB test results older than 12 months when they were re-hired after a period of unemployment. .0701(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. A staff member who began employment on November 6, 2023 did not have an annual staff evaluation or development plan on file. 10A NCAC 09 .0514(f) 1419 All commercially manufactured equipment and furnishings were not assembled and installed according to procedures specified by the manufacturer and/or the manufacturer's instructions were not kept on file or electronically accessible, if available. A piece of playground equipment labeled "for domestic use only" was observed on the playground used by children one and two years of age. .0601(b) 1757 A valid qualification letter was not on file and available to review at the facility. A valid qualification letter was not on file for a staff member who began employment in April 2022. G.S. 110-90.2(b) & (d) & .2703(e) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. Staff members were observed drinking soft drinks in classrooms with children during rest time. .0901(i) A compliance letter including detailed information about how all violations have been corrected must be received by December 17, 2024. Include any supporting documentation with your response (if applicable). Your letter will be used as verification that violations have been corrected and compliance is maintained; your written response is considered a legal document so must be accurate and truthful. If you email the compliance letter, it must be sent using the email address registered with DCDEE and include your facility name and ID number. If sufficient information is not received by the due date, a follow-up visit will be conducted. Technical Assistance Regarding Violations Cited The qualification letter on file today for Riley Cox was a provisional qualification which expired in October 2022. You stated you must not have realized you never filed her final determination letter because you listed it as valid for five years on your Staff and Training Worksheet instead of six months. The ABCMS database was reviewed during the visit and it was determined that Ms. Cox is qualified through August 2027, however she was not able to log in and print her letter due to an issue with the account. I provided the number for the criminal records unit help desk today and suggested she call and explain that she can’t access the application she submitted in 2022. Once she is given access to her letter, she must print it for her file. Remember to send a copy to verify compliance. Today we reviewed requirements for staff members who leave employment and then return later. As discussed, you must ensure qualification letters are still valid and TB test results and medical reports are not older than 12 months at the time of rehire (if they are, they must be redone prior to rehire). I also strongly urged you to ensure that you only write dates on the Staff and Training Worksheet when you have matching documentation in files, rather than copying over from previous versions. Remember to send copies of new TB test results and medical reports as discussed to verify compliance. Technical assistance was provided today regarding the assembly and installation of equipment and furnishings. As discussed, manufacturer’s instructions should not only be followed but kept on file for all equipment installed after 2017. The warning label on the Simplay3 climber placed on the playground used by children one and two years of age stated “for domestic use only,” therefore it is not approved for child care use. You removed it from the playground today to correct the violation. Moving forward, I urged you to read all instructions and warning labels prior to purchasing new equipment to ensure it is safe for commercial use and installed correctly. Child Care Rule 10A NCAC 09 .0901(j) states that staff shall role model appropriate eating behaviors by consuming only food or beverages that meet the nutritional requirements specified in this Rule in the presence of children in care. Soft drinks or fast food meals that staff might consume do not follow these requirements and should not be consumed in the classroom or in the presence of children. Today you stated you would remind staff to eat or drink these items on breaks outside of the classrooms only moving forward. Technical Assistance Technical assistance was also provided today regarding posting infant feeding plans for easy reference in Spaces #1 and 2. I suggested you hang sheet protectors on the wall in such a way that the second page of each child’s plan may be easily seen by all caregivers. This will assist staff in being able to quickly determine what types of foods should be served to each child. Today I also gave some suggestions for the transition between play time and lunch. As discussed in Space #2, if children appear to be falling asleep prior to lunch, it is best practice to try to put them down and let them sleep. You can always feed them lunch after they wake up, and it is sometimes unsafe to allow children who are sleepy to eat as it may be a choking hazard. In Space #4 I also suggested waiting until the food is ready to be served before asking children to wash their hands. This will cut down on wait time and the possibility of children recontaminating hands by touching classroom materials. Rated License Information As shared with you during the September 19, 2024 visit, the “hold harmless” state of rated license reassessments has been extended until the new Quality Rating Improvement System (QRIS) standards are put in place. This means that you will not be required to have a reassessment according to timelines previously discussed, and when your reassessment is due you will have options to choose from regarding how your star level is earned. When more information becomes available about the new QRIS standards, I may assist you in determining which option is best for your program. Please note any Infant Toddler Environment Rating Scales (ITERS) or Early Childhood Environment Rating Scales (ECERS) assessments conducted after February 1, 2025 will be the third editions, or the “3s.” You may find more information regarding the third editions including training materials and how to purchase at https://ncrlap.org/Resources/pages/get-ready-for-3s/. Regarding education standards, when new QRIS rules are implemented, education requirements will be different, but it is still critical that all staff in key positions have complete WORKS evaluations to assist with the rated license reassessment process. Information from DCDEE WORKS was reviewed with you today. It appears you are maintaining compliance pending complete evaluation of new staff members. As discussed, now that the evaluation for Q. Baldwin is complete, you may be eligible for seven points at the lead teacher position, however to increase Education points you must also earn seven points at the teacher position. Today we reviewed requirements and I encouraged you to ensure new assistant teachers complete the WORKS evaluation process. Please let me know if you need assistance with the WORKS portal. Reminders You must schedule and obtain an approved fire inspection by January 24, 2025, and submit a copy within one week as required. You must also ensure a sanitation inspection is conducted by January 17, 2025. Remember to also update staff records in December and January as necessary, as well as complete your annual Emergency Medical Care Plan reviews. North Carolina child care administrators can now view and edit their facility’s staff roster in ABCMS, the DCDEE’s criminal background check system. Provider Access to ABCMS allows administrators to: • See the real-time background check status of staff members. • Run a printable report of the staff roster to assist with compliance visits. • See new background check applicants and add to staff roster. To get started, complete the ABCMS Child Care Provider Portal Training in Moodle—a video tutorial followed by a few questions. The reporting period for child care immunizations is now open. Reporting for 2024-2025 has been extended due to Hurricane Helene. Children have a grace period from requirements until November 30, 2024, and reports will be accepted until January 15, 2025. Use this link to submit your report: https://survey.alchemer.com/s3/7955242/2024-2025-Child-Care-Immunization-Report. Send any questions regarding child care immunization reporting to immunization.reports@dhhs.nc.gov. Keep an eye on your inbox for the 2024 annual license fee invoice. Online payments will be due by December 31, 2024. The amount of your annual license fee is based on the licensed capacity printed on your license as of October 1, 2024, not the number of children enrolled at your facility. At the end of this visit, documentation was completed electronically, printed and reviewed with you. Please remember it is your responsibility to comply with all child care rules and requirements at all times. If you have questions or need assistance please feel free to contact me at 910-338-7038 or amy.wangler@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0901 · Violation

Name of Operation: BRI'S CARING HEART CHILD CARE Facility ID: 24000158 Consultant: AMY WANGLER Operation Type: Center Case Number: Visit Date: 12/3/2024 Number Present: 61 Completed Date: 12/3/2024 Age: From 0 To 3 Total Minutes: 235 Time In: 10:20 AM Time Out: 02:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of my visit was to monitor compliance with applicable child care requirements pertinent to this visit type. This facility currently operates with a Four Star license issued June 26, 2024, earning 4 points in Education, 5 points in Program Standards, and 1 Quality Point. Restrictions on the permit include: a first shift capacity of 86 children 0-12 years of age and meets enhanced ratios and space. Restrictions were in compliance today. The last annual compliance visit was conducted December 12, 2023. A Superior sanitation rating was earned January 17, 2024, and a fire inspection was conducted January 24, 2024; the facility was approved for day time care only. Prior to the visit, the facility had an eighteen-month compliance history score of 95%. Owner/Administrator, M. Spivey, was present and available for consultation today. Due to the proximity of a program needing an afternoon visit, this visit began after 9:00 A.M. Six indoor and three outdoor spaces are approved for use by children. Upon arrival, infants were observed in individual sleeping and feeding routines as well as play activities. Safe sleep practices including documentation were monitored and in compliance today. Children one year of age were observed playing with blocks, using push toys and relaxing in cozy areas. Children two years of age participated in hand washing routines and transition activities as they waited for lunch to be served. Children three years of age were also observed in toileting and hand washing routines as well as a music and movement activity as they waited for lunch to be served. Lunch consisted of whole grain-breaded chicken tenders, green beans, tropical fruit salad and milk. After lunch, children one through three years of age transitioned to rest time routines. They rested on cots which were appropriately spaced or separated by dividers. Lights were dimmed and soft music played. All staff members employed more than one year have completed the Health and Safety trainings as outlined in Child Care Rule 10A NCAC 09 .1102, and staff members employed at least five years have now repeated all topics as required. Child Care programs are expected to always achieve and maintain compliance with child care rules, and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The following violations were observed today and must be corrected immediately: Violation Number Comment Rule 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. Two staff members had medical reports which were older than 12 months when they were re-hired after a period of unemployment. 