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Home › NC › Vale › THE Pa-Paw Patch
3819 CAT Square RD, Vale NC 28168 · License #18000609 · Center · Child Care Center
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10A NCAC 09 . 1102 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 8/20/2025 Number Present: 46 Completed Date: 8/20/2025 Age: From 0 To 5 Total Minutes: 441 Time In: 09:10 AM Time Out: 12:59 PM Time In: 01:58 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Teri Knollhoff, Administrator, assisted me with today’s visit. I conducted your last annual compliance visit on September 4, 2024. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, web address or corporate contact for the facility. I reviewed the facility’s permit with you today including the restrictions, capacity, and age range and observed these being maintained today. Toddler's Cove Academy Inc that owns your facility was reviewed and listed as current-active on the North Carolina Secretary of State website on August 19, 2025 and was reviewed with you today. Your center's compliance history was 82% as of August 19, 2025 and was reviewed with you today. Your program currently operates with a three-star license, issued on April 8, 2023, earning four points in staff education, two points in program standards, and one quality point for a combined turnover rate of 20% or less for Administrator, Lead Teacher, Teacher, and Group Leader. Your most recent fire inspection was dated May 21, 2025 and received in my office by email on May 21, 2025. Your most recent sanitation inspection was dated June 6, 2025 with an approved classification and three demerits. I verified that the lead water testing required to be completed every three years was completed. Your most recent lead water test results dated August 6, 2024 indicated that the facility’s drinking water source was within the required limits. I verified that you have completed the enrollment process for the lead-based paint testing and are exempt from those tests. I verified that you completed the enrollment process for asbestos testing and are exempt from those tests. You and I visited each licensed indoor and outdoor space today. You stated that Space 4 was currently closed due to enrollment and staffing, and Playground 2 was currently not being used due to Space 4 being temporarily closed. Children were playing in activity areas, transitioning from outdoors to indoors, participating in whole group language activity, eating lunch, napping, attending to personal care needs and departing. Infant age children were playing on the floor, napping, eating lunch, and interacting with staff. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Today’s lunch met the meal pattern requirements. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of thirty-seven degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at thirty-five degrees Fahrenheit in Space 1. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, and staff record files. Your written operational, administrative, and personnel policies and your parent participation plan were reviewed during a routine unannounced visit on February 12, 2025. Today, you stated that your written operational policies were updated on July 8, 2025. I verified this change was documented on a memo given to and signed by both currently enrolled parents and newly enrolled parents. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. The following violations were observed and cited during today's visit: Violation Number Comment Rule 808 The child care center premises, including the outdoor learning environment, was not clean, drained to minimize standing water, free of litter and hazards, and/or maintained in a manner which does not create conditions that attract or harbor pests. On Playground 2, one water table with a broken lid and one dump truck had standing water in them. 15A NCAC 18A .2832(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. The First Aid training for one staff member with a date of employment of 04/24/2023 had expired on 05/09/2025. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. The CPR training for one staff member with a date of employment of 04/24/2023 had expired on 05/09/2025. .1102(d) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member with a date of employment of 04/24/2023 who was required to complete twenty hours of on-going training had completed some on-going training from an unapproved training agency and had not completed twenty hours as required. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. The acknowledgement statement for written notification of operational policy changes was not on file for one child with a date of enrollment of 07/01/2024. 10A NCAC 09 .0514(b) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. A staff roster was not established in the ABCMS portal to notify DCDEE of current and new staff member employment. G.S. 110-90.2 & .2703(r) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. The EPR Plan was updated on 06/09/2025 but had not been reviewed with eleven out of twelve staff members. .0607(f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. On Playground 1, the rubber mulch and pea gravel surfacing measured less than one inch to seven inches within the fall zone of the composite structure and the spring rockers. .0605(k)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One staff member with a date of employment of 01/21/2025 completed Recognizing and Responding to Suspicions of Child Maltreatment training on 04/27/2025 rather than 04/21/2025 as required. .1102(g) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 . 1102(g), each child care administrator and all staff should complete the Recognizing and Responding to Suspicions of Child Maltreatment (R&R) training through the NC Prevent Child Abuse website and/or present the administrator with the completion certificate within the first ninety days of employment. Today, I observed one staff member with a date of employment of 01/21/2025 had completed R&R training on 04/27/2025 but the training was due by 04/21/2025. Because the training was completed prior to today’s visit, the violation was considered corrected during the visit. I suggested you create a tracking tool that assists you in keeping up with the required training due dates for each of your employees. Please let me know if you need assistance with developing a tracking tool. 2. As stated in G.S. 110-90.2 & .2703(r), child care operators have five business days to notify the Division of any new child care providers working who were hired or moved into the child care facility. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. The compliance of this rule will be monitored during your next visit. Prior to today’s visit, I observed that a staff roster for this facility had not been established on the ABCMS Provider Portal listing currently employed staff members as being hired by this facility. To correct this violation, you will need both an Individual NCID and a Business NCID. You will need an email address for your Individual NCID and a different email address for your Business NCID account. Once you have created your Business NCID, complete the ABCMS Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given to you, you must verify your facility roster to ensure current staff or current FCCH residents are noted on the roster. To maintain compliance with this child care requirement, this information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. These actions satisfy the requirement to notify the Division within five business days of new child care providers working who were hired or moved into the child care facility. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance, please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. 3. Per sanitation rule 15A NCAC 18A.2832(a), the child care center premises, including the outdoor learning environment, should be clean, drained to minimize standing water, free of litter and hazards and/or maintained in a manner which does not create conditions that attract or harbor pests. On Playground 2 which is currently not being used, one water table with a broken lid and one dump truck had standing water in them. Today, the administrator dumped the water out of the water table and the dump truck and turned the dump trucks upside down to prevent water from collecting in the future. These actions corrected this violation during today’s visit. To maintain compliance with this child care requirement, I suggested you remind staff to keep water tables covered and dump trucks turned upside down. 4. Per child care rule 10A NCAC 09 .0605(k)(1-4), the depth of the loose surfacing should be based on the critical height of the equipment. To maintain compliance with this child care requirement, I suggested you replenish the rubber mulch and pea gravel combination under and around the stationary composite play structure and the spring rockers on Playground 1 to a depth of six inches within fall zone extending six feet from the composite structure in all directions and three feet from the spring rockers in all directions. 5. Per child care rule 10A NCAC 09 .0607(f), all staff should review the center's Emergency Preparedness Response (EPR) with the trained staff during orientation, on an annual basis, or when the plan is updated for any reason. Documentation of the initial and the annual review should be maintained on file. During today’s visit, I observed the EPR Plan had been updated on June 9, 2025. However, there was no documentation on file that included staff signature and date that could be used to verify that the plan had been reviewed with staff to date. To maintain compliance with this child care requirement, I suggested you sit down as a staff group and review the EPR Plan with each staff member as soon as possible and have them sign and date a statement or roster as documentation that the plan was reviewed. 6. Per child care rule 10A NCAC 09 .1103 (a), after the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, should complete on-going training activities each year from training agencies approved by DCDEE. The number of required on-going training hours is calculated based on the staff member’s education, experience, and number of hours worked weekly. To maintain compliance with this child care requirement, I suggested you encourage your staff to complete on-going training from DCDEE approved agencies only. Many free approved training opportunities are available through DCDEE Moodle, NCRLAP, and NC Health and Safety Resource Center. 7. Per child care rule 10A NCAC 09 .1102(c)(d), each employee should complete First Aid and CPR training within ninety days of employment and prior to the expiration date and documentation should be maintained in their staff record file as verification that the employee has completed First Aid and CPR training and maintains a current and valid First Aid and CPR certificate. Today, one staff member’s First Aid and CPR training certification had expired on May 9, 2025 and no updated certificate or documentation of completion was in the file. To maintain compliance with this child care requirement, I suggest you encourage staff members to register for First Aid and CPR training three months prior to the expiration date. 8. Per child care rule 10A NCAC 09. 0514(b), a statement signed and dated by each parent acknowledging the receipt and discussion of the operational policies on or before the first day of attendance and written notice of changes should be on file for each child. To maintain compliance with this child care requirement, I suggested that when changes are made to the operational policies, you provide written notice to each parent of the operational policy change and have the parent sign and date an acknowledgement statement that they received written notice of the operational policy change. I also suggested that you add the updated operational policies to the parent handbook to be given to new enrolling families prior to the first day of attendance and continue securing a parent signature and date from the parent on the acknowledgement form that you include in your enrollment packets. CONSULTATION: 1. On the Emergency Medical Care (EMC) Plan, at least one of the persons listed as the responsible person or the alternate person for each of the assigned tasks must be on-site at all times. 2. When and if you update your fire evacuation route, shelter-in-place, and/or lock-down drill plan, you need to have the fire department approve the your plan first BEFORE you put it in your EPR plan as an update. 3. On July 1, 2025, the North Carolina Rules Review Commission (RRC) approved the new child care rule language for the QRIS Modernization Plan, known as “Pathways to the Stars”. The Division of Child Development and Early Education is currently preparing a summary of the rules, an online training module for Moodle, and an implementation plan. Child care consultants will be conducting center administrator and FCCH owner/operator training/meetings in September 2025 as the next step for implementing the plan to transition to the “Pathways to the Stars”. The implementation plan will allow time for administrators and operators to learn and understand the different pathways and the changes within our system. An invitation and announcement of the date, time, and location for these important meetings will be shared as soon as details are finalized. Please make plans to attend. Please be reminded that any ERS assessment completed on or after February 1, 2025 will be assessed using the ERS-3 versions. We encourage you to visit the QRIS Modernization page on the DCDEE website at this link: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization to learn more now. 4. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. 5. Here are some important links on the DCEEE website that may be helpful: Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Licensing/Getting-a-License Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development QRIS Modernization Plan resources: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings Healthy Social Behaviors: https://www.childcarerrnc.org/special-projects/healthy-social-behaviors/. Healthy Social Behaviors Helpline: Call at 1-704-376-6697 or toll free at 1-888-600-1685 Option 1 or email at sbrawley@childcareresourcesinc.org or jbyrd@childcareresources.org. Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New 6. Here is the link to the Children’s Resource Center training calendar: https://childrensresourcecenter.org/training-calendar/. 7. If you would like an electronic link to any of the links shared above, please send me an email requesting the links that you’d wish to receive, and I will be glad to send the hyperlinks to you by email. COMPLIANCE PLAN: No compliance documentation is needed for violation item numbers 808 and 1897 corrected during today’s visit. I documented the corrective actions taken today to correct those violations in this visit summary. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. I must receive your compliance letter no later than September 3, 2025. Please be aware any information submitted by you is legal documentation. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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
Generated from this facility's specific inspection record
Data synced from North Carolina's child care licensing agency on Jul 9, 2026 · Report an error
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
10A NCAC 09 .0514 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 8/20/2025 Number Present: 46 Completed Date: 8/20/2025 Age: From 0 To 5 Total Minutes: 441 Time In: 09:10 AM Time Out: 12:59 PM Time In: 01:58 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Teri Knollhoff, Administrator, assisted me with today’s visit. I conducted your last annual compliance visit on September 4, 2024. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, web address or corporate contact for the facility. I reviewed the facility’s permit with you today including the restrictions, capacity, and age range and observed these being maintained today. Toddler's Cove Academy Inc that owns your facility was reviewed and listed as current-active on the North Carolina Secretary of State website on August 19, 2025 and was reviewed with you today. Your center's compliance history was 82% as of August 19, 2025 and was reviewed with you today. Your program currently operates with a three-star license, issued on April 8, 2023, earning four points in staff education, two points in program standards, and one quality point for a combined turnover rate of 20% or less for Administrator, Lead Teacher, Teacher, and Group Leader. Your most recent fire inspection was dated May 21, 2025 and received in my office by email on May 21, 2025. Your most recent sanitation inspection was dated June 6, 2025 with an approved classification and three demerits. I verified that the lead water testing required to be completed every three years was completed. Your most recent lead water test results dated August 6, 2024 indicated that the facility’s drinking water source was within the required limits. I verified that you have completed the enrollment process for the lead-based paint testing and are exempt from those tests. I verified that you completed the enrollment process for asbestos testing and are exempt from those tests. You and I visited each licensed indoor and outdoor space today. You stated that Space 4 was currently closed due to enrollment and staffing, and Playground 2 was currently not being used due to Space 4 being temporarily closed. Children were playing in activity areas, transitioning from outdoors to indoors, participating in whole group language activity, eating lunch, napping, attending to personal care needs and departing. Infant age children were playing on the floor, napping, eating lunch, and interacting with staff. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Today’s lunch met the meal pattern requirements. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of thirty-seven degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at thirty-five degrees Fahrenheit in Space 1. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, and staff record files. Your written operational, administrative, and personnel policies and your parent participation plan were reviewed during a routine unannounced visit on February 12, 2025. Today, you stated that your written operational policies were updated on July 8, 2025. I verified this change was documented on a memo given to and signed by both currently enrolled parents and newly enrolled parents. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. The following violations were observed and cited during today's visit: Violation Number Comment Rule 808 The child care center premises, including the outdoor learning environment, was not clean, drained to minimize standing water, free of litter and hazards, and/or maintained in a manner which does not create conditions that attract or harbor pests. On Playground 2, one water table with a broken lid and one dump truck had standing water in them. 15A NCAC 18A .2832(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. The First Aid training for one staff member with a date of employment of 04/24/2023 had expired on 05/09/2025. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. The CPR training for one staff member with a date of employment of 04/24/2023 had expired on 05/09/2025. .1102(d) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member with a date of employment of 04/24/2023 who was required to complete twenty hours of on-going training had completed some on-going training from an unapproved training agency and had not completed twenty hours as required. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. The acknowledgement statement for written notification of operational policy changes was not on file for one child with a date of enrollment of 07/01/2024. 10A NCAC 09 .0514(b) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. A staff roster was not established in the ABCMS portal to notify DCDEE of current and new staff member employment. G.S. 110-90.2 & .2703(r) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. The EPR Plan was updated on 06/09/2025 but had not been reviewed with eleven out of twelve staff members. .0607(f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. On Playground 1, the rubber mulch and pea gravel surfacing measured less than one inch to seven inches within the fall zone of the composite structure and the spring rockers. .0605(k)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One staff member with a date of employment of 01/21/2025 completed Recognizing and Responding to Suspicions of Child Maltreatment training on 04/27/2025 rather than 04/21/2025 as required. .1102(g) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 . 1102(g), each child care administrator and all staff should complete the Recognizing and Responding to Suspicions of Child Maltreatment (R&R) training through the NC Prevent Child Abuse website and/or present the administrator with the completion certificate within the first ninety days of employment. Today, I observed one staff member with a date of employment of 01/21/2025 had completed R&R training on 04/27/2025 but the training was due by 04/21/2025. Because the training was completed prior to today’s visit, the violation was considered corrected during the visit. I suggested you create a tracking tool that assists you in keeping up with the required training due dates for each of your employees. Please let me know if you need assistance with developing a tracking tool. 2. As stated in G.S. 110-90.2 & .2703(r), child care operators have five business days to notify the Division of any new child care providers working who were hired or moved into the child care facility. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. The compliance of this rule will be monitored during your next visit. Prior to today’s visit, I observed that a staff roster for this facility had not been established on the ABCMS Provider Portal listing currently employed staff members as being hired by this facility. To correct this violation, you will need both an Individual NCID and a Business NCID. You will need an email address for your Individual NCID and a different email address for your Business NCID account. Once you have created your Business NCID, complete the ABCMS Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given to you, you must verify your facility roster to ensure current staff or current FCCH residents are noted on the roster. To maintain compliance with this child care requirement, this information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. These actions satisfy the requirement to notify the Division within five business days of new child care providers working who were hired or moved into the child care facility. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance, please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. 3. Per sanitation rule 15A NCAC 18A.2832(a), the child care center premises, including the outdoor learning environment, should be clean, drained to minimize standing water, free of litter and hazards and/or maintained in a manner which does not create conditions that attract or harbor pests. On Playground 2 which is currently not being used, one water table with a broken lid and one dump truck had standing water in them. Today, the administrator dumped the water out of the water table and the dump truck and turned the dump trucks upside down to prevent water from collecting in the future. These actions corrected this violation during today’s visit. To maintain compliance with this child care requirement, I suggested you remind staff to keep water tables covered and dump trucks turned upside down. 4. Per child care rule 10A NCAC 09 .0605(k)(1-4), the depth of the loose surfacing should be based on the critical height of the equipment. To maintain compliance with this child care requirement, I suggested you replenish the rubber mulch and pea gravel combination under and around the stationary composite play structure and the spring rockers on Playground 1 to a depth of six inches within fall zone extending six feet from the composite structure in all directions and three feet from the spring rockers in all directions. 5. Per child care rule 10A NCAC 09 .0607(f), all staff should review the center's Emergency Preparedness Response (EPR) with the trained staff during orientation, on an annual basis, or when the plan is updated for any reason. Documentation of the initial and the annual review should be maintained on file. During today’s visit, I observed the EPR Plan had been updated on June 9, 2025. However, there was no documentation on file that included staff signature and date that could be used to verify that the plan had been reviewed with staff to date. To maintain compliance with this child care requirement, I suggested you sit down as a staff group and review the EPR Plan with each staff member as soon as possible and have them sign and date a statement or roster as documentation that the plan was reviewed. 6. Per child care rule 10A NCAC 09 .1103 (a), after the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, should complete on-going training activities each year from training agencies approved by DCDEE. The number of required on-going training hours is calculated based on the staff member’s education, experience, and number of hours worked weekly. To maintain compliance with this child care requirement, I suggested you encourage your staff to complete on-going training from DCDEE approved agencies only. Many free approved training opportunities are available through DCDEE Moodle, NCRLAP, and NC Health and Safety Resource Center. 7. Per child care rule 10A NCAC 09 .1102(c)(d), each employee should complete First Aid and CPR training within ninety days of employment and prior to the expiration date and documentation should be maintained in their staff record file as verification that the employee has completed First Aid and CPR training and maintains a current and valid First Aid and CPR certificate. Today, one staff member’s First Aid and CPR training certification had expired on May 9, 2025 and no updated certificate or documentation of completion was in the file. To maintain compliance with this child care requirement, I suggest you encourage staff members to register for First Aid and CPR training three months prior to the expiration date. 8. Per child care rule 10A NCAC 09. 0514(b), a statement signed and dated by each parent acknowledging the receipt and discussion of the operational policies on or before the first day of attendance and written notice of changes should be on file for each child. To maintain compliance with this child care requirement, I suggested that when changes are made to the operational policies, you provide written notice to each parent of the operational policy change and have the parent sign and date an acknowledgement statement that they received written notice of the operational policy change. I also suggested that you add the updated operational policies to the parent handbook to be given to new enrolling families prior to the first day of attendance and continue securing a parent signature and date from the parent on the acknowledgement form that you include in your enrollment packets. CONSULTATION: 1. On the Emergency Medical Care (EMC) Plan, at least one of the persons listed as the responsible person or the alternate person for each of the assigned tasks must be on-site at all times. 2. When and if you update your fire evacuation route, shelter-in-place, and/or lock-down drill plan, you need to have the fire department approve the your plan first BEFORE you put it in your EPR plan as an update. 3. On July 1, 2025, the North Carolina Rules Review Commission (RRC) approved the new child care rule language for the QRIS Modernization Plan, known as “Pathways to the Stars”. The Division of Child Development and Early Education is currently preparing a summary of the rules, an online training module for Moodle, and an implementation plan. Child care consultants will be conducting center administrator and FCCH owner/operator training/meetings in September 2025 as the next step for implementing the plan to transition to the “Pathways to the Stars”. The implementation plan will allow time for administrators and operators to learn and understand the different pathways and the changes within our system. An invitation and announcement of the date, time, and location for these important meetings will be shared as soon as details are finalized. Please make plans to attend. Please be reminded that any ERS assessment completed on or after February 1, 2025 will be assessed using the ERS-3 versions. We encourage you to visit the QRIS Modernization page on the DCDEE website at this link: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization to learn more now. 4. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. 5. Here are some important links on the DCEEE website that may be helpful: Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Licensing/Getting-a-License Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development QRIS Modernization Plan resources: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings Healthy Social Behaviors: https://www.childcarerrnc.org/special-projects/healthy-social-behaviors/. Healthy Social Behaviors Helpline: Call at 1-704-376-6697 or toll free at 1-888-600-1685 Option 1 or email at sbrawley@childcareresourcesinc.org or jbyrd@childcareresources.org. Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New 6. Here is the link to the Children’s Resource Center training calendar: https://childrensresourcecenter.org/training-calendar/. 7. If you would like an electronic link to any of the links shared above, please send me an email requesting the links that you’d wish to receive, and I will be glad to send the hyperlinks to you by email. COMPLIANCE PLAN: No compliance documentation is needed for violation item numbers 808 and 1897 corrected during today’s visit. I documented the corrective actions taken today to correct those violations in this visit summary. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. I must receive your compliance letter no later than September 3, 2025. Please be aware any information submitted by you is legal documentation. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
10A NCAC 09 .0605 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 8/20/2025 Number Present: 46 Completed Date: 8/20/2025 Age: From 0 To 5 Total Minutes: 441 Time In: 09:10 AM Time Out: 12:59 PM Time In: 01:58 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Teri Knollhoff, Administrator, assisted me with today’s visit. I conducted your last annual compliance visit on September 4, 2024. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, web address or corporate contact for the facility. I reviewed the facility’s permit with you today including the restrictions, capacity, and age range and observed these being maintained today. Toddler's Cove Academy Inc that owns your facility was reviewed and listed as current-active on the North Carolina Secretary of State website on August 19, 2025 and was reviewed with you today. Your center's compliance history was 82% as of August 19, 2025 and was reviewed with you today. Your program currently operates with a three-star license, issued on April 8, 2023, earning four points in staff education, two points in program standards, and one quality point for a combined turnover rate of 20% or less for Administrator, Lead Teacher, Teacher, and Group Leader. Your most recent fire inspection was dated May 21, 2025 and received in my office by email on May 21, 2025. Your most recent sanitation inspection was dated June 6, 2025 with an approved classification and three demerits. I verified that the lead water testing required to be completed every three years was completed. Your most recent lead water test results dated August 6, 2024 indicated that the facility’s drinking water source was within the required limits. I verified that you have completed the enrollment process for the lead-based paint testing and are exempt from those tests. I verified that you completed the enrollment process for asbestos testing and are exempt from those tests. You and I visited each licensed indoor and outdoor space today. You stated that Space 4 was currently closed due to enrollment and staffing, and Playground 2 was currently not being used due to Space 4 being temporarily closed. Children were playing in activity areas, transitioning from outdoors to indoors, participating in whole group language activity, eating lunch, napping, attending to personal care needs and departing. Infant age children were playing on the floor, napping, eating lunch, and interacting with staff. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Today’s lunch met the meal pattern requirements. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of thirty-seven degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at thirty-five degrees Fahrenheit in Space 1. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, and staff record files. Your written operational, administrative, and personnel policies and your parent participation plan were reviewed during a routine unannounced visit on February 12, 2025. Today, you stated that your written operational policies were updated on July 8, 2025. I verified this change was documented on a memo given to and signed by both currently enrolled parents and newly enrolled parents. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. The following violations were observed and cited during today's visit: Violation Number Comment Rule 808 The child care center premises, including the outdoor learning environment, was not clean, drained to minimize standing water, free of litter and hazards, and/or maintained in a manner which does not create conditions that attract or harbor pests. On Playground 2, one water table with a broken lid and one dump truck had standing water in them. 15A NCAC 18A .2832(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. The First Aid training for one staff member with a date of employment of 04/24/2023 had expired on 05/09/2025. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. The CPR training for one staff member with a date of employment of 04/24/2023 had expired on 05/09/2025. .1102(d) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member with a date of employment of 04/24/2023 who was required to complete twenty hours of on-going training had completed some on-going training from an unapproved training agency and had not completed twenty hours as required. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. The acknowledgement statement for written notification of operational policy changes was not on file for one child with a date of enrollment of 07/01/2024. 10A NCAC 09 .0514(b) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. A staff roster was not established in the ABCMS portal to notify DCDEE of current and new staff member employment. G.S. 110-90.2 & .2703(r) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. The EPR Plan was updated on 06/09/2025 but had not been reviewed with eleven out of twelve staff members. .0607(f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. On Playground 1, the rubber mulch and pea gravel surfacing measured less than one inch to seven inches within the fall zone of the composite structure and the spring rockers. .0605(k)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One staff member with a date of employment of 01/21/2025 completed Recognizing and Responding to Suspicions of Child Maltreatment training on 04/27/2025 rather than 04/21/2025 as required. .1102(g) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 . 1102(g), each child care administrator and all staff should complete the Recognizing and Responding to Suspicions of Child Maltreatment (R&R) training through the NC Prevent Child Abuse website and/or present the administrator with the completion certificate within the first ninety days of employment. Today, I observed one staff member with a date of employment of 01/21/2025 had completed R&R training on 04/27/2025 but the training was due by 04/21/2025. Because the training was completed prior to today’s visit, the violation was considered corrected during the visit. I suggested you create a tracking tool that assists you in keeping up with the required training due dates for each of your employees. Please let me know if you need assistance with developing a tracking tool. 2. As stated in G.S. 110-90.2 & .2703(r), child care operators have five business days to notify the Division of any new child care providers working who were hired or moved into the child care facility. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. The compliance of this rule will be monitored during your next visit. Prior to today’s visit, I observed that a staff roster for this facility had not been established on the ABCMS Provider Portal listing currently employed staff members as being hired by this facility. To correct this violation, you will need both an Individual NCID and a Business NCID. You will need an email address for your Individual NCID and a different email address for your Business NCID account. Once you have created your Business NCID, complete the ABCMS Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given to you, you must verify your facility roster to ensure current staff or current FCCH residents are noted on the roster. To maintain compliance with this child care requirement, this information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. These actions satisfy the requirement to notify the Division within five business days of new child care providers working who were hired or moved into the child care facility. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance, please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. 3. Per sanitation rule 15A NCAC 18A.2832(a), the child care center premises, including the outdoor learning environment, should be clean, drained to minimize standing water, free of litter and hazards and/or maintained in a manner which does not create conditions that attract or harbor pests. On Playground 2 which is currently not being used, one water table with a broken lid and one dump truck had standing water in them. Today, the administrator dumped the water out of the water table and the dump truck and turned the dump trucks upside down to prevent water from collecting in the future. These actions corrected this violation during today’s visit. To maintain compliance with this child care requirement, I suggested you remind staff to keep water tables covered and dump trucks turned upside down. 4. Per child care rule 10A NCAC 09 .0605(k)(1-4), the depth of the loose surfacing should be based on the critical height of the equipment. To maintain compliance with this child care requirement, I suggested you replenish the rubber mulch and pea gravel combination under and around the stationary composite play structure and the spring rockers on Playground 1 to a depth of six inches within fall zone extending six feet from the composite structure in all directions and three feet from the spring rockers in all directions. 5. Per child care rule 10A NCAC 09 .0607(f), all staff should review the center's Emergency Preparedness Response (EPR) with the trained staff during orientation, on an annual basis, or when the plan is updated for any reason. Documentation of the initial and the annual review should be maintained on file. During today’s visit, I observed the EPR Plan had been updated on June 9, 2025. However, there was no documentation on file that included staff signature and date that could be used to verify that the plan had been reviewed with staff to date. To maintain compliance with this child care requirement, I suggested you sit down as a staff group and review the EPR Plan with each staff member as soon as possible and have them sign and date a statement or roster as documentation that the plan was reviewed. 6. Per child care rule 10A NCAC 09 .1103 (a), after the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, should complete on-going training activities each year from training agencies approved by DCDEE. The number of required on-going training hours is calculated based on the staff member’s education, experience, and number of hours worked weekly. To maintain compliance with this child care requirement, I suggested you encourage your staff to complete on-going training from DCDEE approved agencies only. Many free approved training opportunities are available through DCDEE Moodle, NCRLAP, and NC Health and Safety Resource Center. 7. Per child care rule 10A NCAC 09 .1102(c)(d), each employee should complete First Aid and CPR training within ninety days of employment and prior to the expiration date and documentation should be maintained in their staff record file as verification that the employee has completed First Aid and CPR training and maintains a current and valid First Aid and CPR certificate. Today, one staff member’s First Aid and CPR training certification had expired on May 9, 2025 and no updated certificate or documentation of completion was in the file. To maintain compliance with this child care requirement, I suggest you encourage staff members to register for First Aid and CPR training three months prior to the expiration date. 8. Per child care rule 10A NCAC 09. 0514(b), a statement signed and dated by each parent acknowledging the receipt and discussion of the operational policies on or before the first day of attendance and written notice of changes should be on file for each child. To maintain compliance with this child care requirement, I suggested that when changes are made to the operational policies, you provide written notice to each parent of the operational policy change and have the parent sign and date an acknowledgement statement that they received written notice of the operational policy change. I also suggested that you add the updated operational policies to the parent handbook to be given to new enrolling families prior to the first day of attendance and continue securing a parent signature and date from the parent on the acknowledgement form that you include in your enrollment packets. CONSULTATION: 1. On the Emergency Medical Care (EMC) Plan, at least one of the persons listed as the responsible person or the alternate person for each of the assigned tasks must be on-site at all times. 2. When and if you update your fire evacuation route, shelter-in-place, and/or lock-down drill plan, you need to have the fire department approve the your plan first BEFORE you put it in your EPR plan as an update. 3. On July 1, 2025, the North Carolina Rules Review Commission (RRC) approved the new child care rule language for the QRIS Modernization Plan, known as “Pathways to the Stars”. The Division of Child Development and Early Education is currently preparing a summary of the rules, an online training module for Moodle, and an implementation plan. Child care consultants will be conducting center administrator and FCCH owner/operator training/meetings in September 2025 as the next step for implementing the plan to transition to the “Pathways to the Stars”. The implementation plan will allow time for administrators and operators to learn and understand the different pathways and the changes within our system. An invitation and announcement of the date, time, and location for these important meetings will be shared as soon as details are finalized. Please make plans to attend. Please be reminded that any ERS assessment completed on or after February 1, 2025 will be assessed using the ERS-3 versions. We encourage you to visit the QRIS Modernization page on the DCDEE website at this link: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization to learn more now. 4. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. 5. Here are some important links on the DCEEE website that may be helpful: Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Licensing/Getting-a-License Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development QRIS Modernization Plan resources: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings Healthy Social Behaviors: https://www.childcarerrnc.org/special-projects/healthy-social-behaviors/. Healthy Social Behaviors Helpline: Call at 1-704-376-6697 or toll free at 1-888-600-1685 Option 1 or email at sbrawley@childcareresourcesinc.org or jbyrd@childcareresources.org. Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New 6. Here is the link to the Children’s Resource Center training calendar: https://childrensresourcecenter.org/training-calendar/. 7. If you would like an electronic link to any of the links shared above, please send me an email requesting the links that you’d wish to receive, and I will be glad to send the hyperlinks to you by email. COMPLIANCE PLAN: No compliance documentation is needed for violation item numbers 808 and 1897 corrected during today’s visit. I documented the corrective actions taken today to correct those violations in this visit summary. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. I must receive your compliance letter no later than September 3, 2025. Please be aware any information submitted by you is legal documentation. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