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. Two staff members had TB test results older than 12 months when they were re-hired after a period of unemployment. .0701(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. A staff member who began employment on November 6, 2023 did not have an annual staff evaluation or development plan on file. 10A NCAC 09 .0514(f) 1419 All commercially manufactured equipment and furnishings were not assembled and installed according to procedures specified by the manufacturer and/or the manufacturer's instructions were not kept on file or electronically accessible, if available. A piece of playground equipment labeled "for domestic use only" was observed on the playground used by children one and two years of age. .0601(b) 1757 A valid qualification letter was not on file and available to review at the facility. A valid qualification letter was not on file for a staff member who began employment in April 2022. G.S. 110-90.2(b) & (d) & .2703(e) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. Staff members were observed drinking soft drinks in classrooms with children during rest time. .0901(i) A compliance letter including detailed information about how all violations have been corrected must be received by December 17, 2024. Include any supporting documentation with your response (if applicable). Your letter will be used as verification that violations have been corrected and compliance is maintained; your written response is considered a legal document so must be accurate and truthful. If you email the compliance letter, it must be sent using the email address registered with DCDEE and include your facility name and ID number. If sufficient information is not received by the due date, a follow-up visit will be conducted. Technical Assistance Regarding Violations Cited The qualification letter on file today for Riley Cox was a provisional qualification which expired in October 2022. You stated you must not have realized you never filed her final determination letter because you listed it as valid for five years on your Staff and Training Worksheet instead of six months. The ABCMS database was reviewed during the visit and it was determined that Ms. Cox is qualified through August 2027, however she was not able to log in and print her letter due to an issue with the account. I provided the number for the criminal records unit help desk today and suggested she call and explain that she can’t access the application she submitted in 2022. Once she is given access to her letter, she must print it for her file. Remember to send a copy to verify compliance. Today we reviewed requirements for staff members who leave employment and then return later. As discussed, you must ensure qualification letters are still valid and TB test results and medical reports are not older than 12 months at the time of rehire (if they are, they must be redone prior to rehire). I also strongly urged you to ensure that you only write dates on the Staff and Training Worksheet when you have matching documentation in files, rather than copying over from previous versions. Remember to send copies of new TB test results and medical reports as discussed to verify compliance. Technical assistance was provided today regarding the assembly and installation of equipment and furnishings. As discussed, manufacturer’s instructions should not only be followed but kept on file for all equipment installed after 2017. The warning label on the Simplay3 climber placed on the playground used by children one and two years of age stated “for domestic use only,” therefore it is not approved for child care use. You removed it from the playground today to correct the violation. Moving forward, I urged you to read all instructions and warning labels prior to purchasing new equipment to ensure it is safe for commercial use and installed correctly. Child Care Rule 10A NCAC 09 .0901(j) states that staff shall role model appropriate eating behaviors by consuming only food or beverages that meet the nutritional requirements specified in this Rule in the presence of children in care. Soft drinks or fast food meals that staff might consume do not follow these requirements and should not be consumed in the classroom or in the presence of children. Today you stated you would remind staff to eat or drink these items on breaks outside of the classrooms only moving forward. Technical Assistance Technical assistance was also provided today regarding posting infant feeding plans for easy reference in Spaces #1 and 2. I suggested you hang sheet protectors on the wall in such a way that the second page of each child’s plan may be easily seen by all caregivers. This will assist staff in being able to quickly determine what types of foods should be served to each child. Today I also gave some suggestions for the transition between play time and lunch. As discussed in Space #2, if children appear to be falling asleep prior to lunch, it is best practice to try to put them down and let them sleep. You can always feed them lunch after they wake up, and it is sometimes unsafe to allow children who are sleepy to eat as it may be a choking hazard. In Space #4 I also suggested waiting until the food is ready to be served before asking children to wash their hands. This will cut down on wait time and the possibility of children recontaminating hands by touching classroom materials. Rated License Information As shared with you during the September 19, 2024 visit, the “hold harmless” state of rated license reassessments has been extended until the new Quality Rating Improvement System (QRIS) standards are put in place. This means that you will not be required to have a reassessment according to timelines previously discussed, and when your reassessment is due you will have options to choose from regarding how your star level is earned. When more information becomes available about the new QRIS standards, I may assist you in determining which option is best for your program. Please note any Infant Toddler Environment Rating Scales (ITERS) or Early Childhood Environment Rating Scales (ECERS) assessments conducted after February 1, 2025 will be the third editions, or the “3s.” You may find more information regarding the third editions including training materials and how to purchase at https://ncrlap.org/Resources/pages/get-ready-for-3s/. Regarding education standards, when new QRIS rules are implemented, education requirements will be different, but it is still critical that all staff in key positions have complete WORKS evaluations to assist with the rated license reassessment process. Information from DCDEE WORKS was reviewed with you today. It appears you are maintaining compliance pending complete evaluation of new staff members. As discussed, now that the evaluation for Q. Baldwin is complete, you may be eligible for seven points at the lead teacher position, however to increase Education points you must also earn seven points at the teacher position. Today we reviewed requirements and I encouraged you to ensure new assistant teachers complete the WORKS evaluation process. Please let me know if you need assistance with the WORKS portal. Reminders You must schedule and obtain an approved fire inspection by January 24, 2025, and submit a copy within one week as required. You must also ensure a sanitation inspection is conducted by January 17, 2025. Remember to also update staff records in December and January as necessary, as well as complete your annual Emergency Medical Care Plan reviews. North Carolina child care administrators can now view and edit their facility’s staff roster in ABCMS, the DCDEE’s criminal background check system. Provider Access to ABCMS allows administrators to: • See the real-time background check status of staff members. • Run a printable report of the staff roster to assist with compliance visits. • See new background check applicants and add to staff roster. To get started, complete the ABCMS Child Care Provider Portal Training in Moodle—a video tutorial followed by a few questions. The reporting period for child care immunizations is now open. Reporting for 2024-2025 has been extended due to Hurricane Helene. Children have a grace period from requirements until November 30, 2024, and reports will be accepted until January 15, 2025. Use this link to submit your report: https://survey.alchemer.com/s3/7955242/2024-2025-Child-Care-Immunization-Report. Send any questions regarding child care immunization reporting to immunization.reports@dhhs.nc.gov. Keep an eye on your inbox for the 2024 annual license fee invoice. Online payments will be due by December 31, 2024. The amount of your annual license fee is based on the licensed capacity printed on your license as of October 1, 2024, not the number of children enrolled at your facility. At the end of this visit, documentation was completed electronically, printed and reviewed with you. Please remember it is your responsibility to comply with all child care rules and requirements at all times. If you have questions or need assistance please feel free to contact me at 910-338-7038 or amy.wangler@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: BRI'S CARING HEART CHILD CARE Facility ID: 24000158 Consultant: AMY WANGLER Operation Type: Center Case Number: Visit Date: 12/3/2024 Number Present: 61 Completed Date: 12/3/2024 Age: From 0 To 3 Total Minutes: 235 Time In: 10:20 AM Time Out: 02:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of my visit was to monitor compliance with applicable child care requirements pertinent to this visit type. This facility currently operates with a Four Star license issued June 26, 2024, earning 4 points in Education, 5 points in Program Standards, and 1 Quality Point. Restrictions on the permit include: a first shift capacity of 86 children 0-12 years of age and meets enhanced ratios and space. Restrictions were in compliance today. The last annual compliance visit was conducted December 12, 2023. A Superior sanitation rating was earned January 17, 2024, and a fire inspection was conducted January 24, 2024; the facility was approved for day time care only. Prior to the visit, the facility had an eighteen-month compliance history score of 95%. Owner/Administrator, M. Spivey, was present and available for consultation today. Due to the proximity of a program needing an afternoon visit, this visit began after 9:00 A.M. Six indoor and three outdoor spaces are approved for use by children. Upon arrival, infants were observed in individual sleeping and feeding routines as well as play activities. Safe sleep practices including documentation were monitored and in compliance today. Children one year of age were observed playing with blocks, using push toys and relaxing in cozy areas. Children two years of age participated in hand washing routines and transition activities as they waited for lunch to be served. Children three years of age were also observed in toileting and hand washing routines as well as a music and movement activity as they waited for lunch to be served. Lunch consisted of whole grain-breaded chicken tenders, green beans, tropical fruit salad and milk. After lunch, children one through three years of age transitioned to rest time routines. They rested on cots which were appropriately spaced or separated by dividers. Lights were dimmed and soft music played. All staff members employed more than one year have completed the Health and Safety trainings as outlined in Child Care Rule 10A NCAC 09 .1102, and staff members employed at least five years have now repeated all topics as required. Child Care programs are expected to always achieve and maintain compliance with child care rules, and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The following violations were observed today and must be corrected immediately: Violation Number Comment Rule 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. Two staff members had medical reports which were older than 12 months when they were re-hired after a period of unemployment. 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. Two staff members had TB test results older than 12 months when they were re-hired after a period of unemployment. .0701(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. A staff member who began employment on November 6, 2023 did not have an annual staff evaluation or development plan on file. 10A NCAC 09 .0514(f) 1419 All commercially manufactured equipment and furnishings were not assembled and installed according to procedures specified by the manufacturer and/or the manufacturer's instructions were not kept on file or electronically accessible, if available. A piece of playground equipment labeled "for domestic use only" was observed on the playground used by children one and two years of age. .0601(b) 1757 A valid qualification letter was not on file and available to review at the facility. A valid qualification letter was not on file for a staff member who began employment in April 2022. G.S. 110-90.2(b) & (d) & .2703(e) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. Staff members were observed drinking soft drinks in classrooms with children during rest time. .0901(i) A compliance letter including detailed information about how all violations have been corrected must be received by December 17, 2024. Include any supporting documentation with your response (if applicable). Your letter will be used as verification that violations have been corrected and compliance is maintained; your written response is considered a legal document so must be accurate and truthful. If you email the compliance letter, it must be sent using the email address registered with DCDEE and include your facility name and ID number. If sufficient information is not received by the due date, a follow-up visit will be conducted. Technical Assistance Regarding Violations Cited The qualification letter on file today for Riley Cox was a provisional qualification which expired in October 2022. You stated you must not have realized you never filed her final determination letter because you listed it as valid for five years on your Staff and Training Worksheet instead of six months. The ABCMS database was reviewed during the visit and it was determined that Ms. Cox is qualified through August 2027, however she was not able to log in and print her letter due to an issue with the account. I provided the number for the criminal records unit help desk today and suggested she call and explain that she can’t access the application she submitted in 2022. Once she is given access to her letter, she must print it for her file. Remember to send a copy to verify compliance. Today we reviewed requirements for staff members who leave employment and then return later. As discussed, you must ensure qualification letters are still valid and TB test results and medical reports are not older than 12 months at the time of rehire (if they are, they must be redone prior to rehire). I also strongly urged you to ensure that you only write dates on the Staff and Training Worksheet when you have matching documentation in files, rather than copying over from previous versions. Remember to send copies of new TB test results and medical reports as discussed to verify compliance. Technical assistance was provided today regarding the assembly and installation of equipment and furnishings. As discussed, manufacturer’s instructions should not only be followed but kept on file for all equipment installed after 2017. The warning label on the Simplay3 climber placed on the playground used by children one and two years of age stated “for domestic use only,” therefore it is not approved for child care use. You removed it from the playground today to correct the violation. Moving forward, I urged you to read all instructions and warning labels prior to purchasing new equipment to ensure it is safe for commercial use and installed correctly. Child Care Rule 10A NCAC 09 .0901(j) states that staff shall role model appropriate eating behaviors by consuming only food or beverages that meet the nutritional requirements specified in this Rule in the presence of children in care. Soft drinks or fast food meals that staff might consume do not follow these requirements and should not be consumed in the classroom or in the presence of children. Today you stated you would remind staff to eat or drink these items on breaks outside of the classrooms only moving forward. Technical Assistance Technical assistance was also provided today regarding posting infant feeding plans for easy reference in Spaces #1 and 2. I suggested you hang sheet protectors on the wall in such a way that the second page of each child’s plan may be easily seen by all caregivers. This will assist staff in being able to quickly determine what types of foods should be served to each child. Today I also gave some suggestions for the transition between play time and lunch. As discussed in Space #2, if children appear to be falling asleep prior to lunch, it is best practice to try to put them down and let them sleep. You can always feed them lunch after they wake up, and it is sometimes unsafe to allow children who are sleepy to eat as it may be a choking hazard. In Space #4 I also suggested waiting until the food is ready to be served before asking children to wash their hands. This will cut down on wait time and the possibility of children recontaminating hands by touching classroom materials. Rated License Information As shared with you during the September 19, 2024 visit, the “hold harmless” state of rated license reassessments has been extended until the new Quality Rating Improvement System (QRIS) standards are put in place. This means that you will not be required to have a reassessment according to timelines previously discussed, and when your reassessment is due you will have options to choose from regarding how your star level is earned. When more information becomes available about the new QRIS standards, I may assist you in determining which option is best for your program. Please note any Infant Toddler Environment Rating Scales (ITERS) or Early Childhood Environment Rating Scales (ECERS) assessments conducted after February 1, 2025 will be the third editions, or the “3s.” You may find more information regarding the third editions including training materials and how to purchase at https://ncrlap.org/Resources/pages/get-ready-for-3s/. Regarding education standards, when new QRIS rules are implemented, education requirements will be different, but it is still critical that all staff in key positions have complete WORKS evaluations to assist with the rated license reassessment process. Information from DCDEE WORKS was reviewed with you today. It appears you are maintaining compliance pending complete evaluation of new staff members. As discussed, now that the evaluation for Q. Baldwin is complete, you may be eligible for seven points at the lead teacher position, however to increase Education points you must also earn seven points at the teacher position. Today we reviewed requirements and I encouraged you to ensure new assistant teachers complete the WORKS evaluation process. Please let me know if you need assistance with the WORKS portal. Reminders You must schedule and obtain an approved fire inspection by January 24, 2025, and submit a copy within one week as required. You must also ensure a sanitation inspection is conducted by January 17, 2025. Remember to also update staff records in December and January as necessary, as well as complete your annual Emergency Medical Care Plan reviews. North Carolina child care administrators can now view and edit their facility’s staff roster in ABCMS, the DCDEE’s criminal background check system. Provider Access to ABCMS allows administrators to: • See the real-time background check status of staff members. • Run a printable report of the staff roster to assist with compliance visits. • See new background check applicants and add to staff roster. To get started, complete the ABCMS Child Care Provider Portal Training in Moodle—a video tutorial followed by a few questions. The reporting period for child care immunizations is now open. Reporting for 2024-2025 has been extended due to Hurricane Helene. Children have a grace period from requirements until November 30, 2024, and reports will be accepted until January 15, 2025. Use this link to submit your report: https://survey.alchemer.com/s3/7955242/2024-2025-Child-Care-Immunization-Report. Send any questions regarding child care immunization reporting to immunization.reports@dhhs.nc.gov. Keep an eye on your inbox for the 2024 annual license fee invoice. Online payments will be due by December 31, 2024. The amount of your annual license fee is based on the licensed capacity printed on your license as of October 1, 2024, not the number of children enrolled at your facility. At the end of this visit, documentation was completed electronically, printed and reviewed with you. Please remember it is your responsibility to comply with all child care rules and requirements at all times. If you have questions or need assistance please feel free to contact me at 910-338-7038 or amy.wangler@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: BRI'S CARING HEART CHILD CARE Facility ID: 24000158 Consultant: AMY WANGLER Operation Type: Center Case Number: Visit Date: 12/3/2024 Number Present: 61 Completed Date: 12/3/2024 Age: From 0 To 3 Total Minutes: 235 Time In: 10:20 AM Time Out: 02:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of my visit was to monitor compliance with applicable child care requirements pertinent to this visit type. This facility currently operates with a Four Star license issued June 26, 2024, earning 4 points in Education, 5 points in Program Standards, and 1 Quality Point. Restrictions on the permit include: a first shift capacity of 86 children 0-12 years of age and meets enhanced ratios and space. Restrictions were in compliance today. The last annual compliance visit was conducted December 12, 2023. A Superior sanitation rating was earned January 17, 2024, and a fire inspection was conducted January 24, 2024; the facility was approved for day time care only. Prior to the visit, the facility had an eighteen-month compliance history score of 95%. Owner/Administrator, M. Spivey, was present and available for consultation today. Due to the proximity of a program needing an afternoon visit, this visit began after 9:00 A.M. Six indoor and three outdoor spaces are approved for use by children. Upon arrival, infants were observed in individual sleeping and feeding routines as well as play activities. Safe sleep practices including documentation were monitored and in compliance today. Children one year of age were observed playing with blocks, using push toys and relaxing in cozy areas. Children two years of age participated in hand washing routines and transition activities as they waited for lunch to be served. Children three years of age were also observed in toileting and hand washing routines as well as a music and movement activity as they waited for lunch to be served. Lunch consisted of whole grain-breaded chicken tenders, green beans, tropical fruit salad and milk. After lunch, children one through three years of age transitioned to rest time routines. They rested on cots which were appropriately spaced or separated by dividers. Lights were dimmed and soft music played. All staff members employed more than one year have completed the Health and Safety trainings as outlined in Child Care Rule 10A NCAC 09 .1102, and staff members employed at least five years have now repeated all topics as required. Child Care programs are expected to always achieve and maintain compliance with child care rules, and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The following violations were observed today and must be corrected immediately: Violation Number Comment Rule 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. Two staff members had medical reports which were older than 12 months when they were re-hired after a period of unemployment. 