10A NCAC 09 .0607 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 8/20/2025 Number Present: 46 Completed Date: 8/20/2025 Age: From 0 To 5 Total Minutes: 441 Time In: 09:10 AM Time Out: 12:59 PM Time In: 01:58 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Teri Knollhoff, Administrator, assisted me with today’s visit. I conducted your last annual compliance visit on September 4, 2024. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, web address or corporate contact for the facility. I reviewed the facility’s permit with you today including the restrictions, capacity, and age range and observed these being maintained today. Toddler's Cove Academy Inc that owns your facility was reviewed and listed as current-active on the North Carolina Secretary of State website on August 19, 2025 and was reviewed with you today. Your center's compliance history was 82% as of August 19, 2025 and was reviewed with you today. Your program currently operates with a three-star license, issued on April 8, 2023, earning four points in staff education, two points in program standards, and one quality point for a combined turnover rate of 20% or less for Administrator, Lead Teacher, Teacher, and Group Leader. Your most recent fire inspection was dated May 21, 2025 and received in my office by email on May 21, 2025. Your most recent sanitation inspection was dated June 6, 2025 with an approved classification and three demerits. I verified that the lead water testing required to be completed every three years was completed. Your most recent lead water test results dated August 6, 2024 indicated that the facility’s drinking water source was within the required limits. I verified that you have completed the enrollment process for the lead-based paint testing and are exempt from those tests. I verified that you completed the enrollment process for asbestos testing and are exempt from those tests. You and I visited each licensed indoor and outdoor space today. You stated that Space 4 was currently closed due to enrollment and staffing, and Playground 2 was currently not being used due to Space 4 being temporarily closed. Children were playing in activity areas, transitioning from outdoors to indoors, participating in whole group language activity, eating lunch, napping, attending to personal care needs and departing. Infant age children were playing on the floor, napping, eating lunch, and interacting with staff. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Today’s lunch met the meal pattern requirements. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of thirty-seven degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at thirty-five degrees Fahrenheit in Space 1. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, and staff record files. Your written operational, administrative, and personnel policies and your parent participation plan were reviewed during a routine unannounced visit on February 12, 2025. Today, you stated that your written operational policies were updated on July 8, 2025. I verified this change was documented on a memo given to and signed by both currently enrolled parents and newly enrolled parents. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. The following violations were observed and cited during today's visit: Violation Number Comment Rule 808 The child care center premises, including the outdoor learning environment, was not clean, drained to minimize standing water, free of litter and hazards, and/or maintained in a manner which does not create conditions that attract or harbor pests. On Playground 2, one water table with a broken lid and one dump truck had standing water in them. 15A NCAC 18A .2832(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. The First Aid training for one staff member with a date of employment of 04/24/2023 had expired on 05/09/2025. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. The CPR training for one staff member with a date of employment of 04/24/2023 had expired on 05/09/2025. .1102(d) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member with a date of employment of 04/24/2023 who was required to complete twenty hours of on-going training had completed some on-going training from an unapproved training agency and had not completed twenty hours as required. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. The acknowledgement statement for written notification of operational policy changes was not on file for one child with a date of enrollment of 07/01/2024. 10A NCAC 09 .0514(b) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. A staff roster was not established in the ABCMS portal to notify DCDEE of current and new staff member employment. G.S. 110-90.2 & .2703(r) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. The EPR Plan was updated on 06/09/2025 but had not been reviewed with eleven out of twelve staff members. .0607(f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. On Playground 1, the rubber mulch and pea gravel surfacing measured less than one inch to seven inches within the fall zone of the composite structure and the spring rockers. .0605(k)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One staff member with a date of employment of 01/21/2025 completed Recognizing and Responding to Suspicions of Child Maltreatment training on 04/27/2025 rather than 04/21/2025 as required. .1102(g) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 . 1102(g), each child care administrator and all staff should complete the Recognizing and Responding to Suspicions of Child Maltreatment (R&R) training through the NC Prevent Child Abuse website and/or present the administrator with the completion certificate within the first ninety days of employment. Today, I observed one staff member with a date of employment of 01/21/2025 had completed R&R training on 04/27/2025 but the training was due by 04/21/2025. Because the training was completed prior to today’s visit, the violation was considered corrected during the visit. I suggested you create a tracking tool that assists you in keeping up with the required training due dates for each of your employees. Please let me know if you need assistance with developing a tracking tool. 2. As stated in G.S. 110-90.2 & .2703(r), child care operators have five business days to notify the Division of any new child care providers working who were hired or moved into the child care facility. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. The compliance of this rule will be monitored during your next visit. Prior to today’s visit, I observed that a staff roster for this facility had not been established on the ABCMS Provider Portal listing currently employed staff members as being hired by this facility. To correct this violation, you will need both an Individual NCID and a Business NCID. You will need an email address for your Individual NCID and a different email address for your Business NCID account. Once you have created your Business NCID, complete the ABCMS Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given to you, you must verify your facility roster to ensure current staff or current FCCH residents are noted on the roster. To maintain compliance with this child care requirement, this information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. These actions satisfy the requirement to notify the Division within five business days of new child care providers working who were hired or moved into the child care facility. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance, please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. 3. Per sanitation rule 15A NCAC 18A.2832(a), the child care center premises, including the outdoor learning environment, should be clean, drained to minimize standing water, free of litter and hazards and/or maintained in a manner which does not create conditions that attract or harbor pests. On Playground 2 which is currently not being used, one water table with a broken lid and one dump truck had standing water in them. Today, the administrator dumped the water out of the water table and the dump truck and turned the dump trucks upside down to prevent water from collecting in the future. These actions corrected this violation during today’s visit. To maintain compliance with this child care requirement, I suggested you remind staff to keep water tables covered and dump trucks turned upside down. 4. Per child care rule 10A NCAC 09 .0605(k)(1-4), the depth of the loose surfacing should be based on the critical height of the equipment. To maintain compliance with this child care requirement, I suggested you replenish the rubber mulch and pea gravel combination under and around the stationary composite play structure and the spring rockers on Playground 1 to a depth of six inches within fall zone extending six feet from the composite structure in all directions and three feet from the spring rockers in all directions. 5. Per child care rule 10A NCAC 09 .0607(f), all staff should review the center's Emergency Preparedness Response (EPR) with the trained staff during orientation, on an annual basis, or when the plan is updated for any reason. Documentation of the initial and the annual review should be maintained on file. During today’s visit, I observed the EPR Plan had been updated on June 9, 2025. However, there was no documentation on file that included staff signature and date that could be used to verify that the plan had been reviewed with staff to date. To maintain compliance with this child care requirement, I suggested you sit down as a staff group and review the EPR Plan with each staff member as soon as possible and have them sign and date a statement or roster as documentation that the plan was reviewed. 6. Per child care rule 10A NCAC 09 .1103 (a), after the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, should complete on-going training activities each year from training agencies approved by DCDEE. The number of required on-going training hours is calculated based on the staff member’s education, experience, and number of hours worked weekly. To maintain compliance with this child care requirement, I suggested you encourage your staff to complete on-going training from DCDEE approved agencies only. Many free approved training opportunities are available through DCDEE Moodle, NCRLAP, and NC Health and Safety Resource Center. 7. Per child care rule 10A NCAC 09 .1102(c)(d), each employee should complete First Aid and CPR training within ninety days of employment and prior to the expiration date and documentation should be maintained in their staff record file as verification that the employee has completed First Aid and CPR training and maintains a current and valid First Aid and CPR certificate. Today, one staff member’s First Aid and CPR training certification had expired on May 9, 2025 and no updated certificate or documentation of completion was in the file. To maintain compliance with this child care requirement, I suggest you encourage staff members to register for First Aid and CPR training three months prior to the expiration date. 8. Per child care rule 10A NCAC 09. 0514(b), a statement signed and dated by each parent acknowledging the receipt and discussion of the operational policies on or before the first day of attendance and written notice of changes should be on file for each child. To maintain compliance with this child care requirement, I suggested that when changes are made to the operational policies, you provide written notice to each parent of the operational policy change and have the parent sign and date an acknowledgement statement that they received written notice of the operational policy change. I also suggested that you add the updated operational policies to the parent handbook to be given to new enrolling families prior to the first day of attendance and continue securing a parent signature and date from the parent on the acknowledgement form that you include in your enrollment packets. CONSULTATION: 1. On the Emergency Medical Care (EMC) Plan, at least one of the persons listed as the responsible person or the alternate person for each of the assigned tasks must be on-site at all times. 2. When and if you update your fire evacuation route, shelter-in-place, and/or lock-down drill plan, you need to have the fire department approve the your plan first BEFORE you put it in your EPR plan as an update. 3. On July 1, 2025, the North Carolina Rules Review Commission (RRC) approved the new child care rule language for the QRIS Modernization Plan, known as “Pathways to the Stars”. The Division of Child Development and Early Education is currently preparing a summary of the rules, an online training module for Moodle, and an implementation plan. Child care consultants will be conducting center administrator and FCCH owner/operator training/meetings in September 2025 as the next step for implementing the plan to transition to the “Pathways to the Stars”. The implementation plan will allow time for administrators and operators to learn and understand the different pathways and the changes within our system. An invitation and announcement of the date, time, and location for these important meetings will be shared as soon as details are finalized. Please make plans to attend. Please be reminded that any ERS assessment completed on or after February 1, 2025 will be assessed using the ERS-3 versions. We encourage you to visit the QRIS Modernization page on the DCDEE website at this link: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization to learn more now. 4. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. 5. Here are some important links on the DCEEE website that may be helpful: Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Licensing/Getting-a-License Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development QRIS Modernization Plan resources: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings Healthy Social Behaviors: https://www.childcarerrnc.org/special-projects/healthy-social-behaviors/. Healthy Social Behaviors Helpline: Call at 1-704-376-6697 or toll free at 1-888-600-1685 Option 1 or email at sbrawley@childcareresourcesinc.org or jbyrd@childcareresources.org. Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New 6. Here is the link to the Children’s Resource Center training calendar: https://childrensresourcecenter.org/training-calendar/. 7. If you would like an electronic link to any of the links shared above, please send me an email requesting the links that you’d wish to receive, and I will be glad to send the hyperlinks to you by email. COMPLIANCE PLAN: No compliance documentation is needed for violation item numbers 808 and 1897 corrected during today’s visit. I documented the corrective actions taken today to correct those violations in this visit summary. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. I must receive your compliance letter no later than September 3, 2025. Please be aware any information submitted by you is legal documentation. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
10A NCAC 09 .1102 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 8/20/2025 Number Present: 46 Completed Date: 8/20/2025 Age: From 0 To 5 Total Minutes: 441 Time In: 09:10 AM Time Out: 12:59 PM Time In: 01:58 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Teri Knollhoff, Administrator, assisted me with today’s visit. I conducted your last annual compliance visit on September 4, 2024. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, web address or corporate contact for the facility. I reviewed the facility’s permit with you today including the restrictions, capacity, and age range and observed these being maintained today. Toddler's Cove Academy Inc that owns your facility was reviewed and listed as current-active on the North Carolina Secretary of State website on August 19, 2025 and was reviewed with you today. Your center's compliance history was 82% as of August 19, 2025 and was reviewed with you today. Your program currently operates with a three-star license, issued on April 8, 2023, earning four points in staff education, two points in program standards, and one quality point for a combined turnover rate of 20% or less for Administrator, Lead Teacher, Teacher, and Group Leader. Your most recent fire inspection was dated May 21, 2025 and received in my office by email on May 21, 2025. Your most recent sanitation inspection was dated June 6, 2025 with an approved classification and three demerits. I verified that the lead water testing required to be completed every three years was completed. Your most recent lead water test results dated August 6, 2024 indicated that the facility’s drinking water source was within the required limits. I verified that you have completed the enrollment process for the lead-based paint testing and are exempt from those tests. I verified that you completed the enrollment process for asbestos testing and are exempt from those tests. You and I visited each licensed indoor and outdoor space today. You stated that Space 4 was currently closed due to enrollment and staffing, and Playground 2 was currently not being used due to Space 4 being temporarily closed. Children were playing in activity areas, transitioning from outdoors to indoors, participating in whole group language activity, eating lunch, napping, attending to personal care needs and departing. Infant age children were playing on the floor, napping, eating lunch, and interacting with staff. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Today’s lunch met the meal pattern requirements. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of thirty-seven degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at thirty-five degrees Fahrenheit in Space 1. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, and staff record files. Your written operational, administrative, and personnel policies and your parent participation plan were reviewed during a routine unannounced visit on February 12, 2025. Today, you stated that your written operational policies were updated on July 8, 2025. I verified this change was documented on a memo given to and signed by both currently enrolled parents and newly enrolled parents. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. The following violations were observed and cited during today's visit: Violation Number Comment Rule 808 The child care center premises, including the outdoor learning environment, was not clean, drained to minimize standing water, free of litter and hazards, and/or maintained in a manner which does not create conditions that attract or harbor pests. On Playground 2, one water table with a broken lid and one dump truck had standing water in them. 15A NCAC 18A .2832(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. The First Aid training for one staff member with a date of employment of 04/24/2023 had expired on 05/09/2025. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. The CPR training for one staff member with a date of employment of 04/24/2023 had expired on 05/09/2025. .1102(d) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member with a date of employment of 04/24/2023 who was required to complete twenty hours of on-going training had completed some on-going training from an unapproved training agency and had not completed twenty hours as required. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. The acknowledgement statement for written notification of operational policy changes was not on file for one child with a date of enrollment of 07/01/2024. 10A NCAC 09 .0514(b) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. A staff roster was not established in the ABCMS portal to notify DCDEE of current and new staff member employment. G.S. 110-90.2 & .2703(r) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. The EPR Plan was updated on 06/09/2025 but had not been reviewed with eleven out of twelve staff members. .0607(f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. On Playground 1, the rubber mulch and pea gravel surfacing measured less than one inch to seven inches within the fall zone of the composite structure and the spring rockers. .0605(k)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One staff member with a date of employment of 01/21/2025 completed Recognizing and Responding to Suspicions of Child Maltreatment training on 04/27/2025 rather than 04/21/2025 as required. .1102(g) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 . 1102(g), each child care administrator and all staff should complete the Recognizing and Responding to Suspicions of Child Maltreatment (R&R) training through the NC Prevent Child Abuse website and/or present the administrator with the completion certificate within the first ninety days of employment. Today, I observed one staff member with a date of employment of 01/21/2025 had completed R&R training on 04/27/2025 but the training was due by 04/21/2025. Because the training was completed prior to today’s visit, the violation was considered corrected during the visit. I suggested you create a tracking tool that assists you in keeping up with the required training due dates for each of your employees. Please let me know if you need assistance with developing a tracking tool. 2. As stated in G.S. 110-90.2 & .2703(r), child care operators have five business days to notify the Division of any new child care providers working who were hired or moved into the child care facility. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. The compliance of this rule will be monitored during your next visit. Prior to today’s visit, I observed that a staff roster for this facility had not been established on the ABCMS Provider Portal listing currently employed staff members as being hired by this facility. To correct this violation, you will need both an Individual NCID and a Business NCID. You will need an email address for your Individual NCID and a different email address for your Business NCID account. Once you have created your Business NCID, complete the ABCMS Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given to you, you must verify your facility roster to ensure current staff or current FCCH residents are noted on the roster. To maintain compliance with this child care requirement, this information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. These actions satisfy the requirement to notify the Division within five business days of new child care providers working who were hired or moved into the child care facility. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance, please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. 3. Per sanitation rule 15A NCAC 18A.2832(a), the child care center premises, including the outdoor learning environment, should be clean, drained to minimize standing water, free of litter and hazards and/or maintained in a manner which does not create conditions that attract or harbor pests. On Playground 2 which is currently not being used, one water table with a broken lid and one dump truck had standing water in them. Today, the administrator dumped the water out of the water table and the dump truck and turned the dump trucks upside down to prevent water from collecting in the future. These actions corrected this violation during today’s visit. To maintain compliance with this child care requirement, I suggested you remind staff to keep water tables covered and dump trucks turned upside down. 4. Per child care rule 10A NCAC 09 .0605(k)(1-4), the depth of the loose surfacing should be based on the critical height of the equipment. To maintain compliance with this child care requirement, I suggested you replenish the rubber mulch and pea gravel combination under and around the stationary composite play structure and the spring rockers on Playground 1 to a depth of six inches within fall zone extending six feet from the composite structure in all directions and three feet from the spring rockers in all directions. 5. Per child care rule 10A NCAC 09 .0607(f), all staff should review the center's Emergency Preparedness Response (EPR) with the trained staff during orientation, on an annual basis, or when the plan is updated for any reason. Documentation of the initial and the annual review should be maintained on file. During today’s visit, I observed the EPR Plan had been updated on June 9, 2025. However, there was no documentation on file that included staff signature and date that could be used to verify that the plan had been reviewed with staff to date. To maintain compliance with this child care requirement, I suggested you sit down as a staff group and review the EPR Plan with each staff member as soon as possible and have them sign and date a statement or roster as documentation that the plan was reviewed. 6. Per child care rule 10A NCAC 09 .1103 (a), after the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, should complete on-going training activities each year from training agencies approved by DCDEE. The number of required on-going training hours is calculated based on the staff member’s education, experience, and number of hours worked weekly. To maintain compliance with this child care requirement, I suggested you encourage your staff to complete on-going training from DCDEE approved agencies only. Many free approved training opportunities are available through DCDEE Moodle, NCRLAP, and NC Health and Safety Resource Center. 7. Per child care rule 10A NCAC 09 .1102(c)(d), each employee should complete First Aid and CPR training within ninety days of employment and prior to the expiration date and documentation should be maintained in their staff record file as verification that the employee has completed First Aid and CPR training and maintains a current and valid First Aid and CPR certificate. Today, one staff member’s First Aid and CPR training certification had expired on May 9, 2025 and no updated certificate or documentation of completion was in the file. To maintain compliance with this child care requirement, I suggest you encourage staff members to register for First Aid and CPR training three months prior to the expiration date. 8. Per child care rule 10A NCAC 09. 0514(b), a statement signed and dated by each parent acknowledging the receipt and discussion of the operational policies on or before the first day of attendance and written notice of changes should be on file for each child. To maintain compliance with this child care requirement, I suggested that when changes are made to the operational policies, you provide written notice to each parent of the operational policy change and have the parent sign and date an acknowledgement statement that they received written notice of the operational policy change. I also suggested that you add the updated operational policies to the parent handbook to be given to new enrolling families prior to the first day of attendance and continue securing a parent signature and date from the parent on the acknowledgement form that you include in your enrollment packets. CONSULTATION: 1. On the Emergency Medical Care (EMC) Plan, at least one of the persons listed as the responsible person or the alternate person for each of the assigned tasks must be on-site at all times. 2. When and if you update your fire evacuation route, shelter-in-place, and/or lock-down drill plan, you need to have the fire department approve the your plan first BEFORE you put it in your EPR plan as an update. 3. On July 1, 2025, the North Carolina Rules Review Commission (RRC) approved the new child care rule language for the QRIS Modernization Plan, known as “Pathways to the Stars”. The Division of Child Development and Early Education is currently preparing a summary of the rules, an online training module for Moodle, and an implementation plan. Child care consultants will be conducting center administrator and FCCH owner/operator training/meetings in September 2025 as the next step for implementing the plan to transition to the “Pathways to the Stars”. The implementation plan will allow time for administrators and operators to learn and understand the different pathways and the changes within our system. An invitation and announcement of the date, time, and location for these important meetings will be shared as soon as details are finalized. Please make plans to attend. Please be reminded that any ERS assessment completed on or after February 1, 2025 will be assessed using the ERS-3 versions. We encourage you to visit the QRIS Modernization page on the DCDEE website at this link: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization to learn more now. 4. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. 5. Here are some important links on the DCEEE website that may be helpful: Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Licensing/Getting-a-License Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development QRIS Modernization Plan resources: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings Healthy Social Behaviors: https://www.childcarerrnc.org/special-projects/healthy-social-behaviors/. Healthy Social Behaviors Helpline: Call at 1-704-376-6697 or toll free at 1-888-600-1685 Option 1 or email at sbrawley@childcareresourcesinc.org or jbyrd@childcareresources.org. Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New 6. Here is the link to the Children’s Resource Center training calendar: https://childrensresourcecenter.org/training-calendar/. 7. If you would like an electronic link to any of the links shared above, please send me an email requesting the links that you’d wish to receive, and I will be glad to send the hyperlinks to you by email. COMPLIANCE PLAN: No compliance documentation is needed for violation item numbers 808 and 1897 corrected during today’s visit. I documented the corrective actions taken today to correct those violations in this visit summary. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. I must receive your compliance letter no later than September 3, 2025. Please be aware any information submitted by you is legal documentation. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
10A NCAC 09 .1103 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 8/20/2025 Number Present: 46 Completed Date: 8/20/2025 Age: From 0 To 5 Total Minutes: 441 Time In: 09:10 AM Time Out: 12:59 PM Time In: 01:58 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Teri Knollhoff, Administrator, assisted me with today’s visit. I conducted your last annual compliance visit on September 4, 2024. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, web address or corporate contact for the facility. I reviewed the facility’s permit with you today including the restrictions, capacity, and age range and observed these being maintained today. Toddler's Cove Academy Inc that owns your facility was reviewed and listed as current-active on the North Carolina Secretary of State website on August 19, 2025 and was reviewed with you today. Your center's compliance history was 82% as of August 19, 2025 and was reviewed with you today. Your program currently operates with a three-star license, issued on April 8, 2023, earning four points in staff education, two points in program standards, and one quality point for a combined turnover rate of 20% or less for Administrator, Lead Teacher, Teacher, and Group Leader. Your most recent fire inspection was dated May 21, 2025 and received in my office by email on May 21, 2025. Your most recent sanitation inspection was dated June 6, 2025 with an approved classification and three demerits. I verified that the lead water testing required to be completed every three years was completed. Your most recent lead water test results dated August 6, 2024 indicated that the facility’s drinking water source was within the required limits. I verified that you have completed the enrollment process for the lead-based paint testing and are exempt from those tests. I verified that you completed the enrollment process for asbestos testing and are exempt from those tests. You and I visited each licensed indoor and outdoor space today. You stated that Space 4 was currently closed due to enrollment and staffing, and Playground 2 was currently not being used due to Space 4 being temporarily closed. Children were playing in activity areas, transitioning from outdoors to indoors, participating in whole group language activity, eating lunch, napping, attending to personal care needs and departing. Infant age children were playing on the floor, napping, eating lunch, and interacting with staff. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Today’s lunch met the meal pattern requirements. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of thirty-seven degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at thirty-five degrees Fahrenheit in Space 1. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, and staff record files. Your written operational, administrative, and personnel policies and your parent participation plan were reviewed during a routine unannounced visit on February 12, 2025. Today, you stated that your written operational policies were updated on July 8, 2025. I verified this change was documented on a memo given to and signed by both currently enrolled parents and newly enrolled parents. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. The following violations were observed and cited during today's visit: Violation Number Comment Rule 808 The child care center premises, including the outdoor learning environment, was not clean, drained to minimize standing water, free of litter and hazards, and/or maintained in a manner which does not create conditions that attract or harbor pests. On Playground 2, one water table with a broken lid and one dump truck had standing water in them. 15A NCAC 18A .2832(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. The First Aid training for one staff member with a date of employment of 04/24/2023 had expired on 05/09/2025. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. The CPR training for one staff member with a date of employment of 04/24/2023 had expired on 05/09/2025. .1102(d) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member with a date of employment of 04/24/2023 who was required to complete twenty hours of on-going training had completed some on-going training from an unapproved training agency and had not completed twenty hours as required. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. The acknowledgement statement for written notification of operational policy changes was not on file for one child with a date of enrollment of 07/01/2024. 10A NCAC 09 .0514(b) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. A staff roster was not established in the ABCMS portal to notify DCDEE of current and new staff member employment. G.S. 110-90.2 & .2703(r) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. The EPR Plan was updated on 06/09/2025 but had not been reviewed with eleven out of twelve staff members. .0607(f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. On Playground 1, the rubber mulch and pea gravel surfacing measured less than one inch to seven inches within the fall zone of the composite structure and the spring rockers. .0605(k)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One staff member with a date of employment of 01/21/2025 completed Recognizing and Responding to Suspicions of Child Maltreatment training on 04/27/2025 rather than 04/21/2025 as required. .1102(g) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 . 1102(g), each child care administrator and all staff should complete the Recognizing and Responding to Suspicions of Child Maltreatment (R&R) training through the NC Prevent Child Abuse website and/or present the administrator with the completion certificate within the first ninety days of employment. Today, I observed one staff member with a date of employment of 01/21/2025 had completed R&R training on 04/27/2025 but the training was due by 04/21/2025. Because the training was completed prior to today’s visit, the violation was considered corrected during the visit. I suggested you create a tracking tool that assists you in keeping up with the required training due dates for each of your employees. Please let me know if you need assistance with developing a tracking tool. 2. As stated in G.S. 110-90.2 & .2703(r), child care operators have five business days to notify the Division of any new child care providers working who were hired or moved into the child care facility. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. The compliance of this rule will be monitored during your next visit. Prior to today’s visit, I observed that a staff roster for this facility had not been established on the ABCMS Provider Portal listing currently employed staff members as being hired by this facility. To correct this violation, you will need both an Individual NCID and a Business NCID. You will need an email address for your Individual NCID and a different email address for your Business NCID account. Once you have created your Business NCID, complete the ABCMS Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given to you, you must verify your facility roster to ensure current staff or current FCCH residents are noted on the roster. To maintain compliance with this child care requirement, this information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. These actions satisfy the requirement to notify the Division within five business days of new child care providers working who were hired or moved into the child care facility. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance, please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. 3. Per sanitation rule 15A NCAC 18A.2832(a), the child care center premises, including the outdoor learning environment, should be clean, drained to minimize standing water, free of litter and hazards and/or maintained in a manner which does not create conditions that attract or harbor pests. On Playground 2 which is currently not being used, one water table with a broken lid and one dump truck had standing water in them. Today, the administrator dumped the water out of the water table and the dump truck and turned the dump trucks upside down to prevent water from collecting in the future. These actions corrected this violation during today’s visit. To maintain compliance with this child care requirement, I suggested you remind staff to keep water tables covered and dump trucks turned upside down. 4. Per child care rule 10A NCAC 09 .0605(k)(1-4), the depth of the loose surfacing should be based on the critical height of the equipment. To maintain compliance with this child care requirement, I suggested you replenish the rubber mulch and pea gravel combination under and around the stationary composite play structure and the spring rockers on Playground 1 to a depth of six inches within fall zone extending six feet from the composite structure in all directions and three feet from the spring rockers in all directions. 5. Per child care rule 10A NCAC 09 .0607(f), all staff should review the center's Emergency Preparedness Response (EPR) with the trained staff during orientation, on an annual basis, or when the plan is updated for any reason. Documentation of the initial and the annual review should be maintained on file. During today’s visit, I observed the EPR Plan had been updated on June 9, 2025. However, there was no documentation on file that included staff signature and date that could be used to verify that the plan had been reviewed with staff to date. To maintain compliance with this child care requirement, I suggested you sit down as a staff group and review the EPR Plan with each staff member as soon as possible and have them sign and date a statement or roster as documentation that the plan was reviewed. 6. Per child care rule 10A NCAC 09 .1103 (a), after the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, should complete on-going training activities each year from training agencies approved by DCDEE. The number of required on-going training hours is calculated based on the staff member’s education, experience, and number of hours worked weekly. To maintain compliance with this child care requirement, I suggested you encourage your staff to complete on-going training from DCDEE approved agencies only. Many free approved training opportunities are available through DCDEE Moodle, NCRLAP, and NC Health and Safety Resource Center. 7. Per child care rule 10A NCAC 09 .1102(c)(d), each employee should complete First Aid and CPR training within ninety days of employment and prior to the expiration date and documentation should be maintained in their staff record file as verification that the employee has completed First Aid and CPR training and maintains a current and valid First Aid and CPR certificate. Today, one staff member’s First Aid and CPR training certification had expired on May 9, 2025 and no updated certificate or documentation of completion was in the file. To maintain compliance with this child care requirement, I suggest you encourage staff members to register for First Aid and CPR training three months prior to the expiration date. 8. Per child care rule 10A NCAC 09. 0514(b), a statement signed and dated by each parent acknowledging the receipt and discussion of the operational policies on or before the first day of attendance and written notice of changes should be on file for each child. To maintain compliance with this child care requirement, I suggested that when changes are made to the operational policies, you provide written notice to each parent of the operational policy change and have the parent sign and date an acknowledgement statement that they received written notice of the operational policy change. I also suggested that you add the updated operational policies to the parent handbook to be given to new enrolling families prior to the first day of attendance and continue securing a parent signature and date from the parent on the acknowledgement form that you include in your enrollment packets. CONSULTATION: 1. On the Emergency Medical Care (EMC) Plan, at least one of the persons listed as the responsible person or the alternate person for each of the assigned tasks must be on-site at all times. 2. When and if you update your fire evacuation route, shelter-in-place, and/or lock-down drill plan, you need to have the fire department approve the your plan first BEFORE you put it in your EPR plan as an update. 3. On July 1, 2025, the North Carolina Rules Review Commission (RRC) approved the new child care rule language for the QRIS Modernization Plan, known as “Pathways to the Stars”. The Division of Child Development and Early Education is currently preparing a summary of the rules, an online training module for Moodle, and an implementation plan. Child care consultants will be conducting center administrator and FCCH owner/operator training/meetings in September 2025 as the next step for implementing the plan to transition to the “Pathways to the Stars”. The implementation plan will allow time for administrators and operators to learn and understand the different pathways and the changes within our system. An invitation and announcement of the date, time, and location for these important meetings will be shared as soon as details are finalized. Please make plans to attend. Please be reminded that any ERS assessment completed on or after February 1, 2025 will be assessed using the ERS-3 versions. We encourage you to visit the QRIS Modernization page on the DCDEE website at this link: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization to learn more now. 4. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. 5. Here are some important links on the DCEEE website that may be helpful: Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Licensing/Getting-a-License Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development QRIS Modernization Plan resources: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings Healthy Social Behaviors: https://www.childcarerrnc.org/special-projects/healthy-social-behaviors/. Healthy Social Behaviors Helpline: Call at 1-704-376-6697 or toll free at 1-888-600-1685 Option 1 or email at sbrawley@childcareresourcesinc.org or jbyrd@childcareresources.org. Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New 6. Here is the link to the Children’s Resource Center training calendar: https://childrensresourcecenter.org/training-calendar/. 7. If you would like an electronic link to any of the links shared above, please send me an email requesting the links that you’d wish to receive, and I will be glad to send the hyperlinks to you by email. COMPLIANCE PLAN: No compliance documentation is needed for violation item numbers 808 and 1897 corrected during today’s visit. I documented the corrective actions taken today to correct those violations in this visit summary. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. I must receive your compliance letter no later than September 3, 2025. Please be aware any information submitted by you is legal documentation. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