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. Two staff members had TB test results older than 12 months when they were re-hired after a period of unemployment. .0701(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. A staff member who began employment on November 6, 2023 did not have an annual staff evaluation or development plan on file. 10A NCAC 09 .0514(f) 1419 All commercially manufactured equipment and furnishings were not assembled and installed according to procedures specified by the manufacturer and/or the manufacturer's instructions were not kept on file or electronically accessible, if available. A piece of playground equipment labeled "for domestic use only" was observed on the playground used by children one and two years of age. .0601(b) 1757 A valid qualification letter was not on file and available to review at the facility. A valid qualification letter was not on file for a staff member who began employment in April 2022. G.S. 110-90.2(b) & (d) & .2703(e) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. Staff members were observed drinking soft drinks in classrooms with children during rest time. .0901(i) A compliance letter including detailed information about how all violations have been corrected must be received by December 17, 2024. Include any supporting documentation with your response (if applicable). Your letter will be used as verification that violations have been corrected and compliance is maintained; your written response is considered a legal document so must be accurate and truthful. If you email the compliance letter, it must be sent using the email address registered with DCDEE and include your facility name and ID number. If sufficient information is not received by the due date, a follow-up visit will be conducted. Technical Assistance Regarding Violations Cited The qualification letter on file today for Riley Cox was a provisional qualification which expired in October 2022. You stated you must not have realized you never filed her final determination letter because you listed it as valid for five years on your Staff and Training Worksheet instead of six months. The ABCMS database was reviewed during the visit and it was determined that Ms. Cox is qualified through August 2027, however she was not able to log in and print her letter due to an issue with the account. I provided the number for the criminal records unit help desk today and suggested she call and explain that she can’t access the application she submitted in 2022. Once she is given access to her letter, she must print it for her file. Remember to send a copy to verify compliance. Today we reviewed requirements for staff members who leave employment and then return later. As discussed, you must ensure qualification letters are still valid and TB test results and medical reports are not older than 12 months at the time of rehire (if they are, they must be redone prior to rehire). I also strongly urged you to ensure that you only write dates on the Staff and Training Worksheet when you have matching documentation in files, rather than copying over from previous versions. Remember to send copies of new TB test results and medical reports as discussed to verify compliance. Technical assistance was provided today regarding the assembly and installation of equipment and furnishings. As discussed, manufacturer’s instructions should not only be followed but kept on file for all equipment installed after 2017. The warning label on the Simplay3 climber placed on the playground used by children one and two years of age stated “for domestic use only,” therefore it is not approved for child care use. You removed it from the playground today to correct the violation. Moving forward, I urged you to read all instructions and warning labels prior to purchasing new equipment to ensure it is safe for commercial use and installed correctly. Child Care Rule 10A NCAC 09 .0901(j) states that staff shall role model appropriate eating behaviors by consuming only food or beverages that meet the nutritional requirements specified in this Rule in the presence of children in care. Soft drinks or fast food meals that staff might consume do not follow these requirements and should not be consumed in the classroom or in the presence of children. Today you stated you would remind staff to eat or drink these items on breaks outside of the classrooms only moving forward. Technical Assistance Technical assistance was also provided today regarding posting infant feeding plans for easy reference in Spaces #1 and 2. I suggested you hang sheet protectors on the wall in such a way that the second page of each child’s plan may be easily seen by all caregivers. This will assist staff in being able to quickly determine what types of foods should be served to each child. Today I also gave some suggestions for the transition between play time and lunch. As discussed in Space #2, if children appear to be falling asleep prior to lunch, it is best practice to try to put them down and let them sleep. You can always feed them lunch after they wake up, and it is sometimes unsafe to allow children who are sleepy to eat as it may be a choking hazard. In Space #4 I also suggested waiting until the food is ready to be served before asking children to wash their hands. This will cut down on wait time and the possibility of children recontaminating hands by touching classroom materials. Rated License Information As shared with you during the September 19, 2024 visit, the “hold harmless” state of rated license reassessments has been extended until the new Quality Rating Improvement System (QRIS) standards are put in place. This means that you will not be required to have a reassessment according to timelines previously discussed, and when your reassessment is due you will have options to choose from regarding how your star level is earned. When more information becomes available about the new QRIS standards, I may assist you in determining which option is best for your program. Please note any Infant Toddler Environment Rating Scales (ITERS) or Early Childhood Environment Rating Scales (ECERS) assessments conducted after February 1, 2025 will be the third editions, or the “3s.” You may find more information regarding the third editions including training materials and how to purchase at https://ncrlap.org/Resources/pages/get-ready-for-3s/. Regarding education standards, when new QRIS rules are implemented, education requirements will be different, but it is still critical that all staff in key positions have complete WORKS evaluations to assist with the rated license reassessment process. Information from DCDEE WORKS was reviewed with you today. It appears you are maintaining compliance pending complete evaluation of new staff members. As discussed, now that the evaluation for Q. Baldwin is complete, you may be eligible for seven points at the lead teacher position, however to increase Education points you must also earn seven points at the teacher position. Today we reviewed requirements and I encouraged you to ensure new assistant teachers complete the WORKS evaluation process. Please let me know if you need assistance with the WORKS portal. Reminders You must schedule and obtain an approved fire inspection by January 24, 2025, and submit a copy within one week as required. You must also ensure a sanitation inspection is conducted by January 17, 2025. Remember to also update staff records in December and January as necessary, as well as complete your annual Emergency Medical Care Plan reviews. North Carolina child care administrators can now view and edit their facility’s staff roster in ABCMS, the DCDEE’s criminal background check system. Provider Access to ABCMS allows administrators to: • See the real-time background check status of staff members. • Run a printable report of the staff roster to assist with compliance visits. • See new background check applicants and add to staff roster. To get started, complete the ABCMS Child Care Provider Portal Training in Moodle—a video tutorial followed by a few questions. The reporting period for child care immunizations is now open. Reporting for 2024-2025 has been extended due to Hurricane Helene. Children have a grace period from requirements until November 30, 2024, and reports will be accepted until January 15, 2025. Use this link to submit your report: https://survey.alchemer.com/s3/7955242/2024-2025-Child-Care-Immunization-Report. Send any questions regarding child care immunization reporting to immunization.reports@dhhs.nc.gov. Keep an eye on your inbox for the 2024 annual license fee invoice. Online payments will be due by December 31, 2024. The amount of your annual license fee is based on the licensed capacity printed on your license as of October 1, 2024, not the number of children enrolled at your facility. At the end of this visit, documentation was completed electronically, printed and reviewed with you. Please remember it is your responsibility to comply with all child care rules and requirements at all times. If you have questions or need assistance please feel free to contact me at 910-338-7038 or amy.wangler@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: BRI'S CARING HEART CHILD CARE Facility ID: 24000158 Consultant: AMY WANGLER Operation Type: Center Case Number: Visit Date: 12/3/2024 Number Present: 61 Completed Date: 12/3/2024 Age: From 0 To 3 Total Minutes: 235 Time In: 10:20 AM Time Out: 02:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of my visit was to monitor compliance with applicable child care requirements pertinent to this visit type. This facility currently operates with a Four Star license issued June 26, 2024, earning 4 points in Education, 5 points in Program Standards, and 1 Quality Point. Restrictions on the permit include: a first shift capacity of 86 children 0-12 years of age and meets enhanced ratios and space. Restrictions were in compliance today. The last annual compliance visit was conducted December 12, 2023. A Superior sanitation rating was earned January 17, 2024, and a fire inspection was conducted January 24, 2024; the facility was approved for day time care only. Prior to the visit, the facility had an eighteen-month compliance history score of 95%. Owner/Administrator, M. Spivey, was present and available for consultation today. Due to the proximity of a program needing an afternoon visit, this visit began after 9:00 A.M. Six indoor and three outdoor spaces are approved for use by children. Upon arrival, infants were observed in individual sleeping and feeding routines as well as play activities. Safe sleep practices including documentation were monitored and in compliance today. Children one year of age were observed playing with blocks, using push toys and relaxing in cozy areas. Children two years of age participated in hand washing routines and transition activities as they waited for lunch to be served. Children three years of age were also observed in toileting and hand washing routines as well as a music and movement activity as they waited for lunch to be served. Lunch consisted of whole grain-breaded chicken tenders, green beans, tropical fruit salad and milk. After lunch, children one through three years of age transitioned to rest time routines. They rested on cots which were appropriately spaced or separated by dividers. Lights were dimmed and soft music played. All staff members employed more than one year have completed the Health and Safety trainings as outlined in Child Care Rule 10A NCAC 09 .1102, and staff members employed at least five years have now repeated all topics as required. Child Care programs are expected to always achieve and maintain compliance with child care rules, and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The following violations were observed today and must be corrected immediately: Violation Number Comment Rule 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. Two staff members had medical reports which were older than 12 months when they were re-hired after a period of unemployment. 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. Two staff members had TB test results older than 12 months when they were re-hired after a period of unemployment. .0701(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. A staff member who began employment on November 6, 2023 did not have an annual staff evaluation or development plan on file. 10A NCAC 09 .0514(f) 1419 All commercially manufactured equipment and furnishings were not assembled and installed according to procedures specified by the manufacturer and/or the manufacturer's instructions were not kept on file or electronically accessible, if available. A piece of playground equipment labeled "for domestic use only" was observed on the playground used by children one and two years of age. .0601(b) 1757 A valid qualification letter was not on file and available to review at the facility. A valid qualification letter was not on file for a staff member who began employment in April 2022. G.S. 110-90.2(b) & (d) & .2703(e) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. Staff members were observed drinking soft drinks in classrooms with children during rest time. .0901(i) A compliance letter including detailed information about how all violations have been corrected must be received by December 17, 2024. Include any supporting documentation with your response (if applicable). Your letter will be used as verification that violations have been corrected and compliance is maintained; your written response is considered a legal document so must be accurate and truthful. If you email the compliance letter, it must be sent using the email address registered with DCDEE and include your facility name and ID number. If sufficient information is not received by the due date, a follow-up visit will be conducted. Technical Assistance Regarding Violations Cited The qualification letter on file today for Riley Cox was a provisional qualification which expired in October 2022. You stated you must not have realized you never filed her final determination letter because you listed it as valid for five years on your Staff and Training Worksheet instead of six months. The ABCMS database was reviewed during the visit and it was determined that Ms. Cox is qualified through August 2027, however she was not able to log in and print her letter due to an issue with the account. I provided the number for the criminal records unit help desk today and suggested she call and explain that she can’t access the application she submitted in 2022. Once she is given access to her letter, she must print it for her file. Remember to send a copy to verify compliance. Today we reviewed requirements for staff members who leave employment and then return later. As discussed, you must ensure qualification letters are still valid and TB test results and medical reports are not older than 12 months at the time of rehire (if they are, they must be redone prior to rehire). I also strongly urged you to ensure that you only write dates on the Staff and Training Worksheet when you have matching documentation in files, rather than copying over from previous versions. Remember to send copies of new TB test results and medical reports as discussed to verify compliance. Technical assistance was provided today regarding the assembly and installation of equipment and furnishings. As discussed, manufacturer’s instructions should not only be followed but kept on file for all equipment installed after 2017. The warning label on the Simplay3 climber placed on the playground used by children one and two years of age stated “for domestic use only,” therefore it is not approved for child care use. You removed it from the playground today to correct the violation. Moving forward, I urged you to read all instructions and warning labels prior to purchasing new equipment to ensure it is safe for commercial use and installed correctly. Child Care Rule 10A NCAC 09 .0901(j) states that staff shall role model appropriate eating behaviors by consuming only food or beverages that meet the nutritional requirements specified in this Rule in the presence of children in care. Soft drinks or fast food meals that staff might consume do not follow these requirements and should not be consumed in the classroom or in the presence of children. Today you stated you would remind staff to eat or drink these items on breaks outside of the classrooms only moving forward. Technical Assistance Technical assistance was also provided today regarding posting infant feeding plans for easy reference in Spaces #1 and 2. I suggested you hang sheet protectors on the wall in such a way that the second page of each child’s plan may be easily seen by all caregivers. This will assist staff in being able to quickly determine what types of foods should be served to each child. Today I also gave some suggestions for the transition between play time and lunch. As discussed in Space #2, if children appear to be falling asleep prior to lunch, it is best practice to try to put them down and let them sleep. You can always feed them lunch after they wake up, and it is sometimes unsafe to allow children who are sleepy to eat as it may be a choking hazard. In Space #4 I also suggested waiting until the food is ready to be served before asking children to wash their hands. This will cut down on wait time and the possibility of children recontaminating hands by touching classroom materials. Rated License Information As shared with you during the September 19, 2024 visit, the “hold harmless” state of rated license reassessments has been extended until the new Quality Rating Improvement System (QRIS) standards are put in place. This means that you will not be required to have a reassessment according to timelines previously discussed, and when your reassessment is due you will have options to choose from regarding how your star level is earned. When more information becomes available about the new QRIS standards, I may assist you in determining which option is best for your program. Please note any Infant Toddler Environment Rating Scales (ITERS) or Early Childhood Environment Rating Scales (ECERS) assessments conducted after February 1, 2025 will be the third editions, or the “3s.” You may find more information regarding the third editions including training materials and how to purchase at https://ncrlap.org/Resources/pages/get-ready-for-3s/. Regarding education standards, when new QRIS rules are implemented, education requirements will be different, but it is still critical that all staff in key positions have complete WORKS evaluations to assist with the rated license reassessment process. Information from DCDEE WORKS was reviewed with you today. It appears you are maintaining compliance pending complete evaluation of new staff members. As discussed, now that the evaluation for Q. Baldwin is complete, you may be eligible for seven points at the lead teacher position, however to increase Education points you must also earn seven points at the teacher position. Today we reviewed requirements and I encouraged you to ensure new assistant teachers complete the WORKS evaluation process. Please let me know if you need assistance with the WORKS portal. Reminders You must schedule and obtain an approved fire inspection by January 24, 2025, and submit a copy within one week as required. You must also ensure a sanitation inspection is conducted by January 17, 2025. Remember to also update staff records in December and January as necessary, as well as complete your annual Emergency Medical Care Plan reviews. North Carolina child care administrators can now view and edit their facility’s staff roster in ABCMS, the DCDEE’s criminal background check system. Provider Access to ABCMS allows administrators to: • See the real-time background check status of staff members. • Run a printable report of the staff roster to assist with compliance visits. • See new background check applicants and add to staff roster. To get started, complete the ABCMS Child Care Provider Portal Training in Moodle—a video tutorial followed by a few questions. The reporting period for child care immunizations is now open. Reporting for 2024-2025 has been extended due to Hurricane Helene. Children have a grace period from requirements until November 30, 2024, and reports will be accepted until January 15, 2025. Use this link to submit your report: https://survey.alchemer.com/s3/7955242/2024-2025-Child-Care-Immunization-Report. Send any questions regarding child care immunization reporting to immunization.reports@dhhs.nc.gov. Keep an eye on your inbox for the 2024 annual license fee invoice. Online payments will be due by December 31, 2024. The amount of your annual license fee is based on the licensed capacity printed on your license as of October 1, 2024, not the number of children enrolled at your facility. At the end of this visit, documentation was completed electronically, printed and reviewed with you. Please remember it is your responsibility to comply with all child care rules and requirements at all times. If you have questions or need assistance please feel free to contact me at 910-338-7038 or amy.wangler@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: BRI'S CARING HEART CHILD CARE Facility ID: 24000158 Consultant: AMY WANGLER Operation Type: Center Case Number: Visit Date: 12/12/2023 Number Present: 55 Completed Date: 12/12/2023 Age: From 0 To 4 Total Minutes: 205 Time In: 08:55 AM Time Out: 12:20 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of my visit was to monitor compliance with applicable child care requirements pertinent to this visit type. This facility currently operates with a Four Star license issued March 31, 2022, earning 4 points in Education, 5 points in Program Standards, and 1 Quality Point. Restrictions on the permit include: a first and second shift capacity of 86 children 0-12 years of age and meets enhanced ratios and space. Restrictions were in compliance today. The facility was also monitored for implementing an approved curriculum with children four years of age as required by the star rating; this program uses Creative Curriculum, Fourth Edition. The last annual compliance visit was conducted January 5, 2023. A Superior sanitation rating was earned January 10, 2023, and a fire inspection was conducted January 25, 2023; the facility was approved for day time care only. Prior to the visit, the facility had an eighteen-month compliance history score of 91%. Owner/Administrator, M. Spivey, was present and available for consultation today. Six indoor and three outdoor spaces are approved for use by children. Upon arrival, infants in Space #1 were observed in individual feeding routines and play activities. Two children were observed in high chairs eating cheese toast for breakfast. Later in the visit, five children were observed asleep in cribs. Safe sleep practices including documentation were monitored and in compliance today. One infant and seven children one year of age in Space #2 were observed in free choice activities including using busy boxes and cars and trucks. Children one and two years of age in Space #3 were observed moving freely around the room playing with dramatic play materials and Duplo blocks. Later, both of these groups were observed on one of the fenced playgrounds, using riding toys, slides, balls and the climbing structure. Children two years of age in Space #4 were observed in free choice and small group activities, working on a Christmas collage with one of their caregivers and using dramatic play and science materials. Children two and three years of age in Space #6 were observed in free choice activities including looking at seashells with magnifying glasses in the science center and driving small trains in the block center. In Space #5, preschool children were either engaged in free choice activities or working in a small group with one staff member to create handprint mittens with white paint and construction paper. Lunch served today consisted of breaded pork chops, steamed corn, mixed fruit and milk. After lunch, children one through four years of age transitioned to rest time routines. They rested on appropriately spaced cots with individual linens. All staff members employed more than one year have completed the Health and Safety trainings as outlined in Child Care Rule 10A NCAC 09 .1102, and staff members employed at least five years have now repeated all topics as required. Child Care programs are expected to always achieve and maintain compliance with child care rules, and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The following violations were observed today and must be corrected immediately: Violation Number Comment Rule 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Prescription Albuterol and over-the-counter saline drops were observed unlocked in Space #2. 