10A NCAC 09. 0514 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 8/20/2025 Number Present: 46 Completed Date: 8/20/2025 Age: From 0 To 5 Total Minutes: 441 Time In: 09:10 AM Time Out: 12:59 PM Time In: 01:58 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Teri Knollhoff, Administrator, assisted me with today’s visit. I conducted your last annual compliance visit on September 4, 2024. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, web address or corporate contact for the facility. I reviewed the facility’s permit with you today including the restrictions, capacity, and age range and observed these being maintained today. Toddler's Cove Academy Inc that owns your facility was reviewed and listed as current-active on the North Carolina Secretary of State website on August 19, 2025 and was reviewed with you today. Your center's compliance history was 82% as of August 19, 2025 and was reviewed with you today. Your program currently operates with a three-star license, issued on April 8, 2023, earning four points in staff education, two points in program standards, and one quality point for a combined turnover rate of 20% or less for Administrator, Lead Teacher, Teacher, and Group Leader. Your most recent fire inspection was dated May 21, 2025 and received in my office by email on May 21, 2025. Your most recent sanitation inspection was dated June 6, 2025 with an approved classification and three demerits. I verified that the lead water testing required to be completed every three years was completed. Your most recent lead water test results dated August 6, 2024 indicated that the facility’s drinking water source was within the required limits. I verified that you have completed the enrollment process for the lead-based paint testing and are exempt from those tests. I verified that you completed the enrollment process for asbestos testing and are exempt from those tests. You and I visited each licensed indoor and outdoor space today. You stated that Space 4 was currently closed due to enrollment and staffing, and Playground 2 was currently not being used due to Space 4 being temporarily closed. Children were playing in activity areas, transitioning from outdoors to indoors, participating in whole group language activity, eating lunch, napping, attending to personal care needs and departing. Infant age children were playing on the floor, napping, eating lunch, and interacting with staff. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Today’s lunch met the meal pattern requirements. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of thirty-seven degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at thirty-five degrees Fahrenheit in Space 1. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, and staff record files. Your written operational, administrative, and personnel policies and your parent participation plan were reviewed during a routine unannounced visit on February 12, 2025. Today, you stated that your written operational policies were updated on July 8, 2025. I verified this change was documented on a memo given to and signed by both currently enrolled parents and newly enrolled parents. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. The following violations were observed and cited during today's visit: Violation Number Comment Rule 808 The child care center premises, including the outdoor learning environment, was not clean, drained to minimize standing water, free of litter and hazards, and/or maintained in a manner which does not create conditions that attract or harbor pests. On Playground 2, one water table with a broken lid and one dump truck had standing water in them. 15A NCAC 18A .2832(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. The First Aid training for one staff member with a date of employment of 04/24/2023 had expired on 05/09/2025. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. The CPR training for one staff member with a date of employment of 04/24/2023 had expired on 05/09/2025. .1102(d) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member with a date of employment of 04/24/2023 who was required to complete twenty hours of on-going training had completed some on-going training from an unapproved training agency and had not completed twenty hours as required. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. The acknowledgement statement for written notification of operational policy changes was not on file for one child with a date of enrollment of 07/01/2024. 10A NCAC 09 .0514(b) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. A staff roster was not established in the ABCMS portal to notify DCDEE of current and new staff member employment. G.S. 110-90.2 & .2703(r) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. The EPR Plan was updated on 06/09/2025 but had not been reviewed with eleven out of twelve staff members. .0607(f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. On Playground 1, the rubber mulch and pea gravel surfacing measured less than one inch to seven inches within the fall zone of the composite structure and the spring rockers. .0605(k)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One staff member with a date of employment of 01/21/2025 completed Recognizing and Responding to Suspicions of Child Maltreatment training on 04/27/2025 rather than 04/21/2025 as required. .1102(g) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 . 1102(g), each child care administrator and all staff should complete the Recognizing and Responding to Suspicions of Child Maltreatment (R&R) training through the NC Prevent Child Abuse website and/or present the administrator with the completion certificate within the first ninety days of employment. Today, I observed one staff member with a date of employment of 01/21/2025 had completed R&R training on 04/27/2025 but the training was due by 04/21/2025. Because the training was completed prior to today’s visit, the violation was considered corrected during the visit. I suggested you create a tracking tool that assists you in keeping up with the required training due dates for each of your employees. Please let me know if you need assistance with developing a tracking tool. 2. As stated in G.S. 110-90.2 & .2703(r), child care operators have five business days to notify the Division of any new child care providers working who were hired or moved into the child care facility. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. The compliance of this rule will be monitored during your next visit. Prior to today’s visit, I observed that a staff roster for this facility had not been established on the ABCMS Provider Portal listing currently employed staff members as being hired by this facility. To correct this violation, you will need both an Individual NCID and a Business NCID. You will need an email address for your Individual NCID and a different email address for your Business NCID account. Once you have created your Business NCID, complete the ABCMS Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given to you, you must verify your facility roster to ensure current staff or current FCCH residents are noted on the roster. To maintain compliance with this child care requirement, this information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. These actions satisfy the requirement to notify the Division within five business days of new child care providers working who were hired or moved into the child care facility. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance, please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. 3. Per sanitation rule 15A NCAC 18A.2832(a), the child care center premises, including the outdoor learning environment, should be clean, drained to minimize standing water, free of litter and hazards and/or maintained in a manner which does not create conditions that attract or harbor pests. On Playground 2 which is currently not being used, one water table with a broken lid and one dump truck had standing water in them. Today, the administrator dumped the water out of the water table and the dump truck and turned the dump trucks upside down to prevent water from collecting in the future. These actions corrected this violation during today’s visit. To maintain compliance with this child care requirement, I suggested you remind staff to keep water tables covered and dump trucks turned upside down. 4. Per child care rule 10A NCAC 09 .0605(k)(1-4), the depth of the loose surfacing should be based on the critical height of the equipment. To maintain compliance with this child care requirement, I suggested you replenish the rubber mulch and pea gravel combination under and around the stationary composite play structure and the spring rockers on Playground 1 to a depth of six inches within fall zone extending six feet from the composite structure in all directions and three feet from the spring rockers in all directions. 5. Per child care rule 10A NCAC 09 .0607(f), all staff should review the center's Emergency Preparedness Response (EPR) with the trained staff during orientation, on an annual basis, or when the plan is updated for any reason. Documentation of the initial and the annual review should be maintained on file. During today’s visit, I observed the EPR Plan had been updated on June 9, 2025. However, there was no documentation on file that included staff signature and date that could be used to verify that the plan had been reviewed with staff to date. To maintain compliance with this child care requirement, I suggested you sit down as a staff group and review the EPR Plan with each staff member as soon as possible and have them sign and date a statement or roster as documentation that the plan was reviewed. 6. Per child care rule 10A NCAC 09 .1103 (a), after the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, should complete on-going training activities each year from training agencies approved by DCDEE. The number of required on-going training hours is calculated based on the staff member’s education, experience, and number of hours worked weekly. To maintain compliance with this child care requirement, I suggested you encourage your staff to complete on-going training from DCDEE approved agencies only. Many free approved training opportunities are available through DCDEE Moodle, NCRLAP, and NC Health and Safety Resource Center. 7. Per child care rule 10A NCAC 09 .1102(c)(d), each employee should complete First Aid and CPR training within ninety days of employment and prior to the expiration date and documentation should be maintained in their staff record file as verification that the employee has completed First Aid and CPR training and maintains a current and valid First Aid and CPR certificate. Today, one staff member’s First Aid and CPR training certification had expired on May 9, 2025 and no updated certificate or documentation of completion was in the file. To maintain compliance with this child care requirement, I suggest you encourage staff members to register for First Aid and CPR training three months prior to the expiration date. 8. Per child care rule 10A NCAC 09. 0514(b), a statement signed and dated by each parent acknowledging the receipt and discussion of the operational policies on or before the first day of attendance and written notice of changes should be on file for each child. To maintain compliance with this child care requirement, I suggested that when changes are made to the operational policies, you provide written notice to each parent of the operational policy change and have the parent sign and date an acknowledgement statement that they received written notice of the operational policy change. I also suggested that you add the updated operational policies to the parent handbook to be given to new enrolling families prior to the first day of attendance and continue securing a parent signature and date from the parent on the acknowledgement form that you include in your enrollment packets. CONSULTATION: 1. On the Emergency Medical Care (EMC) Plan, at least one of the persons listed as the responsible person or the alternate person for each of the assigned tasks must be on-site at all times. 2. When and if you update your fire evacuation route, shelter-in-place, and/or lock-down drill plan, you need to have the fire department approve the your plan first BEFORE you put it in your EPR plan as an update. 3. On July 1, 2025, the North Carolina Rules Review Commission (RRC) approved the new child care rule language for the QRIS Modernization Plan, known as “Pathways to the Stars”. The Division of Child Development and Early Education is currently preparing a summary of the rules, an online training module for Moodle, and an implementation plan. Child care consultants will be conducting center administrator and FCCH owner/operator training/meetings in September 2025 as the next step for implementing the plan to transition to the “Pathways to the Stars”. The implementation plan will allow time for administrators and operators to learn and understand the different pathways and the changes within our system. An invitation and announcement of the date, time, and location for these important meetings will be shared as soon as details are finalized. Please make plans to attend. Please be reminded that any ERS assessment completed on or after February 1, 2025 will be assessed using the ERS-3 versions. We encourage you to visit the QRIS Modernization page on the DCDEE website at this link: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization to learn more now. 4. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. 5. Here are some important links on the DCEEE website that may be helpful: Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Licensing/Getting-a-License Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development QRIS Modernization Plan resources: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings Healthy Social Behaviors: https://www.childcarerrnc.org/special-projects/healthy-social-behaviors/. Healthy Social Behaviors Helpline: Call at 1-704-376-6697 or toll free at 1-888-600-1685 Option 1 or email at sbrawley@childcareresourcesinc.org or jbyrd@childcareresources.org. Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New 6. Here is the link to the Children’s Resource Center training calendar: https://childrensresourcecenter.org/training-calendar/. 7. If you would like an electronic link to any of the links shared above, please send me an email requesting the links that you’d wish to receive, and I will be glad to send the hyperlinks to you by email. COMPLIANCE PLAN: No compliance documentation is needed for violation item numbers 808 and 1897 corrected during today’s visit. I documented the corrective actions taken today to correct those violations in this visit summary. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. I must receive your compliance letter no later than September 3, 2025. Please be aware any information submitted by you is legal documentation. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
G.S. 110-90 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 8/20/2025 Number Present: 46 Completed Date: 8/20/2025 Age: From 0 To 5 Total Minutes: 441 Time In: 09:10 AM Time Out: 12:59 PM Time In: 01:58 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Teri Knollhoff, Administrator, assisted me with today’s visit. I conducted your last annual compliance visit on September 4, 2024. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, web address or corporate contact for the facility. I reviewed the facility’s permit with you today including the restrictions, capacity, and age range and observed these being maintained today. Toddler's Cove Academy Inc that owns your facility was reviewed and listed as current-active on the North Carolina Secretary of State website on August 19, 2025 and was reviewed with you today. Your center's compliance history was 82% as of August 19, 2025 and was reviewed with you today. Your program currently operates with a three-star license, issued on April 8, 2023, earning four points in staff education, two points in program standards, and one quality point for a combined turnover rate of 20% or less for Administrator, Lead Teacher, Teacher, and Group Leader. Your most recent fire inspection was dated May 21, 2025 and received in my office by email on May 21, 2025. Your most recent sanitation inspection was dated June 6, 2025 with an approved classification and three demerits. I verified that the lead water testing required to be completed every three years was completed. Your most recent lead water test results dated August 6, 2024 indicated that the facility’s drinking water source was within the required limits. I verified that you have completed the enrollment process for the lead-based paint testing and are exempt from those tests. I verified that you completed the enrollment process for asbestos testing and are exempt from those tests. You and I visited each licensed indoor and outdoor space today. You stated that Space 4 was currently closed due to enrollment and staffing, and Playground 2 was currently not being used due to Space 4 being temporarily closed. Children were playing in activity areas, transitioning from outdoors to indoors, participating in whole group language activity, eating lunch, napping, attending to personal care needs and departing. Infant age children were playing on the floor, napping, eating lunch, and interacting with staff. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Today’s lunch met the meal pattern requirements. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of thirty-seven degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at thirty-five degrees Fahrenheit in Space 1. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, and staff record files. Your written operational, administrative, and personnel policies and your parent participation plan were reviewed during a routine unannounced visit on February 12, 2025. Today, you stated that your written operational policies were updated on July 8, 2025. I verified this change was documented on a memo given to and signed by both currently enrolled parents and newly enrolled parents. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. The following violations were observed and cited during today's visit: Violation Number Comment Rule 808 The child care center premises, including the outdoor learning environment, was not clean, drained to minimize standing water, free of litter and hazards, and/or maintained in a manner which does not create conditions that attract or harbor pests. On Playground 2, one water table with a broken lid and one dump truck had standing water in them. 15A NCAC 18A .2832(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. The First Aid training for one staff member with a date of employment of 04/24/2023 had expired on 05/09/2025. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. The CPR training for one staff member with a date of employment of 04/24/2023 had expired on 05/09/2025. .1102(d) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member with a date of employment of 04/24/2023 who was required to complete twenty hours of on-going training had completed some on-going training from an unapproved training agency and had not completed twenty hours as required. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. The acknowledgement statement for written notification of operational policy changes was not on file for one child with a date of enrollment of 07/01/2024. 10A NCAC 09 .0514(b) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. A staff roster was not established in the ABCMS portal to notify DCDEE of current and new staff member employment. G.S. 110-90.2 & .2703(r) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. The EPR Plan was updated on 06/09/2025 but had not been reviewed with eleven out of twelve staff members. .0607(f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. On Playground 1, the rubber mulch and pea gravel surfacing measured less than one inch to seven inches within the fall zone of the composite structure and the spring rockers. .0605(k)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One staff member with a date of employment of 01/21/2025 completed Recognizing and Responding to Suspicions of Child Maltreatment training on 04/27/2025 rather than 04/21/2025 as required. .1102(g) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 . 1102(g), each child care administrator and all staff should complete the Recognizing and Responding to Suspicions of Child Maltreatment (R&R) training through the NC Prevent Child Abuse website and/or present the administrator with the completion certificate within the first ninety days of employment. Today, I observed one staff member with a date of employment of 01/21/2025 had completed R&R training on 04/27/2025 but the training was due by 04/21/2025. Because the training was completed prior to today’s visit, the violation was considered corrected during the visit. I suggested you create a tracking tool that assists you in keeping up with the required training due dates for each of your employees. Please let me know if you need assistance with developing a tracking tool. 2. As stated in G.S. 110-90.2 & .2703(r), child care operators have five business days to notify the Division of any new child care providers working who were hired or moved into the child care facility. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. The compliance of this rule will be monitored during your next visit. Prior to today’s visit, I observed that a staff roster for this facility had not been established on the ABCMS Provider Portal listing currently employed staff members as being hired by this facility. To correct this violation, you will need both an Individual NCID and a Business NCID. You will need an email address for your Individual NCID and a different email address for your Business NCID account. Once you have created your Business NCID, complete the ABCMS Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given to you, you must verify your facility roster to ensure current staff or current FCCH residents are noted on the roster. To maintain compliance with this child care requirement, this information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. These actions satisfy the requirement to notify the Division within five business days of new child care providers working who were hired or moved into the child care facility. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance, please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. 3. Per sanitation rule 15A NCAC 18A.2832(a), the child care center premises, including the outdoor learning environment, should be clean, drained to minimize standing water, free of litter and hazards and/or maintained in a manner which does not create conditions that attract or harbor pests. On Playground 2 which is currently not being used, one water table with a broken lid and one dump truck had standing water in them. Today, the administrator dumped the water out of the water table and the dump truck and turned the dump trucks upside down to prevent water from collecting in the future. These actions corrected this violation during today’s visit. To maintain compliance with this child care requirement, I suggested you remind staff to keep water tables covered and dump trucks turned upside down. 4. Per child care rule 10A NCAC 09 .0605(k)(1-4), the depth of the loose surfacing should be based on the critical height of the equipment. To maintain compliance with this child care requirement, I suggested you replenish the rubber mulch and pea gravel combination under and around the stationary composite play structure and the spring rockers on Playground 1 to a depth of six inches within fall zone extending six feet from the composite structure in all directions and three feet from the spring rockers in all directions. 5. Per child care rule 10A NCAC 09 .0607(f), all staff should review the center's Emergency Preparedness Response (EPR) with the trained staff during orientation, on an annual basis, or when the plan is updated for any reason. Documentation of the initial and the annual review should be maintained on file. During today’s visit, I observed the EPR Plan had been updated on June 9, 2025. However, there was no documentation on file that included staff signature and date that could be used to verify that the plan had been reviewed with staff to date. To maintain compliance with this child care requirement, I suggested you sit down as a staff group and review the EPR Plan with each staff member as soon as possible and have them sign and date a statement or roster as documentation that the plan was reviewed. 6. Per child care rule 10A NCAC 09 .1103 (a), after the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, should complete on-going training activities each year from training agencies approved by DCDEE. The number of required on-going training hours is calculated based on the staff member’s education, experience, and number of hours worked weekly. To maintain compliance with this child care requirement, I suggested you encourage your staff to complete on-going training from DCDEE approved agencies only. Many free approved training opportunities are available through DCDEE Moodle, NCRLAP, and NC Health and Safety Resource Center. 7. Per child care rule 10A NCAC 09 .1102(c)(d), each employee should complete First Aid and CPR training within ninety days of employment and prior to the expiration date and documentation should be maintained in their staff record file as verification that the employee has completed First Aid and CPR training and maintains a current and valid First Aid and CPR certificate. Today, one staff member’s First Aid and CPR training certification had expired on May 9, 2025 and no updated certificate or documentation of completion was in the file. To maintain compliance with this child care requirement, I suggest you encourage staff members to register for First Aid and CPR training three months prior to the expiration date. 8. Per child care rule 10A NCAC 09. 0514(b), a statement signed and dated by each parent acknowledging the receipt and discussion of the operational policies on or before the first day of attendance and written notice of changes should be on file for each child. To maintain compliance with this child care requirement, I suggested that when changes are made to the operational policies, you provide written notice to each parent of the operational policy change and have the parent sign and date an acknowledgement statement that they received written notice of the operational policy change. I also suggested that you add the updated operational policies to the parent handbook to be given to new enrolling families prior to the first day of attendance and continue securing a parent signature and date from the parent on the acknowledgement form that you include in your enrollment packets. CONSULTATION: 1. On the Emergency Medical Care (EMC) Plan, at least one of the persons listed as the responsible person or the alternate person for each of the assigned tasks must be on-site at all times. 2. When and if you update your fire evacuation route, shelter-in-place, and/or lock-down drill plan, you need to have the fire department approve the your plan first BEFORE you put it in your EPR plan as an update. 3. On July 1, 2025, the North Carolina Rules Review Commission (RRC) approved the new child care rule language for the QRIS Modernization Plan, known as “Pathways to the Stars”. The Division of Child Development and Early Education is currently preparing a summary of the rules, an online training module for Moodle, and an implementation plan. Child care consultants will be conducting center administrator and FCCH owner/operator training/meetings in September 2025 as the next step for implementing the plan to transition to the “Pathways to the Stars”. The implementation plan will allow time for administrators and operators to learn and understand the different pathways and the changes within our system. An invitation and announcement of the date, time, and location for these important meetings will be shared as soon as details are finalized. Please make plans to attend. Please be reminded that any ERS assessment completed on or after February 1, 2025 will be assessed using the ERS-3 versions. We encourage you to visit the QRIS Modernization page on the DCDEE website at this link: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization to learn more now. 4. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. 5. Here are some important links on the DCEEE website that may be helpful: Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Licensing/Getting-a-License Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development QRIS Modernization Plan resources: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings Healthy Social Behaviors: https://www.childcarerrnc.org/special-projects/healthy-social-behaviors/. Healthy Social Behaviors Helpline: Call at 1-704-376-6697 or toll free at 1-888-600-1685 Option 1 or email at sbrawley@childcareresourcesinc.org or jbyrd@childcareresources.org. Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New 6. Here is the link to the Children’s Resource Center training calendar: https://childrensresourcecenter.org/training-calendar/. 7. If you would like an electronic link to any of the links shared above, please send me an email requesting the links that you’d wish to receive, and I will be glad to send the hyperlinks to you by email. COMPLIANCE PLAN: No compliance documentation is needed for violation item numbers 808 and 1897 corrected during today’s visit. I documented the corrective actions taken today to correct those violations in this visit summary. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. I must receive your compliance letter no later than September 3, 2025. Please be aware any information submitted by you is legal documentation. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
10A NCAC 09 .0803 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 2/12/2025 Number Present: 40 Completed Date: 2/12/2025 Age: From 0 To 5 Total Minutes: 380 Time In: 09:10 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. You, Teri Knollhoff, Assistant Director, assisted me with today’s visit. Bianca Gandhi, Administrator/Owner, was not available today. I conducted your last annual compliance visit on September 4, 2024. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, fax number, email address, mailing address, or corporate contact for the facility. You stated there has been no change with the corporation, Toddler's Cove Academy Inc., that owns your facility. I reviewed the facility’s permit with you today including the restrictions, capacity, and age range and observed these being maintained today. Toddler's Cove Academy Inc. that owns your facility was reviewed and listed as current-active on the North Carolina Secretary of State website on February 10, 2025. Your center's compliance history was 81% as of February 11, 2025 and was reviewed with you today. Your program currently operates with a three-star license, issued on April 8, 2023, earning four points in staff education, two points in program standards, and one quality point for a combined turnover rate of 20% or less for Administrator, Lead Teacher, Teacher, and Group Leader. Your most recent fire inspection was dated May 15, 2024 and received in my office by email on May 20, 2024. Your most recent sanitation inspection was dated December 30, 2024 with a Superior classification and ten demerits. I verified that the lead water testing required to be completed every three years was completed on August 6, 2024. Today, I verified that those test results indicated that your facilities drinking water source was within the required limits. I verified that you enrolled for the lead-based paint testing and the facility is free of lead-based paint hazards based on a signed statement from you attesting to providing a lead-based paint free facility. I verified that you enrolled for asbestos testing and the facility was found to be exempt from this testing process. I completed a walk-through of the indoor licensed spaces today. I observed children throughout the facility participating in free play on the floor and in activity areas, whole-group sensory activity, attending to personal care routines, eating lunch and napping. I observed infants engaged in floor play, napping, being bottle fed, and comforted. Due to the rain today, I did not complete a walk-through of the outdoor licensed spaces. I will monitor the outdoor play spaces during the next monitoring visit. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of thirty-eight degrees Fahrenheit. Infant bottles and food were stored at thirty-eight degrees Fahrenheit in a full-size refrigerator located in a food preparation room adjacent to Space 1 where infant care was provided. Today’s lunch included turkey sandwich with whole wheat bread, corn, fruit cocktail, and unflavored milk. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline. I monitored program records including emergency medical care plan, safe arrival and departure procedures, incident log, outdoor safety inspections, fire drills, and emergency drills. I reviewed staff record files for seven returning staff members to verify current and valid Criminal Background Check qualification letters, valid CPR and First Aid training, valid ITS-SIDS training, completion of Basic School Age Care training, completion of the Recognizing and Responding to Suspicions of Child Maltreatment training, completion of Playground Safety training by at least one staff member, and completion of Emergency Preparedness and Response training by at least one staff member. I reviewed staff record files for three new staff members hired since the last annual compliance visit on September 4, 2024. I monitored health and safety requirements. I reviewed your written operational, administrative, and personnel policies and your parent participation plan at your annual compliance visit on September 4, 2024. You stated your written policies and procedures had not changed since September 2024. I monitored supervision, staff-child ratios, group sizes, approved space use, space capacities, and permit restrictions. The following violations were cited during today’s visit: Violation Number Comment Rule 603 All floors and floor coverings were not constructed of nonabsorbent material and/or were not kept clean and in good repair. In Spaces 2, 3, and 6, the rugs were visibly soiled. 15A NCAC 18A .2824(a)&(b) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Spaces 1, 2, and 3, a black substance that may be mold and/or mildew was seen on the ceiling vents and the ceiling tiles surrounding the ceiling vents. In Space 3, the doors, doorframes, and walls were visibly soiled. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. In Spaces 3 and 6, the dramatic play set furniture and toy shelves were visibly soiled. G.S. 110-91(6); .0601(b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In Space 3, the pharmaceutical label on a prescription medication indicated that the medication should be discarded after 11/30/2024 and was not returned to the parent or discarded within 72 hours. .0803(12) TECHNICAL ASSISTANCE: 1. Per sanitation rule 15A NCAC 18A .2825(a), walls, ceilings, doors, and windows should be kept in good repair and clean. As discussed today to maintain compliance with this sanitation rule, it is recommended that you determine why the vents and ceiling tiles became damp enough to support the growth of the black substance that may be mold and/or mildew. It is recommended that you contact a specialist to conduct testing out of precaution for the health and safety of children in your care to determine what the black substance is and how to properly remediate the issue. David Lipton, Industrial Hygiene Consultant with the Occupational and Environmental Epidemiology Branch, has provided guidance to our department concerning best practices for cleaning and remediation that I have emailed you today. I suggested you also require your staff to clean the walls, doors, doorframes, and baseboards in each classroom. 2. Per sanitation rule 15A NCAC 18A.2824(a&b), all floors and floor coverings should be kept clean and in good repair. To maintain compliance with this sanitation rule, I suggested you have your classroom rugs shampooed at least every six months and more often if they become visibly soiled before six months has lapsed between shampooing. I also suggest you have your staff spot clean the rugs with soapy water and a cloth when needed. 3. Per child care rule 10A NCAC 09. 601(b), all equipment and materials should be kept in good repair. To maintain compliance with this child care requirement, I suggested you have your staff deep clean the classrooms including cabinets, diaper pails, trash cans, dramatic play sets, and toy shelving. I advised you to keep your furniture and equipment in good repair at all times and make repairs or replacements before violations are cited. 4. Per child care rule 10A NCAC 09 .0803(12), when a medication, prescription, or permission to administer form has expired, the medication should be returned to the parent within seventy-two hours. To maintain compliance with this child care requirement, I suggested you review medications and permission to administer forms routinely to ensure ongoing compliance. When an expired medication is brought to the center from home, the expired medication should not be received by the center. CONSULTATION: 1. When recording “problems” on the Monthly Outdoor Inspection report, be sure to record the solution and the date the “problem” was resolved. 2. Angela Passmore, Cook, asked me if unserved food items could be brought back to the kitchen to be refrigerated or frozen with the intent to serve the food items to the children another day in the same week or in the future. I suggested Ms. Passmore and/or Ms. Knollhoff contact your Environmental Health Specialist for clarification regarding this sanitation rule. I informed you that food served to the children whether eaten or uneaten should be thrown away. 3. Ms. Passmore asked me if the grapes in fruit cocktail should be removed and not served to children younger than three years of age due to the risk of choking. According to the “Caring for Our Children” document , “Caregivers/teachers should not offer to children under four years of age foods that are associated with young children’s choking incidents (round, hard, small, thick and sticky, smooth, compressible or dense, or slippery). Examples of these foods are hot dogs and other meat sticks (whole or sliced into rounds), raw carrot rounds, whole grapes, hard candy, nuts, seeds, raw peas, hard pretzels, chips, peanuts, popcorn, rice cakes, marshmallows, spoonfuls of peanut butter, and chunks of meat larger than can be swallowed whole.” I also reminded Ms. Knollhoff that all children of preschool age should be supervised while eating. 4. I suggested Ms. Passmore and/or Ms. Knollhoff refer to the “Caring for Our Children” document for further clarification regarding choking hazards related to food items and service. I sent you an electronic copy of the “Caring for Our Children” document by email today. 5. Infant activity plans should include the name and ages in months. 6. In classrooms where children are both one and two years of age, I advised you to use the toddler activity plan for the children one year of age and the preschool activity plan for the children two years of age. If all the children are on the same developmental level, I advised you to use the activity play that matches the developmental level of the group. 7. As discussed today, over-the-counter medications, such as cough syrup, decongestant, acetaminophen, ibuprofen, topical antibiotic cream for abrasions, or medication for intestinal disorders should be stored in the manufacturer's original packaging on which the child's name is written or labeled and shall be accompanied by written instructions specifying: (a) the child's name; (b) the names of the authorized over-the-counter medication; (c) the amount and frequency of the dosages, which shall not exceed the amount and frequency of the dosages on the manufacturer's label; (d) the signature of the parent, physician or other health professional; and (e) the date the instructions were signed by the parent, physician or other health professional. The permission to administer over-the-counter medications may be valid for up to 30 days at a time. Over-the-counter medications should not be administered on an "as needed" basis, 8. When a medication or authorization to administer form expires and the parent brings in a new medication to replace the expired medication, a new permission to administer form should be completed for the new medication and the old permission to administer form should be kept in the child’s file in the office for at least six months. 9. As discussed today, during a fire drill or emergency and non-mobile children are enrolled and attending in the classroom for one-year old children, I suggested you carry one child out of the class, use the twin stroller located in the lobby for two children, and use the bye-bye buggy for three or more children rather than to set-up an evacuation crib in the classroom. 10. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings. 11. The new QRIS Modernization Plan known as “Pathways to Success” is being added to law which included moving to the use of the updated Environmental Rating Scale (ERS-3 versions) for FCCERS, effective February 1, 2025. DCDEE and the NC Child Care Commission will continue the rulemaking process to add the rule language to child care requirements. This process with take several months. Hold Harmless provisions have been extended. Star rated license reassessments are postponed until the QRIS rulemaking process has been completed. Star rated license assessments are still required for new child care programs. A pathway for child care programs currently accredited through the approved accrediting bodies may now move to a 3- or 5-star license if they are not already at this star level. Providers need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. Please be reminded any ERS assessment completed on February 1, 2025 and after will be assessed using the ERS-3 versions. 12. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. Here are some important links on the DCEEE website that may be helpful: Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Licensing/Getting-a-License Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New COMPLIANCE PLAN: All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than February 26, 2025. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