15A NCAC 18A .2820(d) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Safe sleep checks were not documented for an eleven-month old present four out of five days during the week of 12/4/23-12/8/23. .0606(g) 1757 A valid qualification letter was not on file and available to review at the facility. A staff member's qualification letter expired 11/20/2023 and a new one was not obtained until 11/30/2023. G.S. 110-90.2(b) & (d) & .2703(e) A compliance letter including detailed information about how all violations have been corrected must be received by December 26, 2023. Include any supporting documentation with your response (if applicable). Your letter will be used as verification that violations have been corrected and compliance is maintained; your written response is considered a legal document so must be accurate and truthful. If you email the compliance letter, it must be sent using the email address registered with DCDEE and include your facility name and ID number. If sufficient information is not received by the due date, a follow-up visit will be conducted. Technical Assistance Regarding Violations Cited On November 29, 2023, you, Ms. Spivey, called me to let me know that the qualification letter you had on file for Jessica Whitley had expired November 20, 2023. You asked what you should do, and I advised you to try to see if she had another qualification letter in the criminal background check portal. You stated she could not access another letter so I told you she needed to have a valid letter on file within fifteen days or she could not be on site. Ms. Whitley completed her background check the next day and a valid qualification letter was issued November 30, 2023, therefore the violation for not having a valid letter on file is corrected. I encouraged you to audit staff files for qualification letter dates and let me know if you need assistance looking anything up in the criminal background check portal. Technical assistance was provided today regarding medication storage and permission requirements. As discussed, any medication which is not a topical ointment, including prescriptions and over-the-counter medications, must be kept in locked storage. Only topical ointments such as diaper creams, sunscreens and bug sprays (non-aerosol) may be unlocked but stored at a height of five feet. You may also use this “topical vs. non-topical” rule of thumb to determine which type of permission form is required. There are two sample forms on the DCDEE website, one for topical ointments and one for everything else. Please review these requirements with all staff and let me know if there are further questions. Regarding safe sleep checks, you messaged the lead teacher who was working in that class last week and stated she thought she had completed the chart, however it could not be located today. As discussed, conducting and documenting safe sleep checks is critical in the prevention of ITS-SIDS. You may need to check behind staff members on a regular basis to ensure charts are being filled out appropriately. Technical Assistance Technical assistance was provided today regarding room arrangement in Space #5. I suggested you move the dramatic play kitchen to a different part of the room, or use a different orientation against the wall, to ensure there is not blind spot behind it where the art center is. Since the art center is close to the sink as it should be, it may be easier to relocate the kitchen. Please consider your ability to see all of the children at a glance as you look around the room or even when you are seated working with individuals or small groups of children. Technical assistance was also provided in Spaces #1 and 2 regarding infant feeding plans. I encouraged you to ensure both pages of the feeding plans are posted and easily visible for all staff who may work in these rooms. This may assist with staff being able to easily look and reference what types and amounts of food each child should be served, since many of them have individualized feeding plans. Technical assistance was provided today regarding re-hiring staff. As discussed, unless staff members are on a leave of absence, if they leave employment and then return to employment later, you should treat them as a new hire with a new start date. You may wish to review orientation topics and policies and procedures if nothing has changed since they left, however you need to check dates of qualification letters, medical statements, TB test results and health and safety training. As a reminder, medical statements and TB tests must be less than 12 months old at the time of hire. In addition, health and safety training topics must be repeated if completion dates are not within the past year. You must also ensure you review the current Emergency Preparedness and Response plan as well as the Emergency Medical Care plan and the Prevention of Shaken Baby and Abusive Head Trauma policy as if they were new hires. Please let me know if you have further questions about requirements. Technical assistance was also provided today regarding playground capacity. During the July 20, 2022 Routine Unannounced visit, I shared with you that the requirement for enhanced space outdoors may be changing from 75 to 100 square feet per child, and this rule change did in fact become effective July 1, 2023. The new capacities are as follows: Outdoor Space #1 (infants and toddlers)- 11 children Outdoor Space #2 (twos)- 16 children Outdoor Space #3 (preschool)- 29 children I strongly urged you to review these with all staff members and post signs in each space so compliance may be maintained. Rated License Information Your facility’s three-year rated license reassessment was voluntarily conducted in March 2022, therefore you have been placed in “Cohort 3” of the cohort model of resuming rated license reassessments. This means your planning/preparation year will be 7/1/25-6/30/26, and your next reassessment will be due between 7/1/26 and 6/30/27. As you typically have the Environment Rating Scales (ERS) conducted, we discussed that you will have the option to request an ERS assessment during your planning year if you wish, or you may wait until your reassessment year. In the meantime, I encourage you to use resources such as the NCRLAP website, Columbus County Partnership for Children, and Region 4 CCR&R to prepare for your reassessment. I will be in touch regarding timelines as your planning year approaches. Information from DCDEE WORKS was reviewed with you and noted on the Staff and Training Worksheet today. Regarding Education standards, it appears you are maintaining compliance pending evaluation of five new staff members. You must ensure all staff in key positions including lead teacher and teacher have registered for WORKS accounts, applied for appropriate positions and submitted official transcripts as required for evaluation. Please let me know if you need assistance with the WORKS portal. Reminders Ensure you update staff health questionnaires and emergency information forms in December as well as evaluations and professional development plans in January. You must also have a sanitation inspection by January 10, 2024 and a fire inspection by January 25, 2024 to maintain compliance. Please let me know if you need assistance requesting your inspections. Invoices for annual licensing fees were emailed on December 1, 2023. Payment must be made online by December 31, 2023. Failure to pay the license fee is a violation of North Carolina General Statute § 110-90(1a) and will result in a penalty assessment, accrued interest, and issuance of an administrative action, up to and including revocation of your child care license. No partial payments will be accepted, and no payment plans will be established. Please retain your invoice as you will need the number to make your payment. Child Care Rules were revised July 1, 2023, and a new rule book was posted to the DCDEE website. As discussed, you should discard any old versions of the rules and ensure you are referring to the most current rule book when reviewing or researching requirements. Sanitation rules were also readopted July 1, 2023. I strongly urge you to review the training information at https://ehs.dph.ncdhhs.gov/hhccehb/cehu/ccs/op-training.htm, and contact Children’s Environmental Health Services with any questions. For more information regarding the “cohort model” of resuming rated license reassessments, and opportunities for training and technical assistance as you prepare for a reassessment, you may visit https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-Star-Rated-License. At the end of this visit, documentation was completed electronically, printed and reviewed with you. Please remember it is your responsibility to comply with all child care rules and requirements at all times. If you have questions or need assistance please feel free to contact me at 910-338-7038 or amy.wangler@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

G.S. 110-90 · Violation

Name of Operation: BRI'S CARING HEART CHILD CARE Facility ID: 24000158 Consultant: AMY WANGLER Operation Type: Center Case Number: Visit Date: 12/12/2023 Number Present: 55 Completed Date: 12/12/2023 Age: From 0 To 4 Total Minutes: 205 Time In: 08:55 AM Time Out: 12:20 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of my visit was to monitor compliance with applicable child care requirements pertinent to this visit type. This facility currently operates with a Four Star license issued March 31, 2022, earning 4 points in Education, 5 points in Program Standards, and 1 Quality Point. Restrictions on the permit include: a first and second shift capacity of 86 children 0-12 years of age and meets enhanced ratios and space. Restrictions were in compliance today. The facility was also monitored for implementing an approved curriculum with children four years of age as required by the star rating; this program uses Creative Curriculum, Fourth Edition. The last annual compliance visit was conducted January 5, 2023. A Superior sanitation rating was earned January 10, 2023, and a fire inspection was conducted January 25, 2023; the facility was approved for day time care only. Prior to the visit, the facility had an eighteen-month compliance history score of 91%. Owner/Administrator, M. Spivey, was present and available for consultation today. Six indoor and three outdoor spaces are approved for use by children. Upon arrival, infants in Space #1 were observed in individual feeding routines and play activities. Two children were observed in high chairs eating cheese toast for breakfast. Later in the visit, five children were observed asleep in cribs. Safe sleep practices including documentation were monitored and in compliance today. One infant and seven children one year of age in Space #2 were observed in free choice activities including using busy boxes and cars and trucks. Children one and two years of age in Space #3 were observed moving freely around the room playing with dramatic play materials and Duplo blocks. Later, both of these groups were observed on one of the fenced playgrounds, using riding toys, slides, balls and the climbing structure. Children two years of age in Space #4 were observed in free choice and small group activities, working on a Christmas collage with one of their caregivers and using dramatic play and science materials. Children two and three years of age in Space #6 were observed in free choice activities including looking at seashells with magnifying glasses in the science center and driving small trains in the block center. In Space #5, preschool children were either engaged in free choice activities or working in a small group with one staff member to create handprint mittens with white paint and construction paper. Lunch served today consisted of breaded pork chops, steamed corn, mixed fruit and milk. After lunch, children one through four years of age transitioned to rest time routines. They rested on appropriately spaced cots with individual linens. All staff members employed more than one year have completed the Health and Safety trainings as outlined in Child Care Rule 10A NCAC 09 .1102, and staff members employed at least five years have now repeated all topics as required. Child Care programs are expected to always achieve and maintain compliance with child care rules, and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The following violations were observed today and must be corrected immediately: Violation Number Comment Rule 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Prescription Albuterol and over-the-counter saline drops were observed unlocked in Space #2. 15A NCAC 18A .2820(d) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Safe sleep checks were not documented for an eleven-month old present four out of five days during the week of 12/4/23-12/8/23. .0606(g) 1757 A valid qualification letter was not on file and available to review at the facility. A staff member's qualification letter expired 11/20/2023 and a new one was not obtained until 11/30/2023. G.S. 110-90.2(b) & (d) & .2703(e) A compliance letter including detailed information about how all violations have been corrected must be received by December 26, 2023. Include any supporting documentation with your response (if applicable). Your letter will be used as verification that violations have been corrected and compliance is maintained; your written response is considered a legal document so must be accurate and truthful. If you email the compliance letter, it must be sent using the email address registered with DCDEE and include your facility name and ID number. If sufficient information is not received by the due date, a follow-up visit will be conducted. Technical Assistance Regarding Violations Cited On November 29, 2023, you, Ms. Spivey, called me to let me know that the qualification letter you had on file for Jessica Whitley had expired November 20, 2023. You asked what you should do, and I advised you to try to see if she had another qualification letter in the criminal background check portal. You stated she could not access another letter so I told you she needed to have a valid letter on file within fifteen days or she could not be on site. Ms. Whitley completed her background check the next day and a valid qualification letter was issued November 30, 2023, therefore the violation for not having a valid letter on file is corrected. I encouraged you to audit staff files for qualification letter dates and let me know if you need assistance looking anything up in the criminal background check portal. Technical assistance was provided today regarding medication storage and permission requirements. As discussed, any medication which is not a topical ointment, including prescriptions and over-the-counter medications, must be kept in locked storage. Only topical ointments such as diaper creams, sunscreens and bug sprays (non-aerosol) may be unlocked but stored at a height of five feet. You may also use this “topical vs. non-topical” rule of thumb to determine which type of permission form is required. There are two sample forms on the DCDEE website, one for topical ointments and one for everything else. Please review these requirements with all staff and let me know if there are further questions. Regarding safe sleep checks, you messaged the lead teacher who was working in that class last week and stated she thought she had completed the chart, however it could not be located today. As discussed, conducting and documenting safe sleep checks is critical in the prevention of ITS-SIDS. You may need to check behind staff members on a regular basis to ensure charts are being filled out appropriately. Technical Assistance Technical assistance was provided today regarding room arrangement in Space #5. I suggested you move the dramatic play kitchen to a different part of the room, or use a different orientation against the wall, to ensure there is not blind spot behind it where the art center is. Since the art center is close to the sink as it should be, it may be easier to relocate the kitchen. Please consider your ability to see all of the children at a glance as you look around the room or even when you are seated working with individuals or small groups of children. Technical assistance was also provided in Spaces #1 and 2 regarding infant feeding plans. I encouraged you to ensure both pages of the feeding plans are posted and easily visible for all staff who may work in these rooms. This may assist with staff being able to easily look and reference what types and amounts of food each child should be served, since many of them have individualized feeding plans. Technical assistance was provided today regarding re-hiring staff. As discussed, unless staff members are on a leave of absence, if they leave employment and then return to employment later, you should treat them as a new hire with a new start date. You may wish to review orientation topics and policies and procedures if nothing has changed since they left, however you need to check dates of qualification letters, medical statements, TB test results and health and safety training. As a reminder, medical statements and TB tests must be less than 12 months old at the time of hire. In addition, health and safety training topics must be repeated if completion dates are not within the past year. You must also ensure you review the current Emergency Preparedness and Response plan as well as the Emergency Medical Care plan and the Prevention of Shaken Baby and Abusive Head Trauma policy as if they were new hires. Please let me know if you have further questions about requirements. Technical assistance was also provided today regarding playground capacity. During the July 20, 2022 Routine Unannounced visit, I shared with you that the requirement for enhanced space outdoors may be changing from 75 to 100 square feet per child, and this rule change did in fact become effective July 1, 2023. The new capacities are as follows: Outdoor Space #1 (infants and toddlers)- 11 children Outdoor Space #2 (twos)- 16 children Outdoor Space #3 (preschool)- 29 children I strongly urged you to review these with all staff members and post signs in each space so compliance may be maintained. Rated License Information Your facility’s three-year rated license reassessment was voluntarily conducted in March 2022, therefore you have been placed in “Cohort 3” of the cohort model of resuming rated license reassessments. This means your planning/preparation year will be 7/1/25-6/30/26, and your next reassessment will be due between 7/1/26 and 6/30/27. As you typically have the Environment Rating Scales (ERS) conducted, we discussed that you will have the option to request an ERS assessment during your planning year if you wish, or you may wait until your reassessment year. In the meantime, I encourage you to use resources such as the NCRLAP website, Columbus County Partnership for Children, and Region 4 CCR&R to prepare for your reassessment. I will be in touch regarding timelines as your planning year approaches. Information from DCDEE WORKS was reviewed with you and noted on the Staff and Training Worksheet today. Regarding Education standards, it appears you are maintaining compliance pending evaluation of five new staff members. You must ensure all staff in key positions including lead teacher and teacher have registered for WORKS accounts, applied for appropriate positions and submitted official transcripts as required for evaluation. Please let me know if you need assistance with the WORKS portal. Reminders Ensure you update staff health questionnaires and emergency information forms in December as well as evaluations and professional development plans in January. You must also have a sanitation inspection by January 10, 2024 and a fire inspection by January 25, 2024 to maintain compliance. Please let me know if you need assistance requesting your inspections. Invoices for annual licensing fees were emailed on December 1, 2023. Payment must be made online by December 31, 2023. Failure to pay the license fee is a violation of North Carolina General Statute § 110-90(1a) and will result in a penalty assessment, accrued interest, and issuance of an administrative action, up to and including revocation of your child care license. No partial payments will be accepted, and no payment plans will be established. Please retain your invoice as you will need the number to make your payment. Child Care Rules were revised July 1, 2023, and a new rule book was posted to the DCDEE website. As discussed, you should discard any old versions of the rules and ensure you are referring to the most current rule book when reviewing or researching requirements. Sanitation rules were also readopted July 1, 2023. I strongly urge you to review the training information at https://ehs.dph.ncdhhs.gov/hhccehb/cehu/ccs/op-training.htm, and contact Children’s Environmental Health Services with any questions. For more information regarding the “cohort model” of resuming rated license reassessments, and opportunities for training and technical assistance as you prepare for a reassessment, you may visit https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-Star-Rated-License. At the end of this visit, documentation was completed electronically, printed and reviewed with you. Please remember it is your responsibility to comply with all child care rules and requirements at all times. If you have questions or need assistance please feel free to contact me at 910-338-7038 or amy.wangler@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: BRI'S CARING HEART CHILD CARE Facility ID: 24000158 Consultant: AMY WANGLER Operation Type: Center Case Number: Visit Date: 12/12/2023 Number Present: 55 Completed Date: 12/12/2023 Age: From 0 To 4 Total Minutes: 205 Time In: 08:55 AM Time Out: 12:20 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of my visit was to monitor compliance with applicable child care requirements pertinent to this visit type. This facility currently operates with a Four Star license issued March 31, 2022, earning 4 points in Education, 5 points in Program Standards, and 1 Quality Point. Restrictions on the permit include: a first and second shift capacity of 86 children 0-12 years of age and meets enhanced