10A NCAC 09. 601 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 2/12/2025 Number Present: 40 Completed Date: 2/12/2025 Age: From 0 To 5 Total Minutes: 380 Time In: 09:10 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. You, Teri Knollhoff, Assistant Director, assisted me with today’s visit. Bianca Gandhi, Administrator/Owner, was not available today. I conducted your last annual compliance visit on September 4, 2024. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, fax number, email address, mailing address, or corporate contact for the facility. You stated there has been no change with the corporation, Toddler's Cove Academy Inc., that owns your facility. I reviewed the facility’s permit with you today including the restrictions, capacity, and age range and observed these being maintained today. Toddler's Cove Academy Inc. that owns your facility was reviewed and listed as current-active on the North Carolina Secretary of State website on February 10, 2025. Your center's compliance history was 81% as of February 11, 2025 and was reviewed with you today. Your program currently operates with a three-star license, issued on April 8, 2023, earning four points in staff education, two points in program standards, and one quality point for a combined turnover rate of 20% or less for Administrator, Lead Teacher, Teacher, and Group Leader. Your most recent fire inspection was dated May 15, 2024 and received in my office by email on May 20, 2024. Your most recent sanitation inspection was dated December 30, 2024 with a Superior classification and ten demerits. I verified that the lead water testing required to be completed every three years was completed on August 6, 2024. Today, I verified that those test results indicated that your facilities drinking water source was within the required limits. I verified that you enrolled for the lead-based paint testing and the facility is free of lead-based paint hazards based on a signed statement from you attesting to providing a lead-based paint free facility. I verified that you enrolled for asbestos testing and the facility was found to be exempt from this testing process. I completed a walk-through of the indoor licensed spaces today. I observed children throughout the facility participating in free play on the floor and in activity areas, whole-group sensory activity, attending to personal care routines, eating lunch and napping. I observed infants engaged in floor play, napping, being bottle fed, and comforted. Due to the rain today, I did not complete a walk-through of the outdoor licensed spaces. I will monitor the outdoor play spaces during the next monitoring visit. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of thirty-eight degrees Fahrenheit. Infant bottles and food were stored at thirty-eight degrees Fahrenheit in a full-size refrigerator located in a food preparation room adjacent to Space 1 where infant care was provided. Today’s lunch included turkey sandwich with whole wheat bread, corn, fruit cocktail, and unflavored milk. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline. I monitored program records including emergency medical care plan, safe arrival and departure procedures, incident log, outdoor safety inspections, fire drills, and emergency drills. I reviewed staff record files for seven returning staff members to verify current and valid Criminal Background Check qualification letters, valid CPR and First Aid training, valid ITS-SIDS training, completion of Basic School Age Care training, completion of the Recognizing and Responding to Suspicions of Child Maltreatment training, completion of Playground Safety training by at least one staff member, and completion of Emergency Preparedness and Response training by at least one staff member. I reviewed staff record files for three new staff members hired since the last annual compliance visit on September 4, 2024. I monitored health and safety requirements. I reviewed your written operational, administrative, and personnel policies and your parent participation plan at your annual compliance visit on September 4, 2024. You stated your written policies and procedures had not changed since September 2024. I monitored supervision, staff-child ratios, group sizes, approved space use, space capacities, and permit restrictions. The following violations were cited during today’s visit: Violation Number Comment Rule 603 All floors and floor coverings were not constructed of nonabsorbent material and/or were not kept clean and in good repair. In Spaces 2, 3, and 6, the rugs were visibly soiled. 15A NCAC 18A .2824(a)&(b) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Spaces 1, 2, and 3, a black substance that may be mold and/or mildew was seen on the ceiling vents and the ceiling tiles surrounding the ceiling vents. In Space 3, the doors, doorframes, and walls were visibly soiled. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. In Spaces 3 and 6, the dramatic play set furniture and toy shelves were visibly soiled. G.S. 110-91(6); .0601(b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In Space 3, the pharmaceutical label on a prescription medication indicated that the medication should be discarded after 11/30/2024 and was not returned to the parent or discarded within 72 hours. .0803(12) TECHNICAL ASSISTANCE: 1. Per sanitation rule 15A NCAC 18A .2825(a), walls, ceilings, doors, and windows should be kept in good repair and clean. As discussed today to maintain compliance with this sanitation rule, it is recommended that you determine why the vents and ceiling tiles became damp enough to support the growth of the black substance that may be mold and/or mildew. It is recommended that you contact a specialist to conduct testing out of precaution for the health and safety of children in your care to determine what the black substance is and how to properly remediate the issue. David Lipton, Industrial Hygiene Consultant with the Occupational and Environmental Epidemiology Branch, has provided guidance to our department concerning best practices for cleaning and remediation that I have emailed you today. I suggested you also require your staff to clean the walls, doors, doorframes, and baseboards in each classroom. 2. Per sanitation rule 15A NCAC 18A.2824(a&b), all floors and floor coverings should be kept clean and in good repair. To maintain compliance with this sanitation rule, I suggested you have your classroom rugs shampooed at least every six months and more often if they become visibly soiled before six months has lapsed between shampooing. I also suggest you have your staff spot clean the rugs with soapy water and a cloth when needed. 3. Per child care rule 10A NCAC 09. 601(b), all equipment and materials should be kept in good repair. To maintain compliance with this child care requirement, I suggested you have your staff deep clean the classrooms including cabinets, diaper pails, trash cans, dramatic play sets, and toy shelving. I advised you to keep your furniture and equipment in good repair at all times and make repairs or replacements before violations are cited. 4. Per child care rule 10A NCAC 09 .0803(12), when a medication, prescription, or permission to administer form has expired, the medication should be returned to the parent within seventy-two hours. To maintain compliance with this child care requirement, I suggested you review medications and permission to administer forms routinely to ensure ongoing compliance. When an expired medication is brought to the center from home, the expired medication should not be received by the center. CONSULTATION: 1. When recording “problems” on the Monthly Outdoor Inspection report, be sure to record the solution and the date the “problem” was resolved. 2. Angela Passmore, Cook, asked me if unserved food items could be brought back to the kitchen to be refrigerated or frozen with the intent to serve the food items to the children another day in the same week or in the future. I suggested Ms. Passmore and/or Ms. Knollhoff contact your Environmental Health Specialist for clarification regarding this sanitation rule. I informed you that food served to the children whether eaten or uneaten should be thrown away. 3. Ms. Passmore asked me if the grapes in fruit cocktail should be removed and not served to children younger than three years of age due to the risk of choking. According to the “Caring for Our Children” document , “Caregivers/teachers should not offer to children under four years of age foods that are associated with young children’s choking incidents (round, hard, small, thick and sticky, smooth, compressible or dense, or slippery). Examples of these foods are hot dogs and other meat sticks (whole or sliced into rounds), raw carrot rounds, whole grapes, hard candy, nuts, seeds, raw peas, hard pretzels, chips, peanuts, popcorn, rice cakes, marshmallows, spoonfuls of peanut butter, and chunks of meat larger than can be swallowed whole.” I also reminded Ms. Knollhoff that all children of preschool age should be supervised while eating. 4. I suggested Ms. Passmore and/or Ms. Knollhoff refer to the “Caring for Our Children” document for further clarification regarding choking hazards related to food items and service. I sent you an electronic copy of the “Caring for Our Children” document by email today. 5. Infant activity plans should include the name and ages in months. 6. In classrooms where children are both one and two years of age, I advised you to use the toddler activity plan for the children one year of age and the preschool activity plan for the children two years of age. If all the children are on the same developmental level, I advised you to use the activity play that matches the developmental level of the group. 7. As discussed today, over-the-counter medications, such as cough syrup, decongestant, acetaminophen, ibuprofen, topical antibiotic cream for abrasions, or medication for intestinal disorders should be stored in the manufacturer's original packaging on which the child's name is written or labeled and shall be accompanied by written instructions specifying: (a) the child's name; (b) the names of the authorized over-the-counter medication; (c) the amount and frequency of the dosages, which shall not exceed the amount and frequency of the dosages on the manufacturer's label; (d) the signature of the parent, physician or other health professional; and (e) the date the instructions were signed by the parent, physician or other health professional. The permission to administer over-the-counter medications may be valid for up to 30 days at a time. Over-the-counter medications should not be administered on an "as needed" basis, 8. When a medication or authorization to administer form expires and the parent brings in a new medication to replace the expired medication, a new permission to administer form should be completed for the new medication and the old permission to administer form should be kept in the child’s file in the office for at least six months. 9. As discussed today, during a fire drill or emergency and non-mobile children are enrolled and attending in the classroom for one-year old children, I suggested you carry one child out of the class, use the twin stroller located in the lobby for two children, and use the bye-bye buggy for three or more children rather than to set-up an evacuation crib in the classroom. 10. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings. 11. The new QRIS Modernization Plan known as “Pathways to Success” is being added to law which included moving to the use of the updated Environmental Rating Scale (ERS-3 versions) for FCCERS, effective February 1, 2025. DCDEE and the NC Child Care Commission will continue the rulemaking process to add the rule language to child care requirements. This process with take several months. Hold Harmless provisions have been extended. Star rated license reassessments are postponed until the QRIS rulemaking process has been completed. Star rated license assessments are still required for new child care programs. A pathway for child care programs currently accredited through the approved accrediting bodies may now move to a 3- or 5-star license if they are not already at this star level. Providers need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. Please be reminded any ERS assessment completed on February 1, 2025 and after will be assessed using the ERS-3 versions. 12. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. Here are some important links on the DCEEE website that may be helpful: Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Licensing/Getting-a-License Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New COMPLIANCE PLAN: All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than February 26, 2025. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 2/12/2025 Number Present: 40 Completed Date: 2/12/2025 Age: From 0 To 5 Total Minutes: 380 Time In: 09:10 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. You, Teri Knollhoff, Assistant Director, assisted me with today’s visit. Bianca Gandhi, Administrator/Owner, was not available today. I conducted your last annual compliance visit on September 4, 2024. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, fax number, email address, mailing address, or corporate contact for the facility. You stated there has been no change with the corporation, Toddler's Cove Academy Inc., that owns your facility. I reviewed the facility’s permit with you today including the restrictions, capacity, and age range and observed these being maintained today. Toddler's Cove Academy Inc. that owns your facility was reviewed and listed as current-active on the North Carolina Secretary of State website on February 10, 2025. Your center's compliance history was 81% as of February 11, 2025 and was reviewed with you today. Your program currently operates with a three-star license, issued on April 8, 2023, earning four points in staff education, two points in program standards, and one quality point for a combined turnover rate of 20% or less for Administrator, Lead Teacher, Teacher, and Group Leader. Your most recent fire inspection was dated May 15, 2024 and received in my office by email on May 20, 2024. Your most recent sanitation inspection was dated December 30, 2024 with a Superior classification and ten demerits. I verified that the lead water testing required to be completed every three years was completed on August 6, 2024. Today, I verified that those test results indicated that your facilities drinking water source was within the required limits. I verified that you enrolled for the lead-based paint testing and the facility is free of lead-based paint hazards based on a signed statement from you attesting to providing a lead-based paint free facility. I verified that you enrolled for asbestos testing and the facility was found to be exempt from this testing process. I completed a walk-through of the indoor licensed spaces today. I observed children throughout the facility participating in free play on the floor and in activity areas, whole-group sensory activity, attending to personal care routines, eating lunch and napping. I observed infants engaged in floor play, napping, being bottle fed, and comforted. Due to the rain today, I did not complete a walk-through of the outdoor licensed spaces. I will monitor the outdoor play spaces during the next monitoring visit. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of thirty-eight degrees Fahrenheit. Infant bottles and food were stored at thirty-eight degrees Fahrenheit in a full-size refrigerator located in a food preparation room adjacent to Space 1 where infant care was provided. Today’s lunch included turkey sandwich with whole wheat bread, corn, fruit cocktail, and unflavored milk. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline. I monitored program records including emergency medical care plan, safe arrival and departure procedures, incident log, outdoor safety inspections, fire drills, and emergency drills. I reviewed staff record files for seven returning staff members to verify current and valid Criminal Background Check qualification letters, valid CPR and First Aid training, valid ITS-SIDS training, completion of Basic School Age Care training, completion of the Recognizing and Responding to Suspicions of Child Maltreatment training, completion of Playground Safety training by at least one staff member, and completion of Emergency Preparedness and Response training by at least one staff member. I reviewed staff record files for three new staff members hired since the last annual compliance visit on September 4, 2024. I monitored health and safety requirements. I reviewed your written operational, administrative, and personnel policies and your parent participation plan at your annual compliance visit on September 4, 2024. You stated your written policies and procedures had not changed since September 2024. I monitored supervision, staff-child ratios, group sizes, approved space use, space capacities, and permit restrictions. The following violations were cited during today’s visit: Violation Number Comment Rule 603 All floors and floor coverings were not constructed of nonabsorbent material and/or were not kept clean and in good repair. In Spaces 2, 3, and 6, the rugs were visibly soiled. 15A NCAC 18A .2824(a)&(b) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Spaces 1, 2, and 3, a black substance that may be mold and/or mildew was seen on the ceiling vents and the ceiling tiles surrounding the ceiling vents. In Space 3, the doors, doorframes, and walls were visibly soiled. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. In Spaces 3 and 6, the dramatic play set furniture and toy shelves were visibly soiled. G.S. 110-91(6); .0601(b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In Space 3, the pharmaceutical label on a prescription medication indicated that the medication should be discarded after 11/30/2024 and was not returned to the parent or discarded within 72 hours. .0803(12) TECHNICAL ASSISTANCE: 1. Per sanitation rule 15A NCAC 18A .2825(a), walls, ceilings, doors, and windows should be kept in good repair and clean. As discussed today to maintain compliance with this sanitation rule, it is recommended that you determine why the vents and ceiling tiles became damp enough to support the growth of the black substance that may be mold and/or mildew. It is recommended that you contact a specialist to conduct testing out of precaution for the health and safety of children in your care to determine what the black substance is and how to properly remediate the issue. David Lipton, Industrial Hygiene Consultant with the Occupational and Environmental Epidemiology Branch, has provided guidance to our department concerning best practices for cleaning and remediation that I have emailed you today. I suggested you also require your staff to clean the walls, doors, doorframes, and baseboards in each classroom. 2. Per sanitation rule 15A NCAC 18A.2824(a&b), all floors and floor coverings should be kept clean and in good repair. To maintain compliance with this sanitation rule, I suggested you have your classroom rugs shampooed at least every six months and more often if they become visibly soiled before six months has lapsed between shampooing. I also suggest you have your staff spot clean the rugs with soapy water and a cloth when needed. 3. Per child care rule 10A NCAC 09. 601(b), all equipment and materials should be kept in good repair. To maintain compliance with this child care requirement, I suggested you have your staff deep clean the classrooms including cabinets, diaper pails, trash cans, dramatic play sets, and toy shelving. I advised you to keep your furniture and equipment in good repair at all times and make repairs or replacements before violations are cited. 4. Per child care rule 10A NCAC 09 .0803(12), when a medication, prescription, or permission to administer form has expired, the medication should be returned to the parent within seventy-two hours. To maintain compliance with this child care requirement, I suggested you review medications and permission to administer forms routinely to ensure ongoing compliance. When an expired medication is brought to the center from home, the expired medication should not be received by the center. CONSULTATION: 1. When recording “problems” on the Monthly Outdoor Inspection report, be sure to record the solution and the date the “problem” was resolved. 2. Angela Passmore, Cook, asked me if unserved food items could be brought back to the kitchen to be refrigerated or frozen with the intent to serve the food items to the children another day in the same week or in the future. I suggested Ms. Passmore and/or Ms. Knollhoff contact your Environmental Health Specialist for clarification regarding this sanitation rule. I informed you that food served to the children whether eaten or uneaten should be thrown away. 3. Ms. Passmore asked me if the grapes in fruit cocktail should be removed and not served to children younger than three years of age due to the risk of choking. According to the “Caring for Our Children” document , “Caregivers/teachers should not offer to children under four years of age foods that are associated with young children’s choking incidents (round, hard, small, thick and sticky, smooth, compressible or dense, or slippery). Examples of these foods are hot dogs and other meat sticks (whole or sliced into rounds), raw carrot rounds, whole grapes, hard candy, nuts, seeds, raw peas, hard pretzels, chips, peanuts, popcorn, rice cakes, marshmallows, spoonfuls of peanut butter, and chunks of meat larger than can be swallowed whole.” I also reminded Ms. Knollhoff that all children of preschool age should be supervised while eating. 4. I suggested Ms. Passmore and/or Ms. Knollhoff refer to the “Caring for Our Children” document for further clarification regarding choking hazards related to food items and service. I sent you an electronic copy of the “Caring for Our Children” document by email today. 5. Infant activity plans should include the name and ages in months. 6. In classrooms where children are both one and two years of age, I advised you to use the toddler activity plan for the children one year of age and the preschool activity plan for the children two years of age. If all the children are on the same developmental level, I advised you to use the activity play that matches the developmental level of the group. 7. As discussed today, over-the-counter medications, such as cough syrup, decongestant, acetaminophen, ibuprofen, topical antibiotic cream for abrasions, or medication for intestinal disorders should be stored in the manufacturer's original packaging on which the child's name is written or labeled and shall be accompanied by written instructions specifying: (a) the child's name; (b) the names of the authorized over-the-counter medication; (c) the amount and frequency of the dosages, which shall not exceed the amount and frequency of the dosages on the manufacturer's label; (d) the signature of the parent, physician or other health professional; and (e) the date the instructions were signed by the parent, physician or other health professional. The permission to administer over-the-counter medications may be valid for up to 30 days at a time. Over-the-counter medications should not be administered on an "as needed" basis, 8. When a medication or authorization to administer form expires and the parent brings in a new medication to replace the expired medication, a new permission to administer form should be completed for the new medication and the old permission to administer form should be kept in the child’s file in the office for at least six months. 9. As discussed today, during a fire drill or emergency and non-mobile children are enrolled and attending in the classroom for one-year old children, I suggested you carry one child out of the class, use the twin stroller located in the lobby for two children, and use the bye-bye buggy for three or more children rather than to set-up an evacuation crib in the classroom. 10. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings. 11. The new QRIS Modernization Plan known as “Pathways to Success” is being added to law which included moving to the use of the updated Environmental Rating Scale (ERS-3 versions) for FCCERS, effective February 1, 2025. DCDEE and the NC Child Care Commission will continue the rulemaking process to add the rule language to child care requirements. This process with take several months. Hold Harmless provisions have been extended. Star rated license reassessments are postponed until the QRIS rulemaking process has been completed. Star rated license assessments are still required for new child care programs. A pathway for child care programs currently accredited through the approved accrediting bodies may now move to a 3- or 5-star license if they are not already at this star level. Providers need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. Please be reminded any ERS assessment completed on February 1, 2025 and after will be assessed using the ERS-3 versions. 12. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. Here are some important links on the DCEEE website that may be helpful: Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Licensing/Getting-a-License Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New COMPLIANCE PLAN: All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than February 26, 2025. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
G.S. 110-91 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 2/12/2025 Number Present: 40 Completed Date: 2/12/2025 Age: From 0 To 5 Total Minutes: 380 Time In: 09:10 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. You, Teri Knollhoff, Assistant Director, assisted me with today’s visit. Bianca Gandhi, Administrator/Owner, was not available today. I conducted your last annual compliance visit on September 4, 2024. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, fax number, email address, mailing address, or corporate contact for the facility. You stated there has been no change with the corporation, Toddler's Cove Academy Inc., that owns your facility. I reviewed the facility’s permit with you today including the restrictions, capacity, and age range and observed these being maintained today. Toddler's Cove Academy Inc. that owns your facility was reviewed and listed as current-active on the North Carolina Secretary of State website on February 10, 2025. Your center's compliance history was 81% as of February 11, 2025 and was reviewed with you today. Your program currently operates with a three-star license, issued on April 8, 2023, earning four points in staff education, two points in program standards, and one quality point for a combined turnover rate of 20% or less for Administrator, Lead Teacher, Teacher, and Group Leader. Your most recent fire inspection was dated May 15, 2024 and received in my office by email on May 20, 2024. Your most recent sanitation inspection was dated December 30, 2024 with a Superior classification and ten demerits. I verified that the lead water testing required to be completed every three years was completed on August 6, 2024. Today, I verified that those test results indicated that your facilities drinking water source was within the required limits. I verified that you enrolled for the lead-based paint testing and the facility is free of lead-based paint hazards based on a signed statement from you attesting to providing a lead-based paint free facility. I verified that you enrolled for asbestos testing and the facility was found to be exempt from this testing process. I completed a walk-through of the indoor licensed spaces today. I observed children throughout the facility participating in free play on the floor and in activity areas, whole-group sensory activity, attending to personal care routines, eating lunch and napping. I observed infants engaged in floor play, napping, being bottle fed, and comforted. Due to the rain today, I did not complete a walk-through of the outdoor licensed spaces. I will monitor the outdoor play spaces during the next monitoring visit. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of thirty-eight degrees Fahrenheit. Infant bottles and food were stored at thirty-eight degrees Fahrenheit in a full-size refrigerator located in a food preparation room adjacent to Space 1 where infant care was provided. Today’s lunch included turkey sandwich with whole wheat bread, corn, fruit cocktail, and unflavored milk. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline. I monitored program records including emergency medical care plan, safe arrival and departure procedures, incident log, outdoor safety inspections, fire drills, and emergency drills. I reviewed staff record files for seven returning staff members to verify current and valid Criminal Background Check qualification letters, valid CPR and First Aid training, valid ITS-SIDS training, completion of Basic School Age Care training, completion of the Recognizing and Responding to Suspicions of Child Maltreatment training, completion of Playground Safety training by at least one staff member, and completion of Emergency Preparedness and Response training by at least one staff member. I reviewed staff record files for three new staff members hired since the last annual compliance visit on September 4, 2024. I monitored health and safety requirements. I reviewed your written operational, administrative, and personnel policies and your parent participation plan at your annual compliance visit on September 4, 2024. You stated your written policies and procedures had not changed since September 2024. I monitored supervision, staff-child ratios, group sizes, approved space use, space capacities, and permit restrictions. The following violations were cited during today’s visit: Violation Number Comment Rule 603 All floors and floor coverings were not constructed of nonabsorbent material and/or were not kept clean and in good repair. In Spaces 2, 3, and 6, the rugs were visibly soiled. 15A NCAC 18A .2824(a)&(b) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Spaces 1, 2, and 3, a black substance that may be mold and/or mildew was seen on the ceiling vents and the ceiling tiles surrounding the ceiling vents. In Space 3, the doors, doorframes, and walls were visibly soiled. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. In Spaces 3 and 6, the dramatic play set furniture and toy shelves were visibly soiled. G.S. 110-91(6); .0601(b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In Space 3, the pharmaceutical label on a prescription medication indicated that the medication should be discarded after 11/30/2024 and was not returned to the parent or discarded within 72 hours. .0803(12) TECHNICAL ASSISTANCE: 1. Per sanitation rule 15A NCAC 18A .2825(a), walls, ceilings, doors, and windows should be kept in good repair and clean. As discussed today to maintain compliance with this sanitation rule, it is recommended that you determine why the vents and ceiling tiles became damp enough to support the growth of the black substance that may be mold and/or mildew. It is recommended that you contact a specialist to conduct testing out of precaution for the health and safety of children in your care to determine what the black substance is and how to properly remediate the issue. David Lipton, Industrial Hygiene Consultant with the Occupational and Environmental Epidemiology Branch, has provided guidance to our department concerning best practices for cleaning and remediation that I have emailed you today. I suggested you also require your staff to clean the walls, doors, doorframes, and baseboards in each classroom. 2. Per sanitation rule 15A NCAC 18A.2824(a&b), all floors and floor coverings should be kept clean and in good repair. To maintain compliance with this sanitation rule, I suggested you have your classroom rugs shampooed at least every six months and more often if they become visibly soiled before six months has lapsed between shampooing. I also suggest you have your staff spot clean the rugs with soapy water and a cloth when needed. 3. Per child care rule 10A NCAC 09. 601(b), all equipment and materials should be kept in good repair. To maintain compliance with this child care requirement, I suggested you have your staff deep clean the classrooms including cabinets, diaper pails, trash cans, dramatic play sets, and toy shelving. I advised you to keep your furniture and equipment in good repair at all times and make repairs or replacements before violations are cited. 4. Per child care rule 10A NCAC 09 .0803(12), when a medication, prescription, or permission to administer form has expired, the medication should be returned to the parent within seventy-two hours. To maintain compliance with this child care requirement, I suggested you review medications and permission to administer forms routinely to ensure ongoing compliance. When an expired medication is brought to the center from home, the expired medication should not be received by the center. CONSULTATION: 1. When recording “problems” on the Monthly Outdoor Inspection report, be sure to record the solution and the date the “problem” was resolved. 2. Angela Passmore, Cook, asked me if unserved food items could be brought back to the kitchen to be refrigerated or frozen with the intent to serve the food items to the children another day in the same week or in the future. I suggested Ms. Passmore and/or Ms. Knollhoff contact your Environmental Health Specialist for clarification regarding this sanitation rule. I informed you that food served to the children whether eaten or uneaten should be thrown away. 3. Ms. Passmore asked me if the grapes in fruit cocktail should be removed and not served to children younger than three years of age due to the risk of choking. According to the “Caring for Our Children” document , “Caregivers/teachers should not offer to children under four years of age foods that are associated with young children’s choking incidents (round, hard, small, thick and sticky, smooth, compressible or dense, or slippery). Examples of these foods are hot dogs and other meat sticks (whole or sliced into rounds), raw carrot rounds, whole grapes, hard candy, nuts, seeds, raw peas, hard pretzels, chips, peanuts, popcorn, rice cakes, marshmallows, spoonfuls of peanut butter, and chunks of meat larger than can be swallowed whole.” I also reminded Ms. Knollhoff that all children of preschool age should be supervised while eating. 4. I suggested Ms. Passmore and/or Ms. Knollhoff refer to the “Caring for Our Children” document for further clarification regarding choking hazards related to food items and service. I sent you an electronic copy of the “Caring for Our Children” document by email today. 5. Infant activity plans should include the name and ages in months. 6. In classrooms where children are both one and two years of age, I advised you to use the toddler activity plan for the children one year of age and the preschool activity plan for the children two years of age. If all the children are on the same developmental level, I advised you to use the activity play that matches the developmental level of the group. 7. As discussed today, over-the-counter medications, such as cough syrup, decongestant, acetaminophen, ibuprofen, topical antibiotic cream for abrasions, or medication for intestinal disorders should be stored in the manufacturer's original packaging on which the child's name is written or labeled and shall be accompanied by written instructions specifying: (a) the child's name; (b) the names of the authorized over-the-counter medication; (c) the amount and frequency of the dosages, which shall not exceed the amount and frequency of the dosages on the manufacturer's label; (d) the signature of the parent, physician or other health professional; and (e) the date the instructions were signed by the parent, physician or other health professional. The permission to administer over-the-counter medications may be valid for up to 30 days at a time. Over-the-counter medications should not be administered on an "as needed" basis, 8. When a medication or authorization to administer form expires and the parent brings in a new medication to replace the expired medication, a new permission to administer form should be completed for the new medication and the old permission to administer form should be kept in the child’s file in the office for at least six months. 9. As discussed today, during a fire drill or emergency and non-mobile children are enrolled and attending in the classroom for one-year old children, I suggested you carry one child out of the class, use the twin stroller located in the lobby for two children, and use the bye-bye buggy for three or more children rather than to set-up an evacuation crib in the classroom. 10. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings. 11. The new QRIS Modernization Plan known as “Pathways to Success” is being added to law which included moving to the use of the updated Environmental Rating Scale (ERS-3 versions) for FCCERS, effective February 1, 2025. DCDEE and the NC Child Care Commission will continue the rulemaking process to add the rule language to child care requirements. This process with take several months. Hold Harmless provisions have been extended. Star rated license reassessments are postponed until the QRIS rulemaking process has been completed. Star rated license assessments are still required for new child care programs. A pathway for child care programs currently accredited through the approved accrediting bodies may now move to a 3- or 5-star license if they are not already at this star level. Providers need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. Please be reminded any ERS assessment completed on February 1, 2025 and after will be assessed using the ERS-3 versions. 12. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. Here are some important links on the DCEEE website that may be helpful: Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Licensing/Getting-a-License Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New COMPLIANCE PLAN: All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than February 26, 2025. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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 .0515 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 9/4/2024 Number Present: 33 Completed Date: 9/4/2024 Age: From 0 To 4 Total Minutes: 462 Time In: 09:18 AM Time Out: 12:40 PM Time In: 01:10 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Bianca Gandhi, Administrator, assisted me with today’s visit. I conducted your last annual compliance visit on September 19, 2023. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, or corporate contact for the facility. You requested that I add your facility’s website to our system information. I reviewed the facility’s permit with you today. You stated there has been no change with the corporation, Toddler's Cove Academy Inc., that owns your facility. I reviewed with you today the restrictions on your license, capacity, and age range on your permit and observed these being maintained. Toddler's Cove Academy Inc., the corporation that owns your facility, was reviewed and listed as current-active on the NC Secretary of State website on September 3, 2024. Your program’s compliance history was 80% as of September 3, 2024 and was reviewed with you today. Your program currently operates with a three-star license, issued on April 8, 2023, earning four points in staff education, two points in program standards, and one quality point. Your last sanitation inspection was dated January 3, 2024 with a Superior classification and four demerits. Lead water tests are required to be completed every three years. Today, I verified that your most recent lead water testing results are dated August 6, 2024 and those test results indicate that the facility’s water is within acceptable limits. I verified that you registered for the lead-based paint and asbestos testing and facility is exempt from this testing requirement. Your last fire inspection was dated May 15, 2024 and was received in my office on May 20, 2024. I visited each licensed indoor and outdoor space with you today. I observed infant and one-year-old children playing on the floor with the teachers interacting. I observed two-year-old children transitioning from the playground to the classroom, washing hands, being diapered, listening to a book being read by the teacher, and playing independently in activity areas. I observed three-year and four-year-old eating lunch. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Today’s lunch included beef patty on a whole wheat bun or beef meatballs and noodles in gravy, broccoli, cantaloupe, and unflavored milk. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of 35 degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at 38 degrees Fahrenheit in Space 1. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. Your written operational, administrative, and personnel policies and your parent participation plan were reviewed during the temporary time period on October 7, 2022. Today, you stated that your written polices had been updated. I monitored your Employee Handbook dated March 21, 2023 and your Parent Handbook dated October 4, 2023. I observed all the required written policy components included in both handbooks. I monitored your Parent Participation Plan. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. The following violations were observed and cited during today's visit: Violation Number Comment Rule 404 All staff did not wash their hands thoroughly after diapering each child. In Space 3, the teacher did not wash her hands after diapering each child. The teacher wore a pair of gloves and changed multiple children without removing the gloves and washing her hands in between diapering each child. 15A NCAC 18A .2803(a) 405 A child's hands were not washed after each diaper change. In Space 3, the teacher did not wash each child's hands after changing each diaper. 15A NCAC 18A .2803(c)(2) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In Space 1, one bottle was not labeled with the name of the child and the date the bottle was to be served. 15A NCAC 18A .2804(d) 619 Diaper changing surfaces were not cleaned with a detergent solution and disinfected after each use. In Space 3, the teacher did not disinfect the diaper changing pad after diapering each child. 15A NCAC 18A .2819(c) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Space 1, walls were visibly soiled and the drywall was torn under the soap dispenser at the handwashing sink. In Space 2, walls and baseboards were visibly soiled, the drywall was torn under the soap dispenser at the handwashing sink, and paint was chipping on the baseboards. In Space 3, walls, doorframes, doors, baseboards, and cabinets were visibly soiled and paint was chipping on the interior doors. In Space 4, walls, doorframes, and baseboards were visibly soiled and paint was chipping on four of the interior doors 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. In Space 1, one high chair tray, the handwashing sink, and counters were visibly soiled with buildup and two cot sheets were visibly soiled. In Space 2, two diaper pails, all child-sized chairs, two handwashing sinks, and two counters were visibly soiled with buildup. In Space 3, one dustpan, all toy shelves, all child-sized chairs, two dramatic play sets, dress up clothes, rugs, handwashing sinks, and counters were visibly soiled with buildup. In Space 6, four toy shelves, all child-sized chairs, rugs, handwashing sinks, and counters were visibly soiled with buildup and four toy shelves needed to be refinished. G.S. 110-91(6); .0601(b) 847 Parent's medication authorization did not include required information. In Space 1, authorization to administer one oral non-prescription medication was given using the topical permission form with no medication administration log attached. In Space 1, one permission to administer a non-prescription topical medication was missing the valid dates and when to administer the medication. 10A NCAC 09 .0803(4)(6-9) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In Space 3, one diaper pail liner full of soiled diapers was left laying in the floor of the bathroom used by girls. .0604(q) 1206 Center did not have a plan to encourage parent participation and inform them about the program and its services. The director had posted the child care rule for Parent Participation Plan requirements and had included two of the four components of the Parent Participation Plan in the parent handbook. The Parent Participation Plan did not include procedures to encourage families to visit the center with the child prior to enrolling and attending the facility. The Parent Participation Plan did not include procedures for parents to follow when they have a complaint or grievance. 10A NCAC 09 .0515(a) TECHNICAL ASSISTANCE: 1) Per child care rule 10A NCAC 09 .0604(q), plastic bags including opened teacher supply bags, Ziploc bags, grocery bags, diaper wipe refill bags, and diaper pail liners must be stored inaccessible to children above five feet or in a locked cabinet, closet, or drawer. Used diaper pail bags should be removed immediately from the classroom when full bags are removed from the diaper pail. During today’s visit, I observed a full diaper pail liner laying in the floor of the bathroom used by girls in Space 3. The owner/administrator removed the full diaper pail liner from the classroom and took it to the dumpster. To maintain compliance with this child care requirement, I suggest you advise the teachers to lay the full diaper pail liners in the hallway and notify the administrator or a teacher assistant to take the diaper pail liner to the dumpster. 2) Per child care rule 10A NCAC 09 .0803 (7), a parent may give standing authorization for up to 12 months to apply over the counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization should be in writing and should contain: (a) the child's name; (b) the name of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) when and the amount to administer the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) how to apply the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. During today’s visit, one permission to administer form was missing the valid dates and when to administer the medication. The director asked the parent to add the valid dates and information for when to administer the medication which corrected the violation. During today’s visit, the permission to administer acetaminophen was completed on a topical form rather than on the medication permission to administer form with a medication log attached. The director asked the parent to complete medication permission to administer form which corrected this violation during today’s visit. To maintain compliance with this child care requirement, I suggest you review each permission to administer form when it enters the classroom and each week or month as applicable. When information has been omitted from the form, I suggest you ask the parent to add the missing information before leaving the medication at the facility. 3) Per sanitation rules for child care centers 15A NCAC 18A.2803(a), each staff member who changes diapers should wash their hands thoroughly after diapering each child. To maintain compliance with this child care requirement, I suggested you review the diapering procedures with your staff members and/or require additional training. 4) Per sanitation rules for child care centers 15A NCAC 18A.2803(c)(2), each staff member who changes diapers should make sure each child's hands are washed after each diaper change. To maintain compliance with this child care requirement, I suggested you review the diapering procedures with your staff members and/or require additional training. 5) Per sanitation rule 15A NCAC 18A .2825(a), walls should be kept in good repair and clean. To maintain compliance with this sanitation rule, I suggest you require staff to deep clean the classrooms including walls, doors, doorframes, baseboards, and doors, touch up the peeling paint on the interior doors, and repair any wall scars and chipping paint on the dry wall walls. 6) Per sanitation rules for child care centers rule 15A NCAC 18A .2804(d), each bottle prepared at home and brought to the center and any food provided by the parent and brought to the center for any age child should be labeled with the name of the child and the date the bottle or food item(s) can be served to the child. During today’s visit, I observed one bottle in Space 1 that was not labeled with the name of the child and the date to serve the bottle. To label the bottle, the teacher added a piece of tape to the bottle and wrote the child’s name and today’s date on the bottle which corrected this violation. To maintain compliance with this child care requirement, I suggest you review this sanitation rule with your staff and parents. 7) Per child care rule 10A NCAC 09. 601(b), all equipment and materials should be kept in good repair. To maintain compliance with this child care requirement, I suggested you have shelving and furniture replaced or refinished when you notice wear on the finish that results in the furniture no longer being easy to clean and impervious to moisture. I also suggested you have your staff deep clean the classrooms including sinks, counters, cabinets, diaper pails, trash cans, dramatic play sets, toy shelving, high chairs, child-sized chairs, and rugs. Today, I advised you to keep your furniture and equipment in good repair at all times and make repairs or replacements before violations are cited. 8) Per sanitation rules for child care centers rule 15A NCAC 18A.2819(c), diaper changing surfaces should be cleaned with a detergent solution and disinfected after each use. To maintain compliance with this child care requirement, I suggested you review the procedures for cleaning and disinfecting the diaper changing areas with your staff members and/or additional training. 9) Per child care rule 10A NCAC 09 .0515(a), each center should have a plan to encourage parent participation and to inform them about the program and its services. To maintain compliance with this child care requirement, I suggested you add the missing components to your facility’s parent participation plan and either post the plan or add the components to your written operational policies in your parent handbook. CONSULTATION: 1) When recording “problems” on the Monthly Outdoor Inspection report, be sure to record the solution and the date the “problem” was resolved. 2) When closing out the infant room daily, best practice is to remove each crib sheet, disinfect each crib mattress, and turn the crib mattress up on the side to air dry overnight and send a visual reminder to the morning staff member that the crib mattress has been disinfected and is ready for a clean sheet the next morning. 3) Today, after observing the teacher in Space 3 was not following diapering procedures, I reviewed the diaper changing procedures with you and encouraged you to review the diaper changing procedures with your staff and arrange for additional training as needed. Per sanitation rules for child care centers, 15A NCAC 18A .2819(d), child care center employees should change a child's diaper as follows: (1) gathering supplies before placing child on diapering surface; (2) donning disposable gloves (if needed); (3) using disposable towelette or moistened paper towel to clean child, wiping front to back; (4) disposing of gloves if used, soiled towelettes and diaper in a plastic-lined, covered receptacle; (5) wiping the child care center employee's hands and the child's hands each with a separate disposable towelette or moistened paper towel; (6) sliding a clean diaper under the child, applying diapering products if needed, using facial or toilet tissue, and discarding the tissue in a plastic-lined, covered receptacle; (7) fastening the diaper and placing clothing on child; (8) washing child's hands in accordance with Rule .2803 of this Section, or, if child is unable to support the child's head, cleaning the child's hands with a disposable towelette or moistened paper towel, then drying the child's hands and returning the child to a supervised area; (9) spraying entire diapering surface with detergent solution and wipe clean, using disposable paper towels; (10) spraying entire diapering surface with an approved disinfectant and allowing to remain on the surface for two minutes or as specified by the manufacturer, or air dry; and (11) washing hands in accordance with Rule .2803 of this Section even if disposable gloves are used by the child care center employee. 4) Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. 5) Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings including, but not limited to, ITS-SIDS training and Emergency Preparedness and Response in Child Care training. 6) On Friday, July 12, 2024, DCDEE sent a “Raise North Carolina” email blast announcing the signing of Senate Bill 425. The email contained a section entitled, “Quality Rating Improvement System (QRIS) Modernization” which provided updated information regarding the Rated License Reassessment process and approved extended stabilization grant funding. What does all this mean for child care in general? 1. The new QRIS Modifications and additional pathways will be added to law which included moving to the use of the updated Environmental Rating Scale (ERS-3 versions) for ECCERS. ITERS and FCCERS, effective February 1, 2025. DCDEE and the NC Child Care Commission have already begun the rulemaking process to add the rule language to child care requirements. This process with take several months. 2. Hold Harmless provisions have been extended. Star rated license reassessments are postponed until the QRIS rulemaking process has been completed. Providers in any Cohort may voluntarily request a star rated license reassessment if they wish. Star rated license assessments are still required for new child care programs. 3. A pathway for child care programs currently accredited through the approved accrediting bodies may now move to a 3- or 5-star license if they are not already at this star level. Providers will need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. What does all this mean for facilities in Cohorts 1 & 2? A facility may voluntarily request to complete the star rated license reassessment at any time but will not be required to complete the star rated license reassessment process this year. What does this mean for the Environmental Rating Scales? Please be reminded that if a facility voluntarily chooses to complete the star rated license reassessment AND chooses to complete one or more Environmental Rating Scale (ERS) assessments, the ERS-revised editions will continue to be used until January 31, 2025. Any ERS assessment completed on February 1, 2025 and after will be assessed using the ERS-3 versions. If you wish to VOLUNTARILY move forward with a rated license reassessment, please reach out to me as soon as possible so plans can be made on both our calendars to ensure ease and success with completing the star rated license reassessment process in a timely manner that benefits us both. COMPLIANCE PLAN: No compliance documentation is needed for violations 533, 847, and 858 which were corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than September 18, 2024. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
10A NCAC 09 .0604 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 9/4/2024 Number Present: 33 Completed Date: 9/4/2024 Age: From 0 To 4 Total Minutes: 462 Time In: 09:18 AM Time Out: 12:40 PM Time In: 01:10 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Bianca Gandhi, Administrator, assisted me with today’s visit. I conducted your last annual compliance visit on September 19, 2023. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, or corporate contact for the facility. You requested that I add your facility’s website to our system information. I reviewed the facility’s permit with you today. You stated there has been no change with the corporation, Toddler's Cove Academy Inc., that owns your facility. I reviewed with you today the restrictions on your license, capacity, and age range on your permit and observed these being maintained. Toddler's Cove Academy Inc., the corporation that owns your facility, was reviewed and listed as current-active on the NC Secretary of State website on September 3, 2024. Your program’s compliance history was 80% as of September 3, 2024 and was reviewed with you today. Your program currently operates with a three-star license, issued on April 8, 2023, earning four points in staff education, two points in program standards, and one quality point. Your last sanitation inspection was dated January 3, 2024 with a Superior classification and four demerits. Lead water tests are required to be completed every three years. Today, I verified that your most recent lead water testing results are dated August 6, 2024 and those test results indicate that the facility’s water is within acceptable limits. I verified that you registered for the lead-based paint and asbestos testing and facility is exempt from this testing requirement. Your last fire inspection was dated May 15, 2024 and was received in my office on May 20, 2024. I visited each licensed indoor and outdoor space with you today. I observed infant and one-year-old children playing on the floor with the teachers interacting. I observed two-year-old children transitioning from the playground to the classroom, washing hands, being diapered, listening to a book being read by the teacher, and playing independently in activity areas. I observed three-year and four-year-old eating lunch. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Today’s lunch included beef patty on a whole wheat bun or beef meatballs and noodles in gravy, broccoli, cantaloupe, and unflavored milk. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of 35 degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at 38 degrees Fahrenheit in Space 1. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. Your written operational, administrative, and personnel policies and your parent participation plan were reviewed during the temporary time period on October 7, 2022. Today, you stated that your written polices had been updated. I monitored your Employee Handbook dated March 21, 2023 and your Parent Handbook dated October 4, 2023. I observed all the required written policy components included in both handbooks. I monitored your Parent Participation Plan. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. The following violations were observed and cited during today's visit: Violation Number Comment Rule 404 All staff did not wash their hands thoroughly after diapering each child. In Space 3, the teacher did not wash her hands after diapering each child. The teacher wore a pair of gloves and changed multiple children without removing the gloves and washing her hands in between diapering each child. 15A NCAC 18A .2803(a) 405 A child's hands were not washed after each diaper change. In Space 3, the teacher did not wash each child's hands after changing each diaper. 15A NCAC 18A .2803(c)(2) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In Space 1, one bottle was not labeled with the name of the child and the date the bottle was to be served. 15A NCAC 18A .2804(d) 619 Diaper changing surfaces were not cleaned with a detergent solution and disinfected after each use. In Space 3, the teacher did not disinfect the diaper changing pad after diapering each child. 15A NCAC 18A .2819(c) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Space 1, walls were visibly soiled and the drywall was torn under the soap dispenser at the handwashing sink. In Space 2, walls and baseboards were visibly soiled, the drywall was torn under the soap dispenser at the handwashing sink, and paint was chipping on the baseboards. In Space 3, walls, doorframes, doors, baseboards, and cabinets were visibly soiled and paint was chipping on the interior doors. In Space 4, walls, doorframes, and baseboards were visibly soiled and paint was chipping on four of the interior doors 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. In Space 1, one high chair tray, the handwashing sink, and counters were visibly soiled with buildup and two cot sheets were visibly soiled. In Space 2, two diaper pails, all child-sized chairs, two handwashing sinks, and two counters were visibly soiled with buildup. In Space 3, one dustpan, all toy shelves, all child-sized chairs, two dramatic play sets, dress up clothes, rugs, handwashing sinks, and counters were visibly soiled with buildup. In Space 6, four toy shelves, all child-sized chairs, rugs, handwashing sinks, and counters were visibly soiled with buildup and four toy shelves needed to be refinished. G.S. 110-91(6); .0601(b) 847 Parent's medication authorization did not include required information. In Space 1, authorization to administer one oral non-prescription medication was given using the topical permission form with no medication administration log attached. In Space 1, one permission to administer a non-prescription topical medication was missing the valid dates and when to administer the medication. 10A NCAC 09 .0803(4)(6-9) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In Space 3, one diaper pail liner full of soiled diapers was left laying in the floor of the bathroom used by girls. .0604(q) 1206 Center did not have a plan to encourage parent participation and inform them about the program and its services. The director had posted the child care rule for Parent Participation Plan requirements and had included two of the four components of the Parent Participation Plan in the parent handbook. The Parent Participation Plan did not include procedures to encourage families to visit the center with the child prior to enrolling and attending the facility. The Parent Participation Plan did not include procedures for parents to follow when they have a complaint or grievance. 10A NCAC 09 .0515(a) TECHNICAL ASSISTANCE: 1) Per child care rule 10A NCAC 09 .0604(q), plastic bags including opened teacher supply bags, Ziploc bags, grocery bags, diaper wipe refill bags, and diaper pail liners must be stored inaccessible to children above five feet or in a locked cabinet, closet, or drawer. Used diaper pail bags should be removed immediately from the classroom when full bags are removed from the diaper pail. During today’s visit, I observed a full diaper pail liner laying in the floor of the bathroom used by girls in Space 3. The owner/administrator removed the full diaper pail liner from the classroom and took it to the dumpster. To maintain compliance with this child care requirement, I suggest you advise the teachers to lay the full diaper pail liners in the hallway and notify the administrator or a teacher assistant to take the diaper pail liner to the dumpster. 2) Per child care rule 10A NCAC 09 .0803 (7), a parent may give standing authorization for up to 12 months to apply over the counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization should be in writing and should contain: (a) the child's name; (b) the name of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) when and the amount to administer the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) how to apply the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. During today’s visit, one permission to administer form was missing the valid dates and when to administer the medication. The director asked the parent to add the valid dates and information for when to administer the medication which corrected the violation. During today’s visit, the permission to administer acetaminophen was completed on a topical form rather than on the medication permission to administer form with a medication log attached. The director asked the parent to complete medication permission to administer form which corrected this violation during today’s visit. To maintain compliance with this child care requirement, I suggest you review each permission to administer form when it enters the classroom and each week or month as applicable. When information has been omitted from the form, I suggest you ask the parent to add the missing information before leaving the medication at the facility. 3) Per sanitation rules for child care centers 15A NCAC 18A.2803(a), each staff member who changes diapers should wash their hands thoroughly after diapering each child. To maintain compliance with this child care requirement, I suggested you review the diapering procedures with your staff members and/or require additional training. 4) Per sanitation rules for child care centers 15A NCAC 18A.2803(c)(2), each staff member who changes diapers should make sure each child's hands are washed after each diaper change. To maintain compliance with this child care requirement, I suggested you review the diapering procedures with your staff members and/or require additional training. 5) Per sanitation rule 15A NCAC 18A .2825(a), walls should be kept in good repair and clean. To maintain compliance with this sanitation rule, I suggest you require staff to deep clean the classrooms including walls, doors, doorframes, baseboards, and doors, touch up the peeling paint on the interior doors, and repair any wall scars and chipping paint on the dry wall walls. 6) Per sanitation rules for child care centers rule 15A NCAC 18A .2804(d), each bottle prepared at home and brought to the center and any food provided by the parent and brought to the center for any age child should be labeled with the name of the child and the date the bottle or food item(s) can be served to the child. During today’s visit, I observed one bottle in Space 1 that was not labeled with the name of the child and the date to serve the bottle. To label the bottle, the teacher added a piece of tape to the bottle and wrote the child’s name and today’s date on the bottle which corrected this violation. To maintain compliance with this child care requirement, I suggest you review this sanitation rule with your staff and parents. 7) Per child care rule 10A NCAC 09. 601(b), all equipment and materials should be kept in good repair. To maintain compliance with this child care requirement, I suggested you have shelving and furniture replaced or refinished when you notice wear on the finish that results in the furniture no longer being easy to clean and impervious to moisture. I also suggested you have your staff deep clean the classrooms including sinks, counters, cabinets, diaper pails, trash cans, dramatic play sets, toy shelving, high chairs, child-sized chairs, and rugs. Today, I advised you to keep your furniture and equipment in good repair at all times and make repairs or replacements before violations are cited. 8) Per sanitation rules for child care centers rule 15A NCAC 18A.2819(c), diaper changing surfaces should be cleaned with a detergent solution and disinfected after each use. To maintain compliance with this child care requirement, I suggested you review the procedures for cleaning and disinfecting the diaper changing areas with your staff members and/or additional training. 9) Per child care rule 10A NCAC 09 .0515(a), each center should have a plan to encourage parent participation and to inform them about the program and its services. To maintain compliance with this child care requirement, I suggested you add the missing components to your facility’s parent participation plan and either post the plan or add the components to your written operational policies in your parent handbook. CONSULTATION: 1) When recording “problems” on the Monthly Outdoor Inspection report, be sure to record the solution and the date the “problem” was resolved. 2) When closing out the infant room daily, best practice is to remove each crib sheet, disinfect each crib mattress, and turn the crib mattress up on the side to air dry overnight and send a visual reminder to the morning staff member that the crib mattress has been disinfected and is ready for a clean sheet the next morning. 3) Today, after observing the teacher in Space 3 was not following diapering procedures, I reviewed the diaper changing procedures with you and encouraged you to review the diaper changing procedures with your staff and arrange for additional training as needed. Per sanitation rules for child care centers, 15A NCAC 18A .2819(d), child care center employees should change a child's diaper as follows: (1) gathering supplies before placing child on diapering surface; (2) donning disposable gloves (if needed); (3) using disposable towelette or moistened paper towel to clean child, wiping front to back; (4) disposing of gloves if used, soiled towelettes and diaper in a plastic-lined, covered receptacle; (5) wiping the child care center employee's hands and the child's hands each with a separate disposable towelette or moistened paper towel; (6) sliding a clean diaper under the child, applying diapering products if needed, using facial or toilet tissue, and discarding the tissue in a plastic-lined, covered receptacle; (7) fastening the diaper and placing clothing on child; (8) washing child's hands in accordance with Rule .2803 of this Section, or, if child is unable to support the child's head, cleaning the child's hands with a disposable towelette or moistened paper towel, then drying the child's hands and returning the child to a supervised area; (9) spraying entire diapering surface with detergent solution and wipe clean, using disposable paper towels; (10) spraying entire diapering surface with an approved disinfectant and allowing to remain on the surface for two minutes or as specified by the manufacturer, or air dry; and (11) washing hands in accordance with Rule .2803 of this Section even if disposable gloves are used by the child care center employee. 4) Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. 5) Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings including, but not limited to, ITS-SIDS training and Emergency Preparedness and Response in Child Care training. 6) On Friday, July 12, 2024, DCDEE sent a “Raise North Carolina” email blast announcing the signing of Senate Bill 425. The email contained a section entitled, “Quality Rating Improvement System (QRIS) Modernization” which provided updated information regarding the Rated License Reassessment process and approved extended stabilization grant funding. What does all this mean for child care in general? 1. The new QRIS Modifications and additional pathways will be added to law which included moving to the use of the updated Environmental Rating Scale (ERS-3 versions) for ECCERS. ITERS and FCCERS, effective February 1, 2025. DCDEE and the NC Child Care Commission have already begun the rulemaking process to add the rule language to child care requirements. This process with take several months. 2. Hold Harmless provisions have been extended. Star rated license reassessments are postponed until the QRIS rulemaking process has been completed. Providers in any Cohort may voluntarily request a star rated license reassessment if they wish. Star rated license assessments are still required for new child care programs. 3. A pathway for child care programs currently accredited through the approved accrediting bodies may now move to a 3- or 5-star license if they are not already at this star level. Providers will need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. What does all this mean for facilities in Cohorts 1 & 2? A facility may voluntarily request to complete the star rated license reassessment at any time but will not be required to complete the star rated license reassessment process this year. What does this mean for the Environmental Rating Scales? Please be reminded that if a facility voluntarily chooses to complete the star rated license reassessment AND chooses to complete one or more Environmental Rating Scale (ERS) assessments, the ERS-revised editions will continue to be used until January 31, 2025. Any ERS assessment completed on February 1, 2025 and after will be assessed using the ERS-3 versions. If you wish to VOLUNTARILY move forward with a rated license reassessment, please reach out to me as soon as possible so plans can be made on both our calendars to ensure ease and success with completing the star rated license reassessment process in a timely manner that benefits us both. COMPLIANCE PLAN: No compliance documentation is needed for violations 533, 847, and 858 which were corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than September 18, 2024. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .0803 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 9/4/2024 Number Present: 33 Completed Date: 9/4/2024 Age: From 0 To 4 Total Minutes: 462 Time In: 09:18 AM Time Out: 12:40 PM Time In: 01:10 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Bianca Gandhi, Administrator, assisted me with today’s visit. I conducted your last annual compliance visit on September 19, 2023. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, or corporate contact for the facility. You requested that I add your facility’s website to our system information. I reviewed the facility’s permit with you today. You stated there has been no change with the corporation, Toddler's Cove Academy Inc., that owns your facility. I reviewed with you today the restrictions on your license, capacity, and age range on your permit and observed these being maintained. Toddler's Cove Academy Inc., the corporation that owns your facility, was reviewed and listed as current-active on the NC Secretary of State website on September 3, 2024. Your program’s compliance history was 80% as of September 3, 2024 and was reviewed with you today. Your program currently operates with a three-star license, issued on April 8, 2023, earning four points in staff education, two points in program standards, and one quality point. Your last sanitation inspection was dated January 3, 2024 with a Superior classification and four demerits. Lead water tests are required to be completed every three years. Today, I verified that your most recent lead water testing results are dated August 6, 2024 and those test results indicate that the facility’s water is within acceptable limits. I verified that you registered for the lead-based paint and asbestos testing and facility is exempt from this testing requirement. Your last fire inspection was dated May 15, 2024 and was received in my office on May 20, 2024. I visited each licensed indoor and outdoor space with you today. I observed infant and one-year-old children playing on the floor with the teachers interacting. I observed two-year-old children transitioning from the playground to the classroom, washing hands, being diapered, listening to a book being read by the teacher, and playing independently in activity areas. I observed three-year and four-year-old eating lunch. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Today’s lunch included beef patty on a whole wheat bun or beef meatballs and noodles in gravy, broccoli, cantaloupe, and unflavored milk. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of 35 degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at 38 degrees Fahrenheit in Space 1. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. Your written operational, administrative, and personnel policies and your parent participation plan were reviewed during the temporary time period on October 7, 2022. Today, you stated that your written polices had been updated. I monitored your Employee Handbook dated March 21, 2023 and your Parent Handbook dated October 4, 2023. I observed all the required written policy components included in both handbooks. I monitored your Parent Participation Plan. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. The following violations were observed and cited during today's visit: Violation Number Comment Rule 404 All staff did not wash their hands thoroughly after diapering each child. In Space 3, the teacher did not wash her hands after diapering each child. The teacher wore a pair of gloves and changed multiple children without removing the gloves and washing her hands in between diapering each child. 15A NCAC 18A .2803(a) 405 A child's hands were not washed after each diaper change. In Space 3, the teacher did not wash each child's hands after changing each diaper. 15A NCAC 18A .2803(c)(2) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In Space 1, one bottle was not labeled with the name of the child and the date the bottle was to be served. 15A NCAC 18A .2804(d) 619 Diaper changing surfaces were not cleaned with a detergent solution and disinfected after each use. In Space 3, the teacher did not disinfect the diaper changing pad after diapering each child. 15A NCAC 18A .2819(c) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Space 1, walls were visibly soiled and the drywall was torn under the soap dispenser at the handwashing sink. In Space 2, walls and baseboards were visibly soiled, the drywall was torn under the soap dispenser at the handwashing sink, and paint was chipping on the baseboards. In Space 3, walls, doorframes, doors, baseboards, and cabinets were visibly soiled and paint was chipping on the interior doors. In Space 4, walls, doorframes, and baseboards were visibly soiled and paint was chipping on four of the interior doors 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. In Space 1, one high chair tray, the handwashing sink, and counters were visibly soiled with buildup and two cot sheets were visibly soiled. In Space 2, two diaper pails, all child-sized chairs, two handwashing sinks, and two counters were visibly soiled with buildup. In Space 3, one dustpan, all toy shelves, all child-sized chairs, two dramatic play sets, dress up clothes, rugs, handwashing sinks, and counters were visibly soiled with buildup. In Space 6, four toy shelves, all child-sized chairs, rugs, handwashing sinks, and counters were visibly soiled with buildup and four toy shelves needed to be refinished. G.S. 110-91(6); .0601(b) 847 Parent's medication authorization did not include required information. In Space 1, authorization to administer one oral non-prescription medication was given using the topical permission form with no medication administration log attached. In Space 1, one permission to administer a non-prescription topical medication was missing the valid dates and when to administer the medication. 10A NCAC 09 .0803(4)(6-9) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In Space 3, one diaper pail liner full of soiled diapers was left laying in the floor of the bathroom used by girls. .0604(q) 1206 Center did not have a plan to encourage parent participation and inform them about the program and its services. The director had posted the child care rule for Parent Participation Plan requirements and had included two of the four components of the Parent Participation Plan in the parent handbook. The Parent Participation Plan did not include procedures to encourage families to visit the center with the child prior to enrolling and attending the facility. The Parent Participation Plan did not include procedures for parents to follow when they have a complaint or grievance. 10A NCAC 09 .0515(a) TECHNICAL ASSISTANCE: 1) Per child care rule 10A NCAC 09 .0604(q), plastic bags including opened teacher supply bags, Ziploc bags, grocery bags, diaper wipe refill bags, and diaper pail liners must be stored inaccessible to children above five feet or in a locked cabinet, closet, or drawer. Used diaper pail bags should be removed immediately from the classroom when full bags are removed from the diaper pail. During today’s visit, I observed a full diaper pail liner laying in the floor of the bathroom used by girls in Space 3. The owner/administrator removed the full diaper pail liner from the classroom and took it to the dumpster. To maintain compliance with this child care requirement, I suggest you advise the teachers to lay the full diaper pail liners in the hallway and notify the administrator or a teacher assistant to take the diaper pail liner to the dumpster. 2) Per child care rule 10A NCAC 09 .0803 (7), a parent may give standing authorization for up to 12 months to apply over the counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization should be in writing and should contain: (a) the child's name; (b) the name of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) when and the amount to administer the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) how to apply the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. During today’s visit, one permission to administer form was missing the valid dates and when to administer the medication. The director asked the parent to add the valid dates and information for when to administer the medication which corrected the violation. During today’s visit, the permission to administer acetaminophen was completed on a topical form rather than on the medication permission to administer form with a medication log attached. The director asked the parent to complete medication permission to administer form which corrected this violation during today’s visit. To maintain compliance with this child care requirement, I suggest you review each permission to administer form when it enters the classroom and each week or month as applicable. When information has been omitted from the form, I suggest you ask the parent to add the missing information before leaving the medication at the facility. 3) Per sanitation rules for child care centers 15A NCAC 18A.2803(a), each staff member who changes diapers should wash their hands thoroughly after diapering each child. To maintain compliance with this child care requirement, I suggested you review the diapering procedures with your staff members and/or require additional training. 4) Per sanitation rules for child care centers 15A NCAC 18A.2803(c)(2), each staff member who changes diapers should make sure each child's hands are washed after each diaper change. To maintain compliance with this child care requirement, I suggested you review the diapering procedures with your staff members and/or require additional training. 