ratios and space. Restrictions were in compliance today. The facility was also monitored for implementing an approved curriculum with children four years of age as required by the star rating; this program uses Creative Curriculum, Fourth Edition. The last annual compliance visit was conducted January 5, 2023. A Superior sanitation rating was earned January 10, 2023, and a fire inspection was conducted January 25, 2023; the facility was approved for day time care only. Prior to the visit, the facility had an eighteen-month compliance history score of 91%. Owner/Administrator, M. Spivey, was present and available for consultation today. Six indoor and three outdoor spaces are approved for use by children. Upon arrival, infants in Space #1 were observed in individual feeding routines and play activities. Two children were observed in high chairs eating cheese toast for breakfast. Later in the visit, five children were observed asleep in cribs. Safe sleep practices including documentation were monitored and in compliance today. One infant and seven children one year of age in Space #2 were observed in free choice activities including using busy boxes and cars and trucks. Children one and two years of age in Space #3 were observed moving freely around the room playing with dramatic play materials and Duplo blocks. Later, both of these groups were observed on one of the fenced playgrounds, using riding toys, slides, balls and the climbing structure. Children two years of age in Space #4 were observed in free choice and small group activities, working on a Christmas collage with one of their caregivers and using dramatic play and science materials. Children two and three years of age in Space #6 were observed in free choice activities including looking at seashells with magnifying glasses in the science center and driving small trains in the block center. In Space #5, preschool children were either engaged in free choice activities or working in a small group with one staff member to create handprint mittens with white paint and construction paper. Lunch served today consisted of breaded pork chops, steamed corn, mixed fruit and milk. After lunch, children one through four years of age transitioned to rest time routines. They rested on appropriately spaced cots with individual linens. All staff members employed more than one year have completed the Health and Safety trainings as outlined in Child Care Rule 10A NCAC 09 .1102, and staff members employed at least five years have now repeated all topics as required. Child Care programs are expected to always achieve and maintain compliance with child care rules, and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The following violations were observed today and must be corrected immediately: Violation Number Comment Rule 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Prescription Albuterol and over-the-counter saline drops were observed unlocked in Space #2. 15A NCAC 18A .2820(d) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Safe sleep checks were not documented for an eleven-month old present four out of five days during the week of 12/4/23-12/8/23. .0606(g) 1757 A valid qualification letter was not on file and available to review at the facility. A staff member's qualification letter expired 11/20/2023 and a new one was not obtained until 11/30/2023. G.S. 110-90.2(b) & (d) & .2703(e) A compliance letter including detailed information about how all violations have been corrected must be received by December 26, 2023. Include any supporting documentation with your response (if applicable). Your letter will be used as verification that violations have been corrected and compliance is maintained; your written response is considered a legal document so must be accurate and truthful. If you email the compliance letter, it must be sent using the email address registered with DCDEE and include your facility name and ID number. If sufficient information is not received by the due date, a follow-up visit will be conducted. Technical Assistance Regarding Violations Cited On November 29, 2023, you, Ms. Spivey, called me to let me know that the qualification letter you had on file for Jessica Whitley had expired November 20, 2023. You asked what you should do, and I advised you to try to see if she had another qualification letter in the criminal background check portal. You stated she could not access another letter so I told you she needed to have a valid letter on file within fifteen days or she could not be on site. Ms. Whitley completed her background check the next day and a valid qualification letter was issued November 30, 2023, therefore the violation for not having a valid letter on file is corrected. I encouraged you to audit staff files for qualification letter dates and let me know if you need assistance looking anything up in the criminal background check portal. Technical assistance was provided today regarding medication storage and permission requirements. As discussed, any medication which is not a topical ointment, including prescriptions and over-the-counter medications, must be kept in locked storage. Only topical ointments such as diaper creams, sunscreens and bug sprays (non-aerosol) may be unlocked but stored at a height of five feet. You may also use this “topical vs. non-topical” rule of thumb to determine which type of permission form is required. There are two sample forms on the DCDEE website, one for topical ointments and one for everything else. Please review these requirements with all staff and let me know if there are further questions. Regarding safe sleep checks, you messaged the lead teacher who was working in that class last week and stated she thought she had completed the chart, however it could not be located today. As discussed, conducting and documenting safe sleep checks is critical in the prevention of ITS-SIDS. You may need to check behind staff members on a regular basis to ensure charts are being filled out appropriately. Technical Assistance Technical assistance was provided today regarding room arrangement in Space #5. I suggested you move the dramatic play kitchen to a different part of the room, or use a different orientation against the wall, to ensure there is not blind spot behind it where the art center is. Since the art center is close to the sink as it should be, it may be easier to relocate the kitchen. Please consider your ability to see all of the children at a glance as you look around the room or even when you are seated working with individuals or small groups of children. Technical assistance was also provided in Spaces #1 and 2 regarding infant feeding plans. I encouraged you to ensure both pages of the feeding plans are posted and easily visible for all staff who may work in these rooms. This may assist with staff being able to easily look and reference what types and amounts of food each child should be served, since many of them have individualized feeding plans. Technical assistance was provided today regarding re-hiring staff. As discussed, unless staff members are on a leave of absence, if they leave employment and then return to employment later, you should treat them as a new hire with a new start date. You may wish to review orientation topics and policies and procedures if nothing has changed since they left, however you need to check dates of qualification letters, medical statements, TB test results and health and safety training. As a reminder, medical statements and TB tests must be less than 12 months old at the time of hire. In addition, health and safety training topics must be repeated if completion dates are not within the past year. You must also ensure you review the current Emergency Preparedness and Response plan as well as the Emergency Medical Care plan and the Prevention of Shaken Baby and Abusive Head Trauma policy as if they were new hires. Please let me know if you have further questions about requirements. Technical assistance was also provided today regarding playground capacity. During the July 20, 2022 Routine Unannounced visit, I shared with you that the requirement for enhanced space outdoors may be changing from 75 to 100 square feet per child, and this rule change did in fact become effective July 1, 2023. The new capacities are as follows: Outdoor Space #1 (infants and toddlers)- 11 children Outdoor Space #2 (twos)- 16 children Outdoor Space #3 (preschool)- 29 children I strongly urged you to review these with all staff members and post signs in each space so compliance may be maintained. Rated License Information Your facility’s three-year rated license reassessment was voluntarily conducted in March 2022, therefore you have been placed in “Cohort 3” of the cohort model of resuming rated license reassessments. This means your planning/preparation year will be 7/1/25-6/30/26, and your next reassessment will be due between 7/1/26 and 6/30/27. As you typically have the Environment Rating Scales (ERS) conducted, we discussed that you will have the option to request an ERS assessment during your planning year if you wish, or you may wait until your reassessment year. In the meantime, I encourage you to use resources such as the NCRLAP website, Columbus County Partnership for Children, and Region 4 CCR&R to prepare for your reassessment. I will be in touch regarding timelines as your planning year approaches. Information from DCDEE WORKS was reviewed with you and noted on the Staff and Training Worksheet today. Regarding Education standards, it appears you are maintaining compliance pending evaluation of five new staff members. You must ensure all staff in key positions including lead teacher and teacher have registered for WORKS accounts, applied for appropriate positions and submitted official transcripts as required for evaluation. Please let me know if you need assistance with the WORKS portal. Reminders Ensure you update staff health questionnaires and emergency information forms in December as well as evaluations and professional development plans in January. You must also have a sanitation inspection by January 10, 2024 and a fire inspection by January 25, 2024 to maintain compliance. Please let me know if you need assistance requesting your inspections. Invoices for annual licensing fees were emailed on December 1, 2023. Payment must be made online by December 31, 2023. Failure to pay the license fee is a violation of North Carolina General Statute § 110-90(1a) and will result in a penalty assessment, accrued interest, and issuance of an administrative action, up to and including revocation of your child care license. No partial payments will be accepted, and no payment plans will be established. Please retain your invoice as you will need the number to make your payment. Child Care Rules were revised July 1, 2023, and a new rule book was posted to the DCDEE website. As discussed, you should discard any old versions of the rules and ensure you are referring to the most current rule book when reviewing or researching requirements. Sanitation rules were also readopted July 1, 2023. I strongly urge you to review the training information at https://ehs.dph.ncdhhs.gov/hhccehb/cehu/ccs/op-training.htm, and contact Children’s Environmental Health Services with any questions. For more information regarding the “cohort model” of resuming rated license reassessments, and opportunities for training and technical assistance as you prepare for a reassessment, you may visit https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-Star-Rated-License. At the end of this visit, documentation was completed electronically, printed and reviewed with you. Please remember it is your responsibility to comply with all child care rules and requirements at all times. If you have questions or need assistance please feel free to contact me at 910-338-7038 or amy.wangler@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times