5) Per sanitation rule 15A NCAC 18A .2825(a), walls should be kept in good repair and clean. To maintain compliance with this sanitation rule, I suggest you require staff to deep clean the classrooms including walls, doors, doorframes, baseboards, and doors, touch up the peeling paint on the interior doors, and repair any wall scars and chipping paint on the dry wall walls. 6) Per sanitation rules for child care centers rule 15A NCAC 18A .2804(d), each bottle prepared at home and brought to the center and any food provided by the parent and brought to the center for any age child should be labeled with the name of the child and the date the bottle or food item(s) can be served to the child. During today’s visit, I observed one bottle in Space 1 that was not labeled with the name of the child and the date to serve the bottle. To label the bottle, the teacher added a piece of tape to the bottle and wrote the child’s name and today’s date on the bottle which corrected this violation. To maintain compliance with this child care requirement, I suggest you review this sanitation rule with your staff and parents. 7) Per child care rule 10A NCAC 09. 601(b), all equipment and materials should be kept in good repair. To maintain compliance with this child care requirement, I suggested you have shelving and furniture replaced or refinished when you notice wear on the finish that results in the furniture no longer being easy to clean and impervious to moisture. I also suggested you have your staff deep clean the classrooms including sinks, counters, cabinets, diaper pails, trash cans, dramatic play sets, toy shelving, high chairs, child-sized chairs, and rugs. Today, I advised you to keep your furniture and equipment in good repair at all times and make repairs or replacements before violations are cited. 8) Per sanitation rules for child care centers rule 15A NCAC 18A.2819(c), diaper changing surfaces should be cleaned with a detergent solution and disinfected after each use. To maintain compliance with this child care requirement, I suggested you review the procedures for cleaning and disinfecting the diaper changing areas with your staff members and/or additional training. 9) Per child care rule 10A NCAC 09 .0515(a), each center should have a plan to encourage parent participation and to inform them about the program and its services. To maintain compliance with this child care requirement, I suggested you add the missing components to your facility’s parent participation plan and either post the plan or add the components to your written operational policies in your parent handbook. CONSULTATION: 1) When recording “problems” on the Monthly Outdoor Inspection report, be sure to record the solution and the date the “problem” was resolved. 2) When closing out the infant room daily, best practice is to remove each crib sheet, disinfect each crib mattress, and turn the crib mattress up on the side to air dry overnight and send a visual reminder to the morning staff member that the crib mattress has been disinfected and is ready for a clean sheet the next morning. 3) Today, after observing the teacher in Space 3 was not following diapering procedures, I reviewed the diaper changing procedures with you and encouraged you to review the diaper changing procedures with your staff and arrange for additional training as needed. Per sanitation rules for child care centers, 15A NCAC 18A .2819(d), child care center employees should change a child's diaper as follows: (1) gathering supplies before placing child on diapering surface; (2) donning disposable gloves (if needed); (3) using disposable towelette or moistened paper towel to clean child, wiping front to back; (4) disposing of gloves if used, soiled towelettes and diaper in a plastic-lined, covered receptacle; (5) wiping the child care center employee's hands and the child's hands each with a separate disposable towelette or moistened paper towel; (6) sliding a clean diaper under the child, applying diapering products if needed, using facial or toilet tissue, and discarding the tissue in a plastic-lined, covered receptacle; (7) fastening the diaper and placing clothing on child; (8) washing child's hands in accordance with Rule .2803 of this Section, or, if child is unable to support the child's head, cleaning the child's hands with a disposable towelette or moistened paper towel, then drying the child's hands and returning the child to a supervised area; (9) spraying entire diapering surface with detergent solution and wipe clean, using disposable paper towels; (10) spraying entire diapering surface with an approved disinfectant and allowing to remain on the surface for two minutes or as specified by the manufacturer, or air dry; and (11) washing hands in accordance with Rule .2803 of this Section even if disposable gloves are used by the child care center employee. 4) Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. 5) Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings including, but not limited to, ITS-SIDS training and Emergency Preparedness and Response in Child Care training. 6) On Friday, July 12, 2024, DCDEE sent a “Raise North Carolina” email blast announcing the signing of Senate Bill 425. The email contained a section entitled, “Quality Rating Improvement System (QRIS) Modernization” which provided updated information regarding the Rated License Reassessment process and approved extended stabilization grant funding. What does all this mean for child care in general? 1. The new QRIS Modifications and additional pathways will be added to law which included moving to the use of the updated Environmental Rating Scale (ERS-3 versions) for ECCERS. ITERS and FCCERS, effective February 1, 2025. DCDEE and the NC Child Care Commission have already begun the rulemaking process to add the rule language to child care requirements. This process with take several months. 2. Hold Harmless provisions have been extended. Star rated license reassessments are postponed until the QRIS rulemaking process has been completed. Providers in any Cohort may voluntarily request a star rated license reassessment if they wish. Star rated license assessments are still required for new child care programs. 3. A pathway for child care programs currently accredited through the approved accrediting bodies may now move to a 3- or 5-star license if they are not already at this star level. Providers will need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. What does all this mean for facilities in Cohorts 1 & 2? A facility may voluntarily request to complete the star rated license reassessment at any time but will not be required to complete the star rated license reassessment process this year. What does this mean for the Environmental Rating Scales? Please be reminded that if a facility voluntarily chooses to complete the star rated license reassessment AND chooses to complete one or more Environmental Rating Scale (ERS) assessments, the ERS-revised editions will continue to be used until January 31, 2025. Any ERS assessment completed on February 1, 2025 and after will be assessed using the ERS-3 versions. If you wish to VOLUNTARILY move forward with a rated license reassessment, please reach out to me as soon as possible so plans can be made on both our calendars to ensure ease and success with completing the star rated license reassessment process in a timely manner that benefits us both. COMPLIANCE PLAN: No compliance documentation is needed for violations 533, 847, and 858 which were corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than September 18, 2024. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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. 601 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 9/4/2024 Number Present: 33 Completed Date: 9/4/2024 Age: From 0 To 4 Total Minutes: 462 Time In: 09:18 AM Time Out: 12:40 PM Time In: 01:10 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Bianca Gandhi, Administrator, assisted me with today’s visit. I conducted your last annual compliance visit on September 19, 2023. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, or corporate contact for the facility. You requested that I add your facility’s website to our system information. I reviewed the facility’s permit with you today. You stated there has been no change with the corporation, Toddler's Cove Academy Inc., that owns your facility. I reviewed with you today the restrictions on your license, capacity, and age range on your permit and observed these being maintained. Toddler's Cove Academy Inc., the corporation that owns your facility, was reviewed and listed as current-active on the NC Secretary of State website on September 3, 2024. Your program’s compliance history was 80% as of September 3, 2024 and was reviewed with you today. Your program currently operates with a three-star license, issued on April 8, 2023, earning four points in staff education, two points in program standards, and one quality point. Your last sanitation inspection was dated January 3, 2024 with a Superior classification and four demerits. Lead water tests are required to be completed every three years. Today, I verified that your most recent lead water testing results are dated August 6, 2024 and those test results indicate that the facility’s water is within acceptable limits. I verified that you registered for the lead-based paint and asbestos testing and facility is exempt from this testing requirement. Your last fire inspection was dated May 15, 2024 and was received in my office on May 20, 2024. I visited each licensed indoor and outdoor space with you today. I observed infant and one-year-old children playing on the floor with the teachers interacting. I observed two-year-old children transitioning from the playground to the classroom, washing hands, being diapered, listening to a book being read by the teacher, and playing independently in activity areas. I observed three-year and four-year-old eating lunch. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Today’s lunch included beef patty on a whole wheat bun or beef meatballs and noodles in gravy, broccoli, cantaloupe, and unflavored milk. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of 35 degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at 38 degrees Fahrenheit in Space 1. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. Your written operational, administrative, and personnel policies and your parent participation plan were reviewed during the temporary time period on October 7, 2022. Today, you stated that your written polices had been updated. I monitored your Employee Handbook dated March 21, 2023 and your Parent Handbook dated October 4, 2023. I observed all the required written policy components included in both handbooks. I monitored your Parent Participation Plan. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. The following violations were observed and cited during today's visit: Violation Number Comment Rule 404 All staff did not wash their hands thoroughly after diapering each child. In Space 3, the teacher did not wash her hands after diapering each child. The teacher wore a pair of gloves and changed multiple children without removing the gloves and washing her hands in between diapering each child. 15A NCAC 18A .2803(a) 405 A child's hands were not washed after each diaper change. In Space 3, the teacher did not wash each child's hands after changing each diaper. 15A NCAC 18A .2803(c)(2) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In Space 1, one bottle was not labeled with the name of the child and the date the bottle was to be served. 15A NCAC 18A .2804(d) 619 Diaper changing surfaces were not cleaned with a detergent solution and disinfected after each use. In Space 3, the teacher did not disinfect the diaper changing pad after diapering each child. 15A NCAC 18A .2819(c) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Space 1, walls were visibly soiled and the drywall was torn under the soap dispenser at the handwashing sink. In Space 2, walls and baseboards were visibly soiled, the drywall was torn under the soap dispenser at the handwashing sink, and paint was chipping on the baseboards. In Space 3, walls, doorframes, doors, baseboards, and cabinets were visibly soiled and paint was chipping on the interior doors. In Space 4, walls, doorframes, and baseboards were visibly soiled and paint was chipping on four of the interior doors 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. In Space 1, one high chair tray, the handwashing sink, and counters were visibly soiled with buildup and two cot sheets were visibly soiled. In Space 2, two diaper pails, all child-sized chairs, two handwashing sinks, and two counters were visibly soiled with buildup. In Space 3, one dustpan, all toy shelves, all child-sized chairs, two dramatic play sets, dress up clothes, rugs, handwashing sinks, and counters were visibly soiled with buildup. In Space 6, four toy shelves, all child-sized chairs, rugs, handwashing sinks, and counters were visibly soiled with buildup and four toy shelves needed to be refinished. G.S. 110-91(6); .0601(b) 847 Parent's medication authorization did not include required information. In Space 1, authorization to administer one oral non-prescription medication was given using the topical permission form with no medication administration log attached. In Space 1, one permission to administer a non-prescription topical medication was missing the valid dates and when to administer the medication. 10A NCAC 09 .0803(4)(6-9) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In Space 3, one diaper pail liner full of soiled diapers was left laying in the floor of the bathroom used by girls. .0604(q) 1206 Center did not have a plan to encourage parent participation and inform them about the program and its services. The director had posted the child care rule for Parent Participation Plan requirements and had included two of the four components of the Parent Participation Plan in the parent handbook. The Parent Participation Plan did not include procedures to encourage families to visit the center with the child prior to enrolling and attending the facility. The Parent Participation Plan did not include procedures for parents to follow when they have a complaint or grievance. 10A NCAC 09 .0515(a) TECHNICAL ASSISTANCE: 1) Per child care rule 10A NCAC 09 .0604(q), plastic bags including opened teacher supply bags, Ziploc bags, grocery bags, diaper wipe refill bags, and diaper pail liners must be stored inaccessible to children above five feet or in a locked cabinet, closet, or drawer. Used diaper pail bags should be removed immediately from the classroom when full bags are removed from the diaper pail. During today’s visit, I observed a full diaper pail liner laying in the floor of the bathroom used by girls in Space 3. The owner/administrator removed the full diaper pail liner from the classroom and took it to the dumpster. To maintain compliance with this child care requirement, I suggest you advise the teachers to lay the full diaper pail liners in the hallway and notify the administrator or a teacher assistant to take the diaper pail liner to the dumpster. 2) Per child care rule 10A NCAC 09 .0803 (7), a parent may give standing authorization for up to 12 months to apply over the counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization should be in writing and should contain: (a) the child's name; (b) the name of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) when and the amount to administer the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) how to apply the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. During today’s visit, one permission to administer form was missing the valid dates and when to administer the medication. The director asked the parent to add the valid dates and information for when to administer the medication which corrected the violation. During today’s visit, the permission to administer acetaminophen was completed on a topical form rather than on the medication permission to administer form with a medication log attached. The director asked the parent to complete medication permission to administer form which corrected this violation during today’s visit. To maintain compliance with this child care requirement, I suggest you review each permission to administer form when it enters the classroom and each week or month as applicable. When information has been omitted from the form, I suggest you ask the parent to add the missing information before leaving the medication at the facility. 3) Per sanitation rules for child care centers 15A NCAC 18A.2803(a), each staff member who changes diapers should wash their hands thoroughly after diapering each child. To maintain compliance with this child care requirement, I suggested you review the diapering procedures with your staff members and/or require additional training. 4) Per sanitation rules for child care centers 15A NCAC 18A.2803(c)(2), each staff member who changes diapers should make sure each child's hands are washed after each diaper change. To maintain compliance with this child care requirement, I suggested you review the diapering procedures with your staff members and/or require additional training. 5) Per sanitation rule 15A NCAC 18A .2825(a), walls should be kept in good repair and clean. To maintain compliance with this sanitation rule, I suggest you require staff to deep clean the classrooms including walls, doors, doorframes, baseboards, and doors, touch up the peeling paint on the interior doors, and repair any wall scars and chipping paint on the dry wall walls. 6) Per sanitation rules for child care centers rule 15A NCAC 18A .2804(d), each bottle prepared at home and brought to the center and any food provided by the parent and brought to the center for any age child should be labeled with the name of the child and the date the bottle or food item(s) can be served to the child. During today’s visit, I observed one bottle in Space 1 that was not labeled with the name of the child and the date to serve the bottle. To label the bottle, the teacher added a piece of tape to the bottle and wrote the child’s name and today’s date on the bottle which corrected this violation. To maintain compliance with this child care requirement, I suggest you review this sanitation rule with your staff and parents. 7) Per child care rule 10A NCAC 09. 601(b), all equipment and materials should be kept in good repair. To maintain compliance with this child care requirement, I suggested you have shelving and furniture replaced or refinished when you notice wear on the finish that results in the furniture no longer being easy to clean and impervious to moisture. I also suggested you have your staff deep clean the classrooms including sinks, counters, cabinets, diaper pails, trash cans, dramatic play sets, toy shelving, high chairs, child-sized chairs, and rugs. Today, I advised you to keep your furniture and equipment in good repair at all times and make repairs or replacements before violations are cited. 8) Per sanitation rules for child care centers rule 15A NCAC 18A.2819(c), diaper changing surfaces should be cleaned with a detergent solution and disinfected after each use. To maintain compliance with this child care requirement, I suggested you review the procedures for cleaning and disinfecting the diaper changing areas with your staff members and/or additional training. 9) Per child care rule 10A NCAC 09 .0515(a), each center should have a plan to encourage parent participation and to inform them about the program and its services. To maintain compliance with this child care requirement, I suggested you add the missing components to your facility’s parent participation plan and either post the plan or add the components to your written operational policies in your parent handbook. CONSULTATION: 1) When recording “problems” on the Monthly Outdoor Inspection report, be sure to record the solution and the date the “problem” was resolved. 2) When closing out the infant room daily, best practice is to remove each crib sheet, disinfect each crib mattress, and turn the crib mattress up on the side to air dry overnight and send a visual reminder to the morning staff member that the crib mattress has been disinfected and is ready for a clean sheet the next morning. 3) Today, after observing the teacher in Space 3 was not following diapering procedures, I reviewed the diaper changing procedures with you and encouraged you to review the diaper changing procedures with your staff and arrange for additional training as needed. Per sanitation rules for child care centers, 15A NCAC 18A .2819(d), child care center employees should change a child's diaper as follows: (1) gathering supplies before placing child on diapering surface; (2) donning disposable gloves (if needed); (3) using disposable towelette or moistened paper towel to clean child, wiping front to back; (4) disposing of gloves if used, soiled towelettes and diaper in a plastic-lined, covered receptacle; (5) wiping the child care center employee's hands and the child's hands each with a separate disposable towelette or moistened paper towel; (6) sliding a clean diaper under the child, applying diapering products if needed, using facial or toilet tissue, and discarding the tissue in a plastic-lined, covered receptacle; (7) fastening the diaper and placing clothing on child; (8) washing child's hands in accordance with Rule .2803 of this Section, or, if child is unable to support the child's head, cleaning the child's hands with a disposable towelette or moistened paper towel, then drying the child's hands and returning the child to a supervised area; (9) spraying entire diapering surface with detergent solution and wipe clean, using disposable paper towels; (10) spraying entire diapering surface with an approved disinfectant and allowing to remain on the surface for two minutes or as specified by the manufacturer, or air dry; and (11) washing hands in accordance with Rule .2803 of this Section even if disposable gloves are used by the child care center employee. 4) Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. 5) Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings including, but not limited to, ITS-SIDS training and Emergency Preparedness and Response in Child Care training. 6) On Friday, July 12, 2024, DCDEE sent a “Raise North Carolina” email blast announcing the signing of Senate Bill 425. The email contained a section entitled, “Quality Rating Improvement System (QRIS) Modernization” which provided updated information regarding the Rated License Reassessment process and approved extended stabilization grant funding. What does all this mean for child care in general? 1. The new QRIS Modifications and additional pathways will be added to law which included moving to the use of the updated Environmental Rating Scale (ERS-3 versions) for ECCERS. ITERS and FCCERS, effective February 1, 2025. DCDEE and the NC Child Care Commission have already begun the rulemaking process to add the rule language to child care requirements. This process with take several months. 2. Hold Harmless provisions have been extended. Star rated license reassessments are postponed until the QRIS rulemaking process has been completed. Providers in any Cohort may voluntarily request a star rated license reassessment if they wish. Star rated license assessments are still required for new child care programs. 3. A pathway for child care programs currently accredited through the approved accrediting bodies may now move to a 3- or 5-star license if they are not already at this star level. Providers will need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. What does all this mean for facilities in Cohorts 1 & 2? A facility may voluntarily request to complete the star rated license reassessment at any time but will not be required to complete the star rated license reassessment process this year. What does this mean for the Environmental Rating Scales? Please be reminded that if a facility voluntarily chooses to complete the star rated license reassessment AND chooses to complete one or more Environmental Rating Scale (ERS) assessments, the ERS-revised editions will continue to be used until January 31, 2025. Any ERS assessment completed on February 1, 2025 and after will be assessed using the ERS-3 versions. If you wish to VOLUNTARILY move forward with a rated license reassessment, please reach out to me as soon as possible so plans can be made on both our calendars to ensure ease and success with completing the star rated license reassessment process in a timely manner that benefits us both. COMPLIANCE PLAN: No compliance documentation is needed for violations 533, 847, and 858 which were corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than September 18, 2024. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
G.S. 110-91 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 9/4/2024 Number Present: 33 Completed Date: 9/4/2024 Age: From 0 To 4 Total Minutes: 462 Time In: 09:18 AM Time Out: 12:40 PM Time In: 01:10 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Bianca Gandhi, Administrator, assisted me with today’s visit. I conducted your last annual compliance visit on September 19, 2023. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, or corporate contact for the facility. You requested that I add your facility’s website to our system information. I reviewed the facility’s permit with you today. You stated there has been no change with the corporation, Toddler's Cove Academy Inc., that owns your facility. I reviewed with you today the restrictions on your license, capacity, and age range on your permit and observed these being maintained. Toddler's Cove Academy Inc., the corporation that owns your facility, was reviewed and listed as current-active on the NC Secretary of State website on September 3, 2024. Your program’s compliance history was 80% as of September 3, 2024 and was reviewed with you today. Your program currently operates with a three-star license, issued on April 8, 2023, earning four points in staff education, two points in program standards, and one quality point. Your last sanitation inspection was dated January 3, 2024 with a Superior classification and four demerits. Lead water tests are required to be completed every three years. Today, I verified that your most recent lead water testing results are dated August 6, 2024 and those test results indicate that the facility’s water is within acceptable limits. I verified that you registered for the lead-based paint and asbestos testing and facility is exempt from this testing requirement. Your last fire inspection was dated May 15, 2024 and was received in my office on May 20, 2024. I visited each licensed indoor and outdoor space with you today. I observed infant and one-year-old children playing on the floor with the teachers interacting. I observed two-year-old children transitioning from the playground to the classroom, washing hands, being diapered, listening to a book being read by the teacher, and playing independently in activity areas. I observed three-year and four-year-old eating lunch. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Today’s lunch included beef patty on a whole wheat bun or beef meatballs and noodles in gravy, broccoli, cantaloupe, and unflavored milk. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of 35 degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at 38 degrees Fahrenheit in Space 1. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. Your written operational, administrative, and personnel policies and your parent participation plan were reviewed during the temporary time period on October 7, 2022. Today, you stated that your written polices had been updated. I monitored your Employee Handbook dated March 21, 2023 and your Parent Handbook dated October 4, 2023. I observed all the required written policy components included in both handbooks. I monitored your Parent Participation Plan. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. The following violations were observed and cited during today's visit: Violation Number Comment Rule 404 All staff did not wash their hands thoroughly after diapering each child. In Space 3, the teacher did not wash her hands after diapering each child. The teacher wore a pair of gloves and changed multiple children without removing the gloves and washing her hands in between diapering each child. 15A NCAC 18A .2803(a) 405 A child's hands were not washed after each diaper change. In Space 3, the teacher did not wash each child's hands after changing each diaper. 15A NCAC 18A .2803(c)(2) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In Space 1, one bottle was not labeled with the name of the child and the date the bottle was to be served. 15A NCAC 18A .2804(d) 619 Diaper changing surfaces were not cleaned with a detergent solution and disinfected after each use. In Space 3, the teacher did not disinfect the diaper changing pad after diapering each child. 15A NCAC 18A .2819(c) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Space 1, walls were visibly soiled and the drywall was torn under the soap dispenser at the handwashing sink. In Space 2, walls and baseboards were visibly soiled, the drywall was torn under the soap dispenser at the handwashing sink, and paint was chipping on the baseboards. In Space 3, walls, doorframes, doors, baseboards, and cabinets were visibly soiled and paint was chipping on the interior doors. In Space 4, walls, doorframes, and baseboards were visibly soiled and paint was chipping on four of the interior doors 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. In Space 1, one high chair tray, the handwashing sink, and counters were visibly soiled with buildup and two cot sheets were visibly soiled. In Space 2, two diaper pails, all child-sized chairs, two handwashing sinks, and two counters were visibly soiled with buildup. In Space 3, one dustpan, all toy shelves, all child-sized chairs, two dramatic play sets, dress up clothes, rugs, handwashing sinks, and counters were visibly soiled with buildup. In Space 6, four toy shelves, all child-sized chairs, rugs, handwashing sinks, and counters were visibly soiled with buildup and four toy shelves needed to be refinished. G.S. 110-91(6); .0601(b) 847 Parent's medication authorization did not include required information. In Space 1, authorization to administer one oral non-prescription medication was given using the topical permission form with no medication administration log attached. In Space 1, one permission to administer a non-prescription topical medication was missing the valid dates and when to administer the medication. 10A NCAC 09 .0803(4)(6-9) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In Space 3, one diaper pail liner full of soiled diapers was left laying in the floor of the bathroom used by girls. .0604(q) 1206 Center did not have a plan to encourage parent participation and inform them about the program and its services. The director had posted the child care rule for Parent Participation Plan requirements and had included two of the four components of the Parent Participation Plan in the parent handbook. The Parent Participation Plan did not include procedures to encourage families to visit the center with the child prior to enrolling and attending the facility. The Parent Participation Plan did not include procedures for parents to follow when they have a complaint or grievance. 10A NCAC 09 .0515(a) TECHNICAL ASSISTANCE: 1) Per child care rule 10A NCAC 09 .0604(q), plastic bags including opened teacher supply bags, Ziploc bags, grocery bags, diaper wipe refill bags, and diaper pail liners must be stored inaccessible to children above five feet or in a locked cabinet, closet, or drawer. Used diaper pail bags should be removed immediately from the classroom when full bags are removed from the diaper pail. During today’s visit, I observed a full diaper pail liner laying in the floor of the bathroom used by girls in Space 3. The owner/administrator removed the full diaper pail liner from the classroom and took it to the dumpster. To maintain compliance with this child care requirement, I suggest you advise the teachers to lay the full diaper pail liners in the hallway and notify the administrator or a teacher assistant to take the diaper pail liner to the dumpster. 2) Per child care rule 10A NCAC 09 .0803 (7), a parent may give standing authorization for up to 12 months to apply over the counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization should be in writing and should contain: (a) the child's name; (b) the name of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) when and the amount to administer the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) how to apply the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. During today’s visit, one permission to administer form was missing the valid dates and when to administer the medication. The director asked the parent to add the valid dates and information for when to administer the medication which corrected the violation. During today’s visit, the permission to administer acetaminophen was completed on a topical form rather than on the medication permission to administer form with a medication log attached. The director asked the parent to complete medication permission to administer form which corrected this violation during today’s visit. To maintain compliance with this child care requirement, I suggest you review each permission to administer form when it enters the classroom and each week or month as applicable. When information has been omitted from the form, I suggest you ask the parent to add the missing information before leaving the medication at the facility. 3) Per sanitation rules for child care centers 15A NCAC 18A.2803(a), each staff member who changes diapers should wash their hands thoroughly after diapering each child. To maintain compliance with this child care requirement, I suggested you review the diapering procedures with your staff members and/or require additional training. 4) Per sanitation rules for child care centers 15A NCAC 18A.2803(c)(2), each staff member who changes diapers should make sure each child's hands are washed after each diaper change. To maintain compliance with this child care requirement, I suggested you review the diapering procedures with your staff members and/or require additional training. 5) Per sanitation rule 15A NCAC 18A .2825(a), walls should be kept in good repair and clean. To maintain compliance with this sanitation rule, I suggest you require staff to deep clean the classrooms including walls, doors, doorframes, baseboards, and doors, touch up the peeling paint on the interior doors, and repair any wall scars and chipping paint on the dry wall walls. 6) Per sanitation rules for child care centers rule 15A NCAC 18A .2804(d), each bottle prepared at home and brought to the center and any food provided by the parent and brought to the center for any age child should be labeled with the name of the child and the date the bottle or food item(s) can be served to the child. During today’s visit, I observed one bottle in Space 1 that was not labeled with the name of the child and the date to serve the bottle. To label the bottle, the teacher added a piece of tape to the bottle and wrote the child’s name and today’s date on the bottle which corrected this violation. To maintain compliance with this child care requirement, I suggest you review this sanitation rule with your staff and parents. 7) Per child care rule 10A NCAC 09. 601(b), all equipment and materials should be kept in good repair. To maintain compliance with this child care requirement, I suggested you have shelving and furniture replaced or refinished when you notice wear on the finish that results in the furniture no longer being easy to clean and impervious to moisture. I also suggested you have your staff deep clean the classrooms including sinks, counters, cabinets, diaper pails, trash cans, dramatic play sets, toy shelving, high chairs, child-sized chairs, and rugs. Today, I advised you to keep your furniture and equipment in good repair at all times and make repairs or replacements before violations are cited. 8) Per sanitation rules for child care centers rule 15A NCAC 18A.2819(c), diaper changing surfaces should be cleaned with a detergent solution and disinfected after each use. To maintain compliance with this child care requirement, I suggested you review the procedures for cleaning and disinfecting the diaper changing areas with your staff members and/or additional training. 9) Per child care rule 10A NCAC 09 .0515(a), each center should have a plan to encourage parent participation and to inform them about the program and its services. To maintain compliance with this child care requirement, I suggested you add the missing components to your facility’s parent participation plan and either post the plan or add the components to your written operational policies in your parent handbook. CONSULTATION: 1) When recording “problems” on the Monthly Outdoor Inspection report, be sure to record the solution and the date the “problem” was resolved. 2) When closing out the infant room daily, best practice is to remove each crib sheet, disinfect each crib mattress, and turn the crib mattress up on the side to air dry overnight and send a visual reminder to the morning staff member that the crib mattress has been disinfected and is ready for a clean sheet the next morning. 3) Today, after observing the teacher in Space 3 was not following diapering procedures, I reviewed the diaper changing procedures with you and encouraged you to review the diaper changing procedures with your staff and arrange for additional training as needed. Per sanitation rules for child care centers, 15A NCAC 18A .2819(d), child care center employees should change a child's diaper as follows: (1) gathering supplies before placing child on diapering surface; (2) donning disposable gloves (if needed); (3) using disposable towelette or moistened paper towel to clean child, wiping front to back; (4) disposing of gloves if used, soiled towelettes and diaper in a plastic-lined, covered receptacle; (5) wiping the child care center employee's hands and the child's hands each with a separate disposable towelette or moistened paper towel; (6) sliding a clean diaper under the child, applying diapering products if needed, using facial or toilet tissue, and discarding the tissue in a plastic-lined, covered receptacle; (7) fastening the diaper and placing clothing on child; (8) washing child's hands in accordance with Rule .2803 of this Section, or, if child is unable to support the child's head, cleaning the child's hands with a disposable towelette or moistened paper towel, then drying the child's hands and returning the child to a supervised area; (9) spraying entire diapering surface with detergent solution and wipe clean, using disposable paper towels; (10) spraying entire diapering surface with an approved disinfectant and allowing to remain on the surface for two minutes or as specified by the manufacturer, or air dry; and (11) washing hands in accordance with Rule .2803 of this Section even if disposable gloves are used by the child care center employee. 4) Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. 5) Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings including, but not limited to, ITS-SIDS training and Emergency Preparedness and Response in Child Care training. 6) On Friday, July 12, 2024, DCDEE sent a “Raise North Carolina” email blast announcing the signing of Senate Bill 425. The email contained a section entitled, “Quality Rating Improvement System (QRIS) Modernization” which provided updated information regarding the Rated License Reassessment process and approved extended stabilization grant funding. What does all this mean for child care in general? 1. The new QRIS Modifications and additional pathways will be added to law which included moving to the use of the updated Environmental Rating Scale (ERS-3 versions) for ECCERS. ITERS and FCCERS, effective February 1, 2025. DCDEE and the NC Child Care Commission have already begun the rulemaking process to add the rule language to child care requirements. This process with take several months. 2. Hold Harmless provisions have been extended. Star rated license reassessments are postponed until the QRIS rulemaking process has been completed. Providers in any Cohort may voluntarily request a star rated license reassessment if they wish. Star rated license assessments are still required for new child care programs. 3. A pathway for child care programs currently accredited through the approved accrediting bodies may now move to a 3- or 5-star license if they are not already at this star level. Providers will need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. What does all this mean for facilities in Cohorts 1 & 2? A facility may voluntarily request to complete the star rated license reassessment at any time but will not be required to complete the star rated license reassessment process this year. What does this mean for the Environmental Rating Scales? Please be reminded that if a facility voluntarily chooses to complete the star rated license reassessment AND chooses to complete one or more Environmental Rating Scale (ERS) assessments, the ERS-revised editions will continue to be used until January 31, 2025. Any ERS assessment completed on February 1, 2025 and after will be assessed using the ERS-3 versions. If you wish to VOLUNTARILY move forward with a rated license reassessment, please reach out to me as soon as possible so plans can be made on both our calendars to ensure ease and success with completing the star rated license reassessment process in a timely manner that benefits us both. COMPLIANCE PLAN: No compliance documentation is needed for violations 533, 847, and 858 which were corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than September 18, 2024. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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 .0802 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: 0724-060L Visit Date: 7/10/2024 Number Present: 36 Completed Date: 7/10/2024 Age: From 0 To 5 Total Minutes: 300 Time In: 09:10 AM Time Out: 02:10 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to gather information regarding an alleged violation of child care requirements. You, Bianca Gandhi, Administrator, assisted me with today’s visit upon your arrival later in the morning. Today, you reported forty-seven children ranging in age from zero to five years of age were enrolled in your facility. You stated thirty-six children ranging in age from zero to five years of age were present during today’s visit. Due to the nature of the report, a walk-through of the entire facility was not conducted today. I visited Spaces 1 and 2 where infant and one-year-old children were enrolled and attending today. In addition to the allegations, I monitored staff-child ratio, adequate space capacity, and approved space use in the classrooms for infant and one-year-old children. I also monitored permit restrictions and posting in the facility. There is a concern of inadequate supervision. There is a concern related to sanitation and health. A child’s diaper was not changed as needed, resulting in a diaper rash. Today, I investigated the concern of inadequate supervision. I visited Space 1 where a total of four infant and one-year-old children were enrolled. Two children were present today with one caregiver supervising the group. Upon arrival in the classroom at 9:15am, I observed the caregiver on the floor playing with the children. From where the caregiver was seated, she was able to see and interact with both children and was within reach able to render assistance as needed. Throughout the observations from 9:15am to 11:00am, I observed the caregiver changing diapers, playing with the children on the floor including reading books, and feeding children lunch. I visited Space 2 where a total of six one-and two-year-old children were enrolled. Four children were present today with one caregiver supervising the group. Upon arrival in the classroom at 9:25am, I observed the caregiver walking around the room interacting with the children, facilitating play, and managing behavior. From where the caregiver was positioned, she was able to see and interact with all children and would be able to render assistance as needed. Throughout the observations from 9:15am to 11:00am, I observed the caregiver engaging the children in a creative art activity with blue finger/hand painting, playing with the children on the floor including a teacher-directed language activity, changing diapers, and serving children lunch. I interviewed five staff members. Staff members stated they understood the facility’s expectation for adequate supervision included being able see and hear each child at all times, having a 360-degree awareness of each child’s presence in the room or outside, not turning their back to a child, and interacting with each child. Staff stated they could not recall a time when children were not being adequately supervised. Based on information included in the report, I monitored incident reports for the incidents that occurred in Space 1 and 2 from May 23, 2024 through July 9, 2024. I monitored fifteen incident reports including four out of six incidents stated in the report. After reviewing the incident reports, I determined that all of the incidents reported were either self-inflicted or child-on-child injuries that were witnessed by staff. Staff were able to provide details related to the how, when, where, and why the incidents occurred which lead me to determine that children were being adequately supervised when these incidents occurred. You allowed me to review messages sent to parents through your Bright Wheel application. I was able to verify that a message and photograph was sent through Bright Wheel to inform that an incident had occurred and an incident report would be prepared. However, I was unable to locate the incident report on file. Today, I observed children in Spaces 1 and 2 adequately supervised. Adequate supervision included staff positioning themselves indoors so they could see and hear each child at all times including during lunch. Based on my interviews with staff, my observations, and my review of incident reports, the allegation of a concern of inadequate supervision could not be confirmed. Therefore, the allegation of inadequate supervision is unsubstantiated. Today, I investigated the concern related to sanitation and health regarding a child’s diaper not being changed as needed, resulting in a diaper rash. I revisited Space 1 where a total of four infant and one-year-old children were present today with one caregiver. I observed written notes for the parents of the two children which included a record of the diapers changed throughout the day. On these written notes, I observed one child’s diaper had been changed at 7:15am and 9:02am and the other child’s diaper was changed at 9:10am. At 9:40am, I returned to the classroom and observed the caregiver holding one child while bottle feeding. The caregiver stated she smelled a BM in the diaper of the other child while she was finishing the bottle feeding. As soon as the bottle-fed child could be sat down and encouraged to play with toys, the caregiver picked up the child with the BM and carried the child to the diaper changing area to change the diaper. I observed the caregiver changing a soiled diaper. I revisited Space 2 where a total of four one-year-old children were present today with one caregiver. Upon arrival in the classroom at 9:25am, I observed a “Diaper Changing Log” used to record the diapers changed throughout the day. On this “Diaper Changing Log”, I observed diapers changed at 7:10am and 8:46am, 7:28am, 8:50am, and 9:20am, 7:55am, 8:43am, and 9:00am, and at 8:40am. At 10:00am, I returned to the classroom and observed the caregiver changing diapers. I conducted staff interviews with five staff members. Staff stated diapers are changed when soiled or wet, before and after nap, and checked at least hourly. Staff stated they could not recall a time when a child’s diaper was not changed resulting in a diaper rash. I reviewed diaper changing logs kept voluntarily by the facility dated from April 2024 through July 9, 2024. A notebook was in the classroom where the “Diaper Changing Log” documents were kept on file. I reviewed the past dated “Diaper Changing Log” documents and observed documentation that supported the facility’s practice of diapers being changed upon arrival, when soiled throughout the day, and after nap. Based on my observations, staff interviews, and a review of the diaper changing logs, the allegation that diapers were not changed as needed resulting in a diaper rash could not be confirmed. Therefore, the allegation of a concern related to sanitation and health is unsubstantiated. The following violation was observed and cited during today’s visit: Violation Number Comment Rule 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. On May 23, 2024, an injury occurred involving a one-year-old child and an incident report was not completed. .0802 (e) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 .0802(e), an incident report should be completed each time an injury occurs while children are in care regardless of the severity of the injury. You stated you notify parents of injuries using the Bright Wheel application and then staff complete an incident report which is signed by the parent. You stated some parents refuse a copy of the incident report when signing the report. To maintain compliance with this child care requirement, I suggested you create a tracking tool or system to assist you in following up with staff to be sure an incident report was completed and with parents to be sure they received an incident report. CONSULTATION: 1. While daily notes are completed and given to parents of children in the infant room, no record or copy of these notes are maintained at the facility as documentation to support your diaper changing practices in the infant room. You stated no daily notes or diaper changing log are maintained in the two-year-old room. Today, I suggested you use the “Diaper Changing Log” document in all the classrooms throughout the facility that perform diaper changing responsibilities. COMPLIANCE PLAN: All violations cited must be corrected immediately. Please submit written, signed, and dated compliance documentation to me at the email/address below detailing the steps taken to correct each violation. Your compliance documentation must include the following: 1) A compliance letter including the following: 1. The name of your facility 2. The ID number of your facility 3. The date you write the letter 4. A corrective action statement for each violation stating how you corrected the violation and are now in compliance. 5. A compliance plan statement for each violation stating how you plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than July 24, 2024. Due to technical issues at the completion of the visit, a handwritten visit summary was prepared, printed, reviewed, signed and a copy was left with you today. A computer-generated visit summary will be prepared and mailed to you within two business days. Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
10A NCAC 09 .0701 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 5/24/2024 Number Present: 42 Completed Date: 5/24/2024 Age: From 0 To 5 Total Minutes: 185 Time In: 09:15 AM Time Out: 12:20 PM Time In: Time Out: List to Use: Center Type Of Visit: Admin Action Follow-Up Lic Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance with applicable child care requirements for an administrative action follow-up visit, including the Corrective Action Plan (CAP) included in the Written Warning issued by the DCDEE to this facility on March 7, 2024. You, Bianca Gandhi, Owner/Administrator, assisted me with today’s visit. Your compliance history was 84% on May 22, 2024 prior to today's visit and was reviewed with you today. Per child care rule .2201(j), during today’s visit, I monitored required Administrative Action postings, CPR training, First Aid training, and Criminal Record Check (CBC) requirements regarding pre-service and 5-year reassessments in accordance with G.S. 110-90.2(b), hazardous items, materials, and equipment, supervision of children, discipline, nurture and care of children, staff/child ratio, group size, licensed capacity, and permit restrictions. In addition, I also monitored ITS-SIDS training and age-appropriate activities as included in the Corrective Action Plan (CAP) of the Administrative Action. I conducted a walk-through of the licensed indoor and outdoor spaces. I observed children participating in free play on the floor, in activity centers and outdoors. Daily schedules and activity plans were current and posted in each classroom. You stated screen-time was not offered to any child in the facility at any time during the operating day. I monitored program records and staff records. I monitored two staff record files for new staff hired since the initial administrative action follow-up visit on April 9, 2024. I monitored nine staff record files for returning staff members. I monitored CBC requirements, CPR training, First Aid training, Recognizing and Responding to Suspicions of Child Maltreatment training, and ITS-SIDS training. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. The following violations were observed, cited, and corrected during today’s visit: Violation Number Comment Rule 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. First Aid training for one staff member with a date of employment of 10/02/2023 was due by 01/02/2024. The staff member completed First Aid training on 01/16/2024. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. CPR training for one staff member with a date of employment of 10/02/2023 was due by 01/02/2024. The staff member completed CPR training on 01/16/2024. .1102(d) TECHNICAL ASSISTANCE: Per child care rule 10A NCAC 09 .1102(c & d), each employee is required to maintain documentation in their staff record file as verification that the employee has completed First Aid and CPR training within the first ninety (90) days of employment and has maintained a current and valid First Aid and CPR certificate. During today’s visit, I observed First Aid and CPR training for one staff member with a date of employment of 10/02/2024 was due to be completed by 01/02/2024. The First Aid & CPR training certificate in the staff member’s file was dated 01/16/2024. You stated the training was completed late because you had a difficult time finding a class for this staff member to attend by 01/02/2024. I suggest you contact fire departments, fire inspectors, community colleges, EMS departments, public health departments, and hospitals in your community as well as your local Resource and Referral agency to acquire information of upcoming First Aid and CPR classes you can register your staff to attend or instructors you may contact. I suggest that you begin searching for a First Aid and CPR class as soon as you hire a new staff member who does not have First Aid and CPR certification. I suggest you begin searching for a First Aid and CPR class at least three months before a staff member’s certification is set to expire. CONSULTATION: 1. Per 10A NCAC 09 .0701(d), each employee must maintain documentation in their staff record file as verification that the employee has completed First Aid and CPR training within the first ninety (90) days of employment and has maintained a current and valid First Aid and CPR certificate. 2. Per 10A NCAC 09 .1102(a), new employee’s must complete the Health & Safety (H&S) Training requirement within the first year of employment. Per 10A NCAC 09 .1103(b), returning employees must revisit each H&S Training topic every five years. The due date of the H&S training five-year renewal is calculated five years from the date on each H&S training certificate. H&S training certificates completed prior to an employee’s date of hire may be counted towards the initial H&S training requirement as long as the date of the training certificate is 12 months or less from the date of hire. 3. Teachers hired with high school diploma only and no early childhood licensed care experience may not be left alone to supervise children until they have satisfied at one of the following requirements: a) Enrolled in EDU 119 and completed at least 20 hours of the coursework. b) Have NC Early Childhood Credentials. c) Have at least one year of early childhood care experience in a licensed facility. 4. When a lead teacher leaves your employment, you may assign a new lead teacher that already holds NC Early Childhood Credentials (NCECC) which is required to meet lead teacher qualifications or you may assign lead teacher responsibilities to a substitute staff member until a new lead teacher meeting qualifications can be hired. Child care rule allows 120 days for you to hire a new lead teacher or assign lead teacher responsibilities to an existing staff member. If the new lead teacher does not meet lead teacher qualifications when lead teacher responsibilities are assigned to that teacher, the new lead teacher has six months to enroll in and complete NCECC coursework to meet lead teacher qualifications. 5. In the two-year-old classroom, I suggested the teachers read a book to the children or sing songs with the children during transitions and diaper change periods to reduce the amount of wait time the children experience in between activities and to reduce behavior issues and better manage the group. COMPLIANCE PLAN: Since the violations observed and cited were corrected during today’s visit, no compliance documentation will be due after this visit. COMPLIANCE HISTORY: Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. I monitored for compliance with the CAP as follows: 1. The child care operator shall maintain compliance at all times with all applicable child care requirements. Item #1 – No violations were observed today related to the requirements included in this stipulation. This item is in compliance. 2. Within one (1) week after this Notice is received, Bianca Gandhi, owner, shall contact Kimberly Crane, Child Care Consultant, PO Box 6217, Hickory, NC 28603, telephone number 828-493-6390, email Kimberly.crane@dhhs.nc.gov, to arrange for a complete review of all child care requirements. All staff members, including administrative, full-time, part-time, auxiliary, substitute, and volunteer staff shall participate in this mandatory training. Special emphasis shall be placed on items addressed in Item #1, as well as each staff person’s responsibility for assuring compliance with all applicable child care requirements. Documentation of the training shall include a training roster with the names and signatures of the trainer and the training participants, as well as the title of the training and the date and time the training was conducted. The documentation shall be maintained in the facility files for review by Division of Child Development and Early Education representatives upon request. Item #2 – The rules review training was completed on Friday, May 10, 2024 from 9:00am to 1:00pm. This item is in compliance. 3. Within two (2) weeks after completing the required rules review training in Item #2, Ms. Gandhi must develop written procedures that include a plan for ensuring staff/child ratios and supervision remain in compliance throughout the day including, but not limited to, the following: • The first and last operating hours of the day, in the classroom, and during transition periods, including naptime, meals and snacks, and bathroom time • When children are on the playground • When more than one group of children is combined • When children are transitioned from one area to another • Absence of staff members • Procedures for informing administration when staff members need to attend to personal care needs or to complete tasks outside the classroom • Procedures for supervisory staff members to visit each classroom and monitor staff members’ implementation of the supervision plan • Procedures for periodic review of the supervision plan with all staff members, including the review of the plan in the orientation of new staff members before they assume child care responsibilities The written procedures shall be submitted to Ms. Crane. Ms. Crane shall notify Ms. Gandhi, orally and in writing, as to whether the written procedures are approved or if modifications are needed. Once approved, the written procedures shall be immediately implemented and permanently incorporated into the facility’s operating procedures. A copy of the approved written procedures shall be maintained in facility files for review by representatives of the Division of Child Development and Early Education upon request. Item #3 – On May 20, 2024, Ms. Gandhi submitted to me by email her written procedures that included a plan for ensuring staff/child ratios and supervision remain in compliance throughout the day. On May 22, 2024, your written procedures were approved. Once approved, the written procedures were immediately implemented and should be permanently incorporated into the facility’s operating procedures. This item is in compliance. 4. Within two (2) weeks after approval of the written procedures in Item #3, a staff meeting shall be conducted to review the approved written procedures. All staff members, including administrative, full-time, part-time, auxiliary, substitute, and volunteer staff, shall participate in the mandatory staff meeting. Documentation of the staff meeting shall include an attendance roster with the printed name and signature of each staff member in attendance, the date, time, and length of the meeting, and minutes documenting the information discussed during the meeting. The documentation shall be emailed to Ms. Crane within two (2) days after the meeting is conducted. All documentation shall be maintained in facility files for review by representatives of the Division of Child Development and Early Education upon request. Item #4 – No later than June 5, 2024, Ms. Gandhi should conduct a staff meeting with all staff members to review and discuss the approved written procedures. Within two business days after the staff meeting, Ms. Gandhi should email the specified documentation of the staff meeting to Ms. Crane for approval. Ms. Gandhi has scheduled a staff meeting for May 28, 2024 at 5:30pm. After today’s visit, a visit summary was prepared, reviewed, signed, and copy was left with you. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
10A NCAC 09 .1102 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 5/24/2024 Number Present: 42 Completed Date: 5/24/2024 Age: From 0 To 5 Total Minutes: 185 Time In: 09:15 AM Time Out: 12:20 PM Time In: Time Out: List to Use: Center Type Of Visit: Admin Action Follow-Up Lic Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance with applicable child care requirements for an administrative action follow-up visit, including the Corrective Action Plan (CAP) included in the Written Warning issued by the DCDEE to this facility on March 7, 2024. You, Bianca Gandhi, Owner/Administrator, assisted me with today’s visit. Your compliance history was 84% on May 22, 2024 prior to today's visit and was reviewed with you today. Per child care rule .2201(j), during today’s visit, I monitored required Administrative Action postings, CPR training, First Aid training, and Criminal Record Check (CBC) requirements regarding pre-service and 5-year reassessments in accordance with G.S. 110-90.2(b), hazardous items, materials, and equipment, supervision of children, discipline, nurture and care of children, staff/child ratio, group size, licensed capacity, and permit restrictions. In addition, I also monitored ITS-SIDS training and age-appropriate activities as included in the Corrective Action Plan (CAP) of the Administrative Action. I conducted a walk-through of the licensed indoor and outdoor spaces. I observed children participating in free play on the floor, in activity centers and outdoors. Daily schedules and activity plans were current and posted in each classroom. You stated screen-time was not offered to any child in the facility at any time during the operating day. I monitored program records and staff records. I monitored two staff record files for new staff hired since the initial administrative action follow-up visit on April 9, 2024. I monitored nine staff record files for returning staff members. I monitored CBC requirements, CPR training, First Aid training, Recognizing and Responding to Suspicions of Child Maltreatment training, and ITS-SIDS training. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. The following violations were observed, cited, and corrected during today’s visit: Violation Number Comment Rule 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. First Aid training for one staff member with a date of employment of 10/02/2023 was due by 01/02/2024. The staff member completed First Aid training on 01/16/2024. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. CPR training for one staff member with a date of employment of 10/02/2023 was due by 01/02/2024. The staff member completed CPR training on 01/16/2024. .1102(d) TECHNICAL ASSISTANCE: Per child care rule 10A NCAC 09 .1102(c & d), each employee is required to maintain documentation in their staff record file as verification that the employee has completed First Aid and CPR training within the first ninety (90) days of employment and has maintained a current and valid First Aid and CPR certificate. During today’s visit, I observed First Aid and CPR training for one staff member with a date of employment of 10/02/2024 was due to be completed by 01/02/2024. The First Aid & CPR training certificate in the staff member’s file was dated 01/16/2024. You stated the training was completed late because you had a difficult time finding a class for this staff member to attend by 01/02/2024. I suggest you contact fire departments, fire inspectors, community colleges, EMS departments, public health departments, and hospitals in your community as well as your local Resource and Referral agency to acquire information of upcoming First Aid and CPR classes you can register your staff to attend or instructors you may contact. I suggest that you begin searching for a First Aid and CPR class as soon as you hire a new staff member who does not have First Aid and CPR certification. I suggest you begin searching for a First Aid and CPR class at least three months before a staff member’s certification is set to expire. CONSULTATION: 1. Per 10A NCAC 09 .0701(d), each employee must maintain documentation in their staff record file as verification that the employee has completed First Aid and CPR training within the first ninety (90) days of employment and has maintained a current and valid First Aid and CPR certificate. 2. Per 10A NCAC 09 .1102(a), new employee’s must complete the Health & Safety (H&S) Training requirement within the first year of employment. Per 10A NCAC 09 .1103(b), returning employees must revisit each H&S Training topic every five years. The due date of the H&S training five-year renewal is calculated five years from the date on each H&S training certificate. H&S training certificates completed prior to an employee’s date of hire may be counted towards the initial H&S training requirement as long as the date of the training certificate is 12 months or less from the date of hire. 3. Teachers hired with high school diploma only and no early childhood licensed care experience may not be left alone to supervise children until they have satisfied at one of the following requirements: a) Enrolled in EDU 119 and completed at least 20 hours of the coursework. b) Have NC Early Childhood Credentials. c) Have at least one year of early childhood care experience in a licensed facility. 4. When a lead teacher leaves your employment, you may assign a new lead teacher that already holds NC Early Childhood Credentials (NCECC) which is required to meet lead teacher qualifications or you may assign lead teacher responsibilities to a substitute staff member until a new lead teacher meeting qualifications can be hired. Child care rule allows 120 days for you to hire a new lead teacher or assign lead teacher responsibilities to an existing staff member. If the new lead teacher does not meet lead teacher qualifications when lead teacher responsibilities are assigned to that teacher, the new lead teacher has six months to enroll in and complete NCECC coursework to meet lead teacher qualifications. 5. In the two-year-old classroom, I suggested the teachers read a book to the children or sing songs with the children during transitions and diaper change periods to reduce the amount of wait time the children experience in between activities and to reduce behavior issues and better manage the group. COMPLIANCE PLAN: Since the violations observed and cited were corrected during today’s visit, no compliance documentation will be due after this visit. COMPLIANCE HISTORY: Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. I monitored for compliance with the CAP as follows: 1. The child care operator shall maintain compliance at all times with all applicable child care requirements. Item #1 – No violations were observed today related to the requirements included in this stipulation. This item is in compliance. 2. Within one (1) week after this Notice is received, Bianca Gandhi, owner, shall contact Kimberly Crane, Child Care Consultant, PO Box 6217, Hickory, NC 28603, telephone number 828-493-6390, email Kimberly.crane@dhhs.nc.gov, to arrange for a complete review of all child care requirements. All staff members, including administrative, full-time, part-time, auxiliary, substitute, and volunteer staff shall participate in this mandatory training. Special emphasis shall be placed on items addressed in Item #1, as well as each staff person’s responsibility for assuring compliance with all applicable child care requirements. Documentation of the training shall include a training roster with the names and signatures of the trainer and the training participants, as well as the title of the training and the date and time the training was conducted. The documentation shall be maintained in the facility files for review by Division of Child Development and Early Education representatives upon request. Item #2 – The rules review training was completed on Friday, May 10, 2024 from 9:00am to 1:00pm. This item is in compliance. 3. Within two (2) weeks after completing the required rules review training in Item #2, Ms. Gandhi must develop written procedures that include a plan for ensuring staff/child ratios and supervision remain in compliance throughout the day including, but not limited to, the following: • The first and last operating hours of the day, in the classroom, and during transition periods, including naptime, meals and snacks, and bathroom time • When children are on the playground • When more than one group of children is combined • When children are transitioned from one area to another • Absence of staff members • Procedures for informing administration when staff members need to attend to personal care needs or to complete tasks outside the classroom • Procedures for supervisory staff members to visit each classroom and monitor staff members’ implementation of the supervision plan • Procedures for periodic review of the supervision plan with all staff members, including the review of the plan in the orientation of new staff members before they assume child care responsibilities The written procedures shall be submitted to Ms. Crane. Ms. Crane shall notify Ms. Gandhi, orally and in writing, as to whether the written procedures are approved or if modifications are needed. Once approved, the written procedures shall be immediately implemented and permanently incorporated into the facility’s operating procedures. A copy of the approved written procedures shall be maintained in facility files for review by representatives of the Division of Child Development and Early Education upon request. Item #3 – On May 20, 2024, Ms. Gandhi submitted to me by email her written procedures that included a plan for ensuring staff/child ratios and supervision remain in compliance throughout the day. On May 22, 2024, your written procedures were approved. Once approved, the written procedures were immediately implemented and should be permanently incorporated into the facility’s operating procedures. This item is in compliance. 4. Within two (2) weeks after approval of the written procedures in Item #3, a staff meeting shall be conducted to review the approved written procedures. All staff members, including administrative, full-time, part-time, auxiliary, substitute, and volunteer staff, shall participate in the mandatory staff meeting. Documentation of the staff meeting shall include an attendance roster with the printed name and signature of each staff member in attendance, the date, time, and length of the meeting, and minutes documenting the information discussed during the meeting. The documentation shall be emailed to Ms. Crane within two (2) days after the meeting is conducted. All documentation shall be maintained in facility files for review by representatives of the Division of Child Development and Early Education upon request. Item #4 – No later than June 5, 2024, Ms. Gandhi should conduct a staff meeting with all staff members to review and discuss the approved written procedures. Within two business days after the staff meeting, Ms. Gandhi should email the specified documentation of the staff meeting to Ms. Crane for approval. Ms. Gandhi has scheduled a staff meeting for May 28, 2024 at 5:30pm. After today’s visit, a visit summary was prepared, reviewed, signed, and copy was left with you. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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 .1103 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 5/24/2024 Number Present: 42 Completed Date: 5/24/2024 Age: From 0 To 5 Total Minutes: 185 Time In: 09:15 AM Time Out: 12:20 PM Time In: Time Out: List to Use: Center Type Of Visit: Admin Action Follow-Up Lic Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance with applicable child care requirements for an administrative action follow-up visit, including the Corrective Action Plan (CAP) included in the Written Warning issued by the DCDEE to this facility on March 7, 2024. You, Bianca Gandhi, Owner/Administrator, assisted me with today’s visit. Your compliance history was 84% on May 22, 2024 prior to today's visit and was reviewed with you today. Per child care rule .2201(j), during today’s visit, I monitored required Administrative Action postings, CPR training, First Aid training, and Criminal Record Check (CBC) requirements regarding pre-service and 5-year reassessments in accordance with G.S. 110-90.2(b), hazardous items, materials, and equipment, supervision of children, discipline, nurture and care of children, staff/child ratio, group size, licensed capacity, and permit restrictions. In addition, I also monitored ITS-SIDS training and age-appropriate activities as included in the Corrective Action Plan (CAP) of the Administrative Action. I conducted a walk-through of the licensed indoor and outdoor spaces. I observed children participating in free play on the floor, in activity centers and outdoors. Daily schedules and activity plans were current and posted in each classroom. You stated screen-time was not offered to any child in the facility at any time during the operating day. I monitored program records and staff records. I monitored two staff record files for new staff hired since the initial administrative action follow-up visit on April 9, 2024. I monitored nine staff record files for returning staff members. I monitored CBC requirements, CPR training, First Aid training, Recognizing and Responding to Suspicions of Child Maltreatment training, and ITS-SIDS training. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. The following violations were observed, cited, and corrected during today’s visit: Violation Number Comment Rule 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. First Aid training for one staff member with a date of employment of 10/02/2023 was due by 01/02/2024. The staff member completed First Aid training on 01/16/2024. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. CPR training for one staff member with a date of employment of 10/02/2023 was due by 01/02/2024. The staff member completed CPR training on 01/16/2024. .1102(d) TECHNICAL ASSISTANCE: Per child care rule 10A NCAC 09 .1102(c & d), each employee is required to maintain documentation in their staff record file as verification that the employee has completed First Aid and CPR training within the first ninety (90) days of employment and has maintained a current and valid First Aid and CPR certificate. During today’s visit, I observed First Aid and CPR training for one staff member with a date of employment of 10/02/2024 was due to be completed by 01/02/2024. The First Aid & CPR training certificate in the staff member’s file was dated 01/16/2024. You stated the training was completed late because you had a difficult time finding a class for this staff member to attend by 01/02/2024. I suggest you contact fire departments, fire inspectors, community colleges, EMS departments, public health departments, and hospitals in your community as well as your local Resource and Referral agency to acquire information of upcoming First Aid and CPR classes you can register your staff to attend or instructors you may contact. I suggest that you begin searching for a First Aid and CPR class as soon as you hire a new staff member who does not have First Aid and CPR certification. I suggest you begin searching for a First Aid and CPR class at least three months before a staff member’s certification is set to expire. CONSULTATION: 1. Per 10A NCAC 09 .0701(d), each employee must maintain documentation in their staff record file as verification that the employee has completed First Aid and CPR training within the first ninety (90) days of employment and has maintained a current and valid First Aid and CPR certificate. 2. Per 10A NCAC 09 .1102(a), new employee’s must complete the Health & Safety (H&S) Training requirement within the first year of employment. Per 10A NCAC 09 .1103(b), returning employees must revisit each H&S Training topic every five years. The due date of the H&S training five-year renewal is calculated five years from the date on each H&S training certificate. H&S training certificates completed prior to an employee’s date of hire may be counted towards the initial H&S training requirement as long as the date of the training certificate is 12 months or less from the date of hire. 3. Teachers hired with high school diploma only and no early childhood licensed care experience may not be left alone to supervise children until they have satisfied at one of the following requirements: a) Enrolled in EDU 119 and completed at least 20 hours of the coursework. b) Have NC Early Childhood Credentials. c) Have at least one year of early childhood care experience in a licensed facility. 4. When a lead teacher leaves your employment, you may assign a new lead teacher that already holds NC Early Childhood Credentials (NCECC) which is required to meet lead teacher qualifications or you may assign lead teacher responsibilities to a substitute staff member until a new lead teacher meeting qualifications can be hired. Child care rule allows 120 days for you to hire a new lead teacher or assign lead teacher responsibilities to an existing staff member. If the new lead teacher does not meet lead teacher qualifications when lead teacher responsibilities are assigned to that teacher, the new lead teacher has six months to enroll in and complete NCECC coursework to meet lead teacher qualifications. 5. In the two-year-old classroom, I suggested the teachers read a book to the children or sing songs with the children during transitions and diaper change periods to reduce the amount of wait time the children experience in between activities and to reduce behavior issues and better manage the group. COMPLIANCE PLAN: Since the violations observed and cited were corrected during today’s visit, no compliance documentation will be due after this visit. COMPLIANCE HISTORY: Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. I monitored for compliance with the CAP as follows: 1. The child care operator shall maintain compliance at all times with all applicable child care requirements. Item #1 – No violations were observed today related to the requirements included in this stipulation. This item is in compliance. 2. Within one (1) week after this Notice is received, Bianca Gandhi, owner, shall contact Kimberly Crane, Child Care Consultant, PO Box 6217, Hickory, NC 28603, telephone number 828-493-6390, email Kimberly.crane@dhhs.nc.gov, to arrange for a complete review of all child care requirements. All staff members, including administrative, full-time, part-time, auxiliary, substitute, and volunteer staff shall participate in this mandatory training. Special emphasis shall be placed on items addressed in Item #1, as well as each staff person’s responsibility for assuring compliance with all applicable child care requirements. Documentation of the training shall include a training roster with the names and signatures of the trainer and the training participants, as well as the title of the training and the date and time the training was conducted. The documentation shall be maintained in the facility files for review by Division of Child Development and Early Education representatives upon request. Item #2 – The rules review training was completed on Friday, May 10, 2024 from 9:00am to 1:00pm. This item is in compliance. 3. Within two (2) weeks after completing the required rules review training in Item #2, Ms. Gandhi must develop written procedures that include a plan for ensuring staff/child ratios and supervision remain in compliance throughout the day including, but not limited to, the following: • The first and last operating hours of the day, in the classroom, and during transition periods, including naptime, meals and snacks, and bathroom time • When children are on the playground • When more than one group of children is combined • When children are transitioned from one area to another • Absence of staff members • Procedures for informing administration when staff members need to attend to personal care needs or to complete tasks outside the classroom • Procedures for supervisory staff members to visit each classroom and monitor staff members’ implementation of the supervision plan • Procedures for periodic review of the supervision plan with all staff members, including the review of the plan in the orientation of new staff members before they assume child care responsibilities The written procedures shall be submitted to Ms. Crane. Ms. Crane shall notify Ms. Gandhi, orally and in writing, as to whether the written procedures are approved or if modifications are needed. Once approved, the written procedures shall be immediately implemented and permanently incorporated into the facility’s operating procedures. A copy of the approved written procedures shall be maintained in facility files for review by representatives of the Division of Child Development and Early Education upon request. Item #3 – On May 20, 2024, Ms. Gandhi submitted to me by email her written procedures that included a plan for ensuring staff/child ratios and supervision remain in compliance throughout the day. On May 22, 2024, your written procedures were approved. Once approved, the written procedures were immediately implemented and should be permanently incorporated into the facility’s operating procedures. This item is in compliance. 4. Within two (2) weeks after approval of the written procedures in Item #3, a staff meeting shall be conducted to review the approved written procedures. All staff members, including administrative, full-time, part-time, auxiliary, substitute, and volunteer staff, shall participate in the mandatory staff meeting. Documentation of the staff meeting shall include an attendance roster with the printed name and signature of each staff member in attendance, the date, time, and length of the meeting, and minutes documenting the information discussed during the meeting. The documentation shall be emailed to Ms. Crane within two (2) days after the meeting is conducted. All documentation shall be maintained in facility files for review by representatives of the Division of Child Development and Early Education upon request. Item #4 – No later than June 5, 2024, Ms. Gandhi should conduct a staff meeting with all staff members to review and discuss the approved written procedures. Within two business days after the staff meeting, Ms. Gandhi should email the specified documentation of the staff meeting to Ms. Crane for approval. Ms. Gandhi has scheduled a staff meeting for May 28, 2024 at 5:30pm. After today’s visit, a visit summary was prepared, reviewed, signed, and copy was left with you. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 5/24/2024 Number Present: 42 Completed Date: 5/24/2024 Age: From 0 To 5 Total Minutes: 185 Time In: 09:15 AM Time Out: 12:20 PM Time In: Time Out: List to Use: Center Type Of Visit: Admin Action Follow-Up Lic Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance with applicable child care requirements for an administrative action follow-up visit, including the Corrective Action Plan (CAP) included in the Written Warning issued by the DCDEE to this facility on March 7, 2024. You, Bianca Gandhi, Owner/Administrator, assisted me with today’s visit. Your compliance history was 84% on May 22, 2024 prior to today's visit and was reviewed with you today. Per child care rule .2201(j), during today’s visit, I monitored required Administrative Action postings, CPR training, First Aid training, and Criminal Record Check (CBC) requirements regarding pre-service and 5-year reassessments in accordance with G.S. 110-90.2(b), hazardous items, materials, and equipment, supervision of children, discipline, nurture and care of children, staff/child ratio, group size, licensed capacity, and permit restrictions. In addition, I also monitored ITS-SIDS training and age-appropriate activities as included in the Corrective Action Plan (CAP) of the Administrative Action. I conducted a walk-through of the licensed indoor and outdoor spaces. I observed children participating in free play on the floor, in activity centers and outdoors. Daily schedules and activity plans were current and posted in each classroom. You stated screen-time was not offered to any child in the facility at any time during the operating day. I monitored program records and staff records. I monitored two staff record files for new staff hired since the initial administrative action follow-up visit on April 9, 2024. I monitored nine staff record files for returning staff members. I monitored CBC requirements, CPR training, First Aid training, Recognizing and Responding to Suspicions of Child Maltreatment training, and ITS-SIDS training. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. The following violations were observed, cited, and corrected during today’s visit: Violation Number Comment Rule 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. First Aid training for one staff member with a date of employment of 10/02/2023 was due by 01/02/2024. The staff member completed First Aid training on 01/16/2024. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. CPR training for one staff member with a date of employment of 10/02/2023 was due by 01/02/2024. The staff member completed CPR training on 01/16/2024. .1102(d) TECHNICAL ASSISTANCE: Per child care rule 10A NCAC 09 .1102(c & d), each employee is required to maintain documentation in their staff record file as verification that the employee has completed First Aid and CPR training within the first ninety (90) days of employment and has maintained a current and valid First Aid and CPR certificate. During today’s visit, I observed First Aid and CPR training for one staff member with a date of employment of 10/02/2024 was due to be completed by 01/02/2024. The First Aid & CPR training certificate in the staff member’s file was dated 01/16/2024. You stated the training was completed late because you had a difficult time finding a class for this staff member to attend by 01/02/2024. I suggest you contact fire departments, fire inspectors, community colleges, EMS departments, public health departments, and hospitals in your community as well as your local Resource and Referral agency to acquire information of upcoming First Aid and CPR classes you can register your staff to attend or instructors you may contact. I suggest that you begin searching for a First Aid and CPR class as soon as you hire a new staff member who does not have First Aid and CPR certification. I suggest you begin searching for a First Aid and CPR class at least three months before a staff member’s certification is set to expire. CONSULTATION: 1. Per 10A NCAC 09 .0701(d), each employee must maintain documentation in their staff record file as verification that the employee has completed First Aid and CPR training within the first ninety (90) days of employment and has maintained a current and valid First Aid and CPR certificate. 2. Per 10A NCAC 09 .1102(a), new employee’s must complete the Health & Safety (H&S) Training requirement within the first year of employment. Per 10A NCAC 09 .1103(b), returning employees must revisit each H&S Training topic every five years. The due date of the H&S training five-year renewal is calculated five years from the date on each H&S training certificate. H&S training certificates completed prior to an employee’s date of hire may be counted towards the initial H&S training requirement as long as the date of the training certificate is 12 months or less from the date of hire. 3. Teachers hired with high school diploma only and no early childhood licensed care experience may not be left alone to supervise children until they have satisfied at one of the following requirements: a) Enrolled in EDU 119 and completed at least 20 hours of the coursework. b) Have NC Early Childhood Credentials. c) Have at least one year of early childhood care experience in a licensed facility. 4. When a lead teacher leaves your employment, you may assign a new lead teacher that already holds NC Early Childhood Credentials (NCECC) which is required to meet lead teacher qualifications or you may assign lead teacher responsibilities to a substitute staff member until a new lead teacher meeting qualifications can be hired. Child care rule allows 120 days for you to hire a new lead teacher or assign lead teacher responsibilities to an existing staff member. If the new lead teacher does not meet lead teacher qualifications when lead teacher responsibilities are assigned to that teacher, the new lead teacher has six months to enroll in and complete NCECC coursework to meet lead teacher qualifications. 5. In the two-year-old classroom, I suggested the teachers read a book to the children or sing songs with the children during transitions and diaper change periods to reduce the amount of wait time the children experience in between activities and to reduce behavior issues and better manage the group. COMPLIANCE PLAN: Since the violations observed and cited were corrected during today’s visit, no compliance documentation will be due after this visit. COMPLIANCE HISTORY: Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. I monitored for compliance with the CAP as follows: 1. The child care operator shall maintain compliance at all times with all applicable child care requirements. Item #1 – No violations were observed today related to the requirements included in this stipulation. This item is in compliance. 2. Within one (1) week after this Notice is received, Bianca Gandhi, owner, shall contact Kimberly Crane, Child Care Consultant, PO Box 6217, Hickory, NC 28603, telephone number 828-493-6390, email Kimberly.crane@dhhs.nc.gov, to arrange for a complete review of all child care requirements. All staff members, including administrative, full-time, part-time, auxiliary, substitute, and volunteer staff shall participate in this mandatory training. Special emphasis shall be placed on items addressed in Item #1, as well as each staff person’s responsibility for assuring compliance with all applicable child care requirements. Documentation of the training shall include a training roster with the names and signatures of the trainer and the training participants, as well as the title of the training and the date and time the training was conducted. The documentation shall be maintained in the facility files for review by Division of Child Development and Early Education representatives upon request. Item #2 – The rules review training was completed on Friday, May 10, 2024 from 9:00am to 1:00pm. This item is in compliance. 3. Within two (2) weeks after completing the required rules review training in Item #2, Ms. Gandhi must develop written procedures that include a plan for ensuring staff/child ratios and supervision remain in compliance throughout the day including, but not limited to, the following: • The first and last operating hours of the day, in the classroom, and during transition periods, including naptime, meals and snacks, and bathroom time • When children are on the playground • When more than one group of children is combined • When children are transitioned from one area to another • Absence of staff members • Procedures for informing administration when staff members need to attend to personal care needs or to complete tasks outside the classroom • Procedures for supervisory staff members to visit each classroom and monitor staff members’ implementation of the supervision plan • Procedures for periodic review of the supervision plan with all staff members, including the review of the plan in the orientation of new staff members before they assume child care responsibilities The written procedures shall be submitted to Ms. Crane. Ms. Crane shall notify Ms. Gandhi, orally and in writing, as to whether the written procedures are approved or if modifications are needed. Once approved, the written procedures shall be immediately implemented and permanently incorporated into the facility’s operating procedures. A copy of the approved written procedures shall be maintained in facility files for review by representatives of the Division of Child Development and Early Education upon request. Item #3 – On May 20, 2024, Ms. Gandhi submitted to me by email her written procedures that included a plan for ensuring staff/child ratios and supervision remain in compliance throughout the day. On May 22, 2024, your written procedures were approved. Once approved, the written procedures were immediately implemented and should be permanently incorporated into the facility’s operating procedures. This item is in compliance. 4. Within two (2) weeks after approval of the written procedures in Item #3, a staff meeting shall be conducted to review the approved written procedures. All staff members, including administrative, full-time, part-time, auxiliary, substitute, and volunteer staff, shall participate in the mandatory staff meeting. Documentation of the staff meeting shall include an attendance roster with the printed name and signature of each staff member in attendance, the date, time, and length of the meeting, and minutes documenting the information discussed during the meeting. The documentation shall be emailed to Ms. Crane within two (2) days after the meeting is conducted. All documentation shall be maintained in facility files for review by representatives of the Division of Child Development and Early Education upon request. Item #4 – No later than June 5, 2024, Ms. Gandhi should conduct a staff meeting with all staff members to review and discuss the approved written procedures. Within two business days after the staff meeting, Ms. Gandhi should email the specified documentation of the staff meeting to Ms. Crane for approval. Ms. Gandhi has scheduled a staff meeting for May 28, 2024 at 5:30pm. After today’s visit, a visit summary was prepared, reviewed, signed, and copy was left with you. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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 .0302 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 3/1/2024 Number Present: 49 Completed Date: 3/1/2024 Age: From 0 To 5 Total Minutes: 260 Time In: 09:15 AM Time Out: 01:35 PM Time In: Time Out: List to Use: Center Type Of Visit: Unannounced Visit Follow-Up Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Bianca Gandhi, Owner and Administrator, assisted me with today’s visit. Your program currently operates with a three-star license, issued on April 8, 2023, earning four points in staff education, two points in program standards, and one quality point for having a combined turnover rate of 20 percent or less for the administrator, program coordinator, lead teacher, teacher, and group leader positions over the last 12 months. Toddlers Cove Academy Inc, the owner of your facility, was viewed as current-active on the North Carolina Secretary of State website on February 26, 2024. Your program’s compliance history was 88% as of February 26, 2024 and was reviewed with you today. Your last sanitation inspection was dated January 3, 2024 with a Superior classification and 4 demerits. Your last fire inspection was dated April 18, 2023. I visited each licensed indoor space today. I observed Space 4 was not currently being used. You stated this room was not used due to staffing. I observed students arriving, playing in activity areas, participating in teacher directed whole group and small group activities, and eating lunch. I monitored arrival records, daily schedules, activity plans, and materials in each classroom. I observed age-appropriate schedules and routines practiced in each classroom. I observed developmentally appropriate materials and equipment provided and used in each classroom. I observed activity plans with developmentally appropriate activities planned and carried out in each classroom. I observed teachers, administrators, and support staff interacting appropriately and meeting the developmental needs of the children. I monitored medication administration and medication storage. I reviewed one staff record for new staff members hired since the last unannounced visit follow up visit on January 17, 2024. I reviewed ten staff records for returning staff members to monitor valid and current criminal background check (CBC) qualification letters, valid and current First Aid and CPR training, and valid and current ITS-SIDS training for applicable staff members. I monitored health and safety requirements. I monitored staff/child ratios, supervision, space capacity, use of approved space, and permit restrictions. I observed and cited the following violations during today's visit: Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. In Space 1, the arrival time for one child was not recorded. The administrator added the missing arrival time for the child. 10A NCAC 09 .0302(d)(4) 605 Toilet fixtures were not cleaned and disinfected at least daily and when visibly soiled. In the bathroom shared by Space 5 and 6, the toilet basins were soiled with build up. 15A NCAC 18A.2817(b) 620 All walls and ceilings including doors and windows were not kept clean and in good repair. In the bathroom shared by Space 5 and 6, the bathroom wall had a tear in the sheet rock where a soap dispenser had been removed from the wall, the walls were visibly soiled, and the rubber baseboards were visibly soiled with buildup. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. In Space 5, a stand-alone dollhouse had worn edges and torn paper covering and a table in the dramatic play area had broken edges and chipping paint. The administrator removed the dollhouse and the table from the classroom. G.S. 110-91(6); .0601(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In Space 2, 5, and 6, four prescription medications for chronic illnesses were stored in locked cabinets making them not readily accessible to the staff in the event of an emergency. The administrator moved these emergency medications to shelves above five feet in cabinets in the classroom making them inaccessible to children but easily assessible to teachers. 15A NCAC 18A .2820(d) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In Space 2, the permission to administer form for one over the counter diaper ointment had expired and the diaper ointment was being administered. In Space 3, one over the counter expired in 01/2024 and was not returned to the parent. In Space 6, the permission to administer from for one over the counter medication had expired and the medication had not been returned to the parent. The administrator removed the three over the counter medications from the classrooms and brought them her office to return to the parents. .0803(12) TECHNICAL ASSISTANCE: 1 Per child care rule 10A NCAC 09 .0302(d)(4), daily records of arrival and departure times for children enrolled at the center should be maintained as children arrive and depart. To maintain compliance with this child care requirement, I suggest you move the arrival and departure record inside the classroom so that staff can easily check behind parents and record any missing arrival and departure times. 2 When a medication or a permission to administer form has expired, the medication should be returned to the parent within 72 hours and the medication should not be administered. To maintain compliance with this child care requirement, I suggest you monitor medications and medication permission forms throughout the facility at least twice a month. 3 Emergency medications for chronic illnesses such as inhalers for asthma and epi-pens for anaphylactic allergies should be stored above five feet in an unlocked cabinet or location that’s easy for the staff member to get to quickly. To maintain compliance with this child care requirement, I suggest you review the sanitation rules regarding medication storage and share this review with your staff at your next staff meeting. 4 Per sanitation rule 15A NCAC 18A .2825(a), walls should be kept in good repair and clean. To maintain compliance with this child care requirement, I suggest you repair and paint the sheet rock in the bathroom shared by Space 5 and 6 and clean the soiled walls. 5 Per sanitation rule 15A NCAC 18A .2817(b), toilet fixtures shall be cleaned and disinfected daily and when visibly soiled. To maintain compliance with this child care requirement, I suggest you review cleaning responsibilities with your staff and inspect the bathrooms throughout the facility for cleanliness multiple times throughout the operating day. 6 Per child care rule 10A NCAC 09. 601(b), all equipment and materials should be kept in good repair. To maintain compliance with this child care requirement, I suggest you review this requirement with your staff and encourage them to alert you to materials and equipment that need to be repaired or replaced so you can remove them from the classroom or playground and repair and/or replace as needed. CONSULTATION: 1 Parent’s permission authorization for over the counter/non-prescription medications such as diaper ointments may not be valid for longer than twelve months. 2 All over the counter/non-prescription medications should be labeled with the name of the child. If the medication is oily and causes permanent marker or ink to be easily rubbed off, I suggest you apply a strip of tape to the medication container and write the child’s name on the tape instead of on the container. 3 Today, we discussed the preservice requirements for teachers and lead teachers and the options you have for helping staff to meet the preservice requirements within six months of being employed which included acquiring one year of early childhood experience, enrolling in EDU 119, or passing the early education equivalency exam. 4 The Change of Information form for CBC is listed in law. When a new staff member starts working at a facility and gives the administrator a CBC qualification letter that was previously completed while working at another facility, but is still current, the administrator must send a Change of Information form for that new staff member to the CBC unit. The Change of Information form can be found on DCDEE’s website under Provider Documents and Forms. COMPLIANCE PLAN: No compliance documentation is needed for those violations corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I should receive your compliance letter no later than March 15, 2024. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
10A NCAC 09. 601 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 3/1/2024 Number Present: 49 Completed Date: 3/1/2024 Age: From 0 To 5 Total Minutes: 260 Time In: 09:15 AM Time Out: 01:35 PM Time In: Time Out: List to Use: Center Type Of Visit: Unannounced Visit Follow-Up Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Bianca Gandhi, Owner and Administrator, assisted me with today’s visit. Your program currently operates with a three-star license, issued on April 8, 2023, earning four points in staff education, two points in program standards, and one quality point for having a combined turnover rate of 20 percent or less for the administrator, program coordinator, lead teacher, teacher, and group leader positions over the last 12 months. Toddlers Cove Academy Inc, the owner of your facility, was viewed as current-active on the North Carolina Secretary of State website on February 26, 2024. Your program’s compliance history was 88% as of February 26, 2024 and was reviewed with you today. Your last sanitation inspection was dated January 3, 2024 with a Superior classification and 4 demerits. Your last fire inspection was dated April 18, 2023. I visited each licensed indoor space today. I observed Space 4 was not currently being used. You stated this room was not used due to staffing. I observed students arriving, playing in activity areas, participating in teacher directed whole group and small group activities, and eating lunch. I monitored arrival records, daily schedules, activity plans, and materials in each classroom. I observed age-appropriate schedules and routines practiced in each classroom. I observed developmentally appropriate materials and equipment provided and used in each classroom. I observed activity plans with developmentally appropriate activities planned and carried out in each classroom. I observed teachers, administrators, and support staff interacting appropriately and meeting the developmental needs of the children. I monitored medication administration and medication storage. I reviewed one staff record for new staff members hired since the last unannounced visit follow up visit on January 17, 2024. I reviewed ten staff records for returning staff members to monitor valid and current criminal background check (CBC) qualification letters, valid and current First Aid and CPR training, and valid and current ITS-SIDS training for applicable staff members. I monitored health and safety requirements. I monitored staff/child ratios, supervision, space capacity, use of approved space, and permit restrictions. I observed and cited the following violations during today's visit: Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. In Space 1, the arrival time for one child was not recorded. The administrator added the missing arrival time for the child. 10A NCAC 09 .0302(d)(4) 605 Toilet fixtures were not cleaned and disinfected at least daily and when visibly soiled. In the bathroom shared by Space 5 and 6, the toilet basins were soiled with build up. 15A NCAC 18A.2817(b) 620 All walls and ceilings including doors and windows were not kept clean and in good repair. In the bathroom shared by Space 5 and 6, the bathroom wall had a tear in the sheet rock where a soap dispenser had been removed from the wall, the walls were visibly soiled, and the rubber baseboards were visibly soiled with buildup. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. In Space 5, a stand-alone dollhouse had worn edges and torn paper covering and a table in the dramatic play area had broken edges and chipping paint. The administrator removed the dollhouse and the table from the classroom. G.S. 110-91(6); .0601(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In Space 2, 5, and 6, four prescription medications for chronic illnesses were stored in locked cabinets making them not readily accessible to the staff in the event of an emergency. The administrator moved these emergency medications to shelves above five feet in cabinets in the classroom making them inaccessible to children but easily assessible to teachers. 15A NCAC 18A .2820(d) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In Space 2, the permission to administer form for one over the counter diaper ointment had expired and the diaper ointment was being administered. In Space 3, one over the counter expired in 01/2024 and was not returned to the parent. In Space 6, the permission to administer from for one over the counter medication had expired and the medication had not been returned to the parent. The administrator removed the three over the counter medications from the classrooms and brought them her office to return to the parents. .0803(12) TECHNICAL ASSISTANCE: 1 Per child care rule 10A NCAC 09 .0302(d)(4), daily records of arrival and departure times for children enrolled at the center should be maintained as children arrive and depart. To maintain compliance with this child care requirement, I suggest you move the arrival and departure record inside the classroom so that staff can easily check behind parents and record any missing arrival and departure times. 2 When a medication or a permission to administer form has expired, the medication should be returned to the parent within 72 hours and the medication should not be administered. To maintain compliance with this child care requirement, I suggest you monitor medications and medication permission forms throughout the facility at least twice a month. 3 Emergency medications for chronic illnesses such as inhalers for asthma and epi-pens for anaphylactic allergies should be stored above five feet in an unlocked cabinet or location that’s easy for the staff member to get to quickly. To maintain compliance with this child care requirement, I suggest you review the sanitation rules regarding medication storage and share this review with your staff at your next staff meeting. 4 Per sanitation rule 15A NCAC 18A .2825(a), walls should be kept in good repair and clean. To maintain compliance with this child care requirement, I suggest you repair and paint the sheet rock in the bathroom shared by Space 5 and 6 and clean the soiled walls. 5 Per sanitation rule 15A NCAC 18A .2817(b), toilet fixtures shall be cleaned and disinfected daily and when visibly soiled. To maintain compliance with this child care requirement, I suggest you review cleaning responsibilities with your staff and inspect the bathrooms throughout the facility for cleanliness multiple times throughout the operating day. 6 Per child care rule 10A NCAC 09. 601(b), all equipment and materials should be kept in good repair. To maintain compliance with this child care requirement, I suggest you review this requirement with your staff and encourage them to alert you to materials and equipment that need to be repaired or replaced so you can remove them from the classroom or playground and repair and/or replace as needed. CONSULTATION: 1 Parent’s permission authorization for over the counter/non-prescription medications such as diaper ointments may not be valid for longer than twelve months. 2 All over the counter/non-prescription medications should be labeled with the name of the child. If the medication is oily and causes permanent marker or ink to be easily rubbed off, I suggest you apply a strip of tape to the medication container and write the child’s name on the tape instead of on the container. 3 Today, we discussed the preservice requirements for teachers and lead teachers and the options you have for helping staff to meet the preservice requirements within six months of being employed which included acquiring one year of early childhood experience, enrolling in EDU 119, or passing the early education equivalency exam. 4 The Change of Information form for CBC is listed in law. When a new staff member starts working at a facility and gives the administrator a CBC qualification letter that was previously completed while working at another facility, but is still current, the administrator must send a Change of Information form for that new staff member to the CBC unit. The Change of Information form can be found on DCDEE’s website under Provider Documents and Forms. COMPLIANCE PLAN: No compliance documentation is needed for those violations corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I should receive your compliance letter no later than March 15, 2024. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
G.S. 110-91 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 3/1/2024 Number Present: 49 Completed Date: 3/1/2024 Age: From 0 To 5 Total Minutes: 260 Time In: 09:15 AM Time Out: 01:35 PM Time In: Time Out: List to Use: Center Type Of Visit: Unannounced Visit Follow-Up Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Bianca Gandhi, Owner and Administrator, assisted me with today’s visit. Your program currently operates with a three-star license, issued on April 8, 2023, earning four points in staff education, two points in program standards, and one quality point for having a combined turnover rate of 20 percent or less for the administrator, program coordinator, lead teacher, teacher, and group leader positions over the last 12 months. Toddlers Cove Academy Inc, the owner of your facility, was viewed as current-active on the North Carolina Secretary of State website on February 26, 2024. Your program’s compliance history was 88% as of February 26, 2024 and was reviewed with you today. Your last sanitation inspection was dated January 3, 2024 with a Superior classification and 4 demerits. Your last fire inspection was dated April 18, 2023. I visited each licensed indoor space today. I observed Space 4 was not currently being used. You stated this room was not used due to staffing. I observed students arriving, playing in activity areas, participating in teacher directed whole group and small group activities, and eating lunch. I monitored arrival records, daily schedules, activity plans, and materials in each classroom. I observed age-appropriate schedules and routines practiced in each classroom. I observed developmentally appropriate materials and equipment provided and used in each classroom. I observed activity plans with developmentally appropriate activities planned and carried out in each classroom. I observed teachers, administrators, and support staff interacting appropriately and meeting the developmental needs of the children. I monitored medication administration and medication storage. I reviewed one staff record for new staff members hired since the last unannounced visit follow up visit on January 17, 2024. I reviewed ten staff records for returning staff members to monitor valid and current criminal background check (CBC) qualification letters, valid and current First Aid and CPR training, and valid and current ITS-SIDS training for applicable staff members. I monitored health and safety requirements. I monitored staff/child ratios, supervision, space capacity, use of approved space, and permit restrictions. I observed and cited the following violations during today's visit: Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. In Space 1, the arrival time for one child was not recorded. The administrator added the missing arrival time for the child. 10A NCAC 09 .0302(d)(4) 605 Toilet fixtures were not cleaned and disinfected at least daily and when visibly soiled. In the bathroom shared by Space 5 and 6, the toilet basins were soiled with build up. 15A NCAC 18A.2817(b) 620 All walls and ceilings including doors and windows were not kept clean and in good repair. In the bathroom shared by Space 5 and 6, the bathroom wall had a tear in the sheet rock where a soap dispenser had been removed from the wall, the walls were visibly soiled, and the rubber baseboards were visibly soiled with buildup. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. In Space 5, a stand-alone dollhouse had worn edges and torn paper covering and a table in the dramatic play area had broken edges and chipping paint. The administrator removed the dollhouse and the table from the classroom. G.S. 110-91(6); .0601(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In Space 2, 5, and 6, four prescription medications for chronic illnesses were stored in locked cabinets making them not readily accessible to the staff in the event of an emergency. The administrator moved these emergency medications to shelves above five feet in cabinets in the classroom making them inaccessible to children but easily assessible to teachers. 15A NCAC 18A .2820(d) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In Space 2, the permission to administer form for one over the counter diaper ointment had expired and the diaper ointment was being administered. In Space 3, one over the counter expired in 01/2024 and was not returned to the parent. In Space 6, the permission to administer from for one over the counter medication had expired and the medication had not been returned to the parent. The administrator removed the three over the counter medications from the classrooms and brought them her office to return to the parents. .0803(12) TECHNICAL ASSISTANCE: 1 Per child care rule 10A NCAC 09 .0302(d)(4), daily records of arrival and departure times for children enrolled at the center should be maintained as children arrive and depart. To maintain compliance with this child care requirement, I suggest you move the arrival and departure record inside the classroom so that staff can easily check behind parents and record any missing arrival and departure times. 2 When a medication or a permission to administer form has expired, the medication should be returned to the parent within 72 hours and the medication should not be administered. To maintain compliance with this child care requirement, I suggest you monitor medications and medication permission forms throughout the facility at least twice a month. 3 Emergency medications for chronic illnesses such as inhalers for asthma and epi-pens for anaphylactic allergies should be stored above five feet in an unlocked cabinet or location that’s easy for the staff member to get to quickly. To maintain compliance with this child care requirement, I suggest you review the sanitation rules regarding medication storage and share this review with your staff at your next staff meeting. 4 Per sanitation rule 15A NCAC 18A .2825(a), walls should be kept in good repair and clean. To maintain compliance with this child care requirement, I suggest you repair and paint the sheet rock in the bathroom shared by Space 5 and 6 and clean the soiled walls. 5 Per sanitation rule 15A NCAC 18A .2817(b), toilet fixtures shall be cleaned and disinfected daily and when visibly soiled. To maintain compliance with this child care requirement, I suggest you review cleaning responsibilities with your staff and inspect the bathrooms throughout the facility for cleanliness multiple times throughout the operating day. 6 Per child care rule 10A NCAC 09. 601(b), all equipment and materials should be kept in good repair. To maintain compliance with this child care requirement, I suggest you review this requirement with your staff and encourage them to alert you to materials and equipment that need to be repaired or replaced so you can remove them from the classroom or playground and repair and/or replace as needed. CONSULTATION: 1 Parent’s permission authorization for over the counter/non-prescription medications such as diaper ointments may not be valid for longer than twelve months. 2 All over the counter/non-prescription medications should be labeled with the name of the child. If the medication is oily and causes permanent marker or ink to be easily rubbed off, I suggest you apply a strip of tape to the medication container and write the child’s name on the tape instead of on the container. 3 Today, we discussed the preservice requirements for teachers and lead teachers and the options you have for helping staff to meet the preservice requirements within six months of being employed which included acquiring one year of early childhood experience, enrolling in EDU 119, or passing the early education equivalency exam. 4 The Change of Information form for CBC is listed in law. When a new staff member starts working at a facility and gives the administrator a CBC qualification letter that was previously completed while working at another facility, but is still current, the administrator must send a Change of Information form for that new staff member to the CBC unit. The Change of Information form can be found on DCDEE’s website under Provider Documents and Forms. COMPLIANCE PLAN: No compliance documentation is needed for those violations corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I should receive your compliance letter no later than March 15, 2024. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 1/17/2024 Number Present: 45 Completed Date: 1/17/2024 Age: From 0 To 5 Total Minutes: 350 Time In: 09:25 AM Time Out: 03:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Unannounced Visit Follow-Up Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Bianca Gandhi, Owner and acting Interim Administrator, assisted me with today’s visit. Your program currently operates with a three-star license, issued on April 8, 2023, earning 4 points in staff education, 2 points in program standards, and one quality point for having a combined turnover rate of 20 percent or less for the administrator, program coordinator, lead teacher, teacher, and group leader positions over the last 12 months. Toddlers Cove Academy Inc, the owner of your facility, was viewed as current-active on the North Carolina Secretary of State website on January 16, 2024. Your program’s compliance history was 87% as of January 16, 2024 and was reviewed with you today. Your last sanitation inspection was dated January 3, 2024 with a Superior classification and 4 demerits. Your last fire inspection was dated May 18, 2023. I visited each licensed indoor space today. Because of the extreme outdoor temperatures, I did not visit the outdoor spaces today. I observed Space 4 was not currently being used due to staffing. I observed infant children playing on the floor and one-year-old children playing in activity areas. I observed two-year-old children sitting at child-sized tables waiting to participate in a whole-group circle stamping free art activity. I observed three-year-old children participating in a teacher directed whole group activity. I observed four-year-old and five-year-old children participating in a teacher directed free art activity and playing in activity areas of choice. I observed children eating lunch in the classrooms, preparing for nap, and napping. Upon arrival and entering the classrooms where infant and one-year-old children were enrolled and attending, I noticed the rooms felt colder than usual. I observed the temperature was 62 degrees Fahrenheit on the thermostat display. I noticed there was not a room thermometer in use to verify the temperature in the classroom. I requested you bring a thermometer into the classroom so we could verify the temperature of the infant classroom. You brought a refrigerator thermometer into the classroom. The refrigerator thermometer registered a temperature of 58 degrees Fahrenheit. I took the refrigerator thermometer to the classroom where one-year-old children were enrolled and attending. I observed the refrigerator thermometer registered a temperature of 62 degrees in this classroom. You stated the repair service had been called and you were waiting on a return call. I observed you make several call attempts during the visit. I suggested you place a baby gate in the doorway of the infant classroom to allow some of the warm air from the lobby and kitchen area to drift into the infant classroom and raise the temperature of the classroom. I observed the temperature in the classroom rise to 62 degrees Fahrenheit. I explained to you and the teachers in the infant room that the facility’s safe sleep policy stated you would maintain a temperature of 68 to 75 degrees Fahrenheit in the room where infants were sleeping. I suggested the teachers carry out infant care as needed and hold sleeping children until my supervisor approved for the infants to sleep in the colder than expected classroom. At approximately 10:00am, the repair service returned your call and stated someone was on the way to your facility. At approximately 10:15am, the repair service arrived at the facility and began to investigate the issue with one side of the building not heating properly. In the meantime, I contacted my supervisor who approved for the infants to sleep in the colder than usual classroom and the repair service advised that the heating system needed an upgrade to a larger heating unit which would be repaired today. I advised you to remain operating today at a temperature of 62 degrees and higher as long as the unit is repaired today. If the heating unit is not to be repaired today, I advised you to send the children home early today and close the facility temporarily until the heating unit can be repaired. Please notify me by phone before 5pm or by email after 5pm to let me know that the heating system was repaired and/or your plans to operate tomorrow. I observed a current menu documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. I observed the current menu posted on a parent information board at the facility entrance door in the office area, the kitchen, and each classroom. I observed lunch prepared in the kitchen and served in the classrooms. I observed lunch included beans and hotdogs, corn, pears, whole wheat bread, and milk. I observed and cited no violations related to nutritional requirements or food preparation. I monitored daily schedules, activity plans, and materials in each classroom. I observed age-appropriate schedules and routines practiced in each classroom. I observed developmentally appropriate materials and equipment provided and used in each classroom. I observed activity plans with developmentally appropriate activities planned and carried out in each classroom. I observed and cited no violations. I observed teachers, administrators, and support staff interacting appropriately and meeting the developmental needs of the children. I observed and cited no violations. I observed children adequately supervised both indoors and outdoors during today’s visit. I observed voluntary enhanced staff-child ratios and group sizes maintained during today’s visit. I observed adequate approved space used during today’s visit. I observed minimum space capacity maintained throughout the center during today's visit. I observed permit restrictions including “Daytime care only” and “Meets enhanced ratios maintained during today’s visit. I reviewed four staff records for new staff members hired since your annual compliance visit on September 19, 2023. I reviewed eight staff records for returning staff members to monitor valid and current criminal background check (CBC) qualification letters, valid and current First Aid and CPR training, and valid and current ITS-SIDS training for applicable staff members. I observed and cited two violations. I observed and cited the following violations during today's visit: Violation Number Comment Rule 1041 Prior to employment a Criminal Background Check was not completed. New staff orientation training was started with three new staff members employed on 01/08/2024, 01/11/2024, and 01/16/2024 prior to receiving their Criminal Background Check qualification letters. G.S. 110-90.2(b) 1831 At least one child care provider, who has completed ITS-SIDS training was not present in the infant room, while children were in care. Two staff members with dates of employment of 01/08/2024 and 01/11/2024 were working alone in the infant room and had not completed ITS-SIDS training. .01102 (f) TECHNICAL ASSISTANCE: 1. Employee’s may not complete any training prior to your receiving a CBC qualification letter. Completing training shows an intent to hire and an employee cannot be hired prior to verifying the employee’s qualification as a child care provider. 2. Per child care rule 10A NCAC 09 .1102(f), at all times, one child care provider who has completed ITS-SIDS training shall be present in the infant room while children are in care. Today, I observed two new staff members who had not completed ITS-SIDS training working alone in the infant room. You stated these two new staff members were registered to take ITS-SIDS training on March 3, 2024. To maintain compliance with this child care requirement, I suggested you temporarily assign a staff member who had completed ITS-SIDS training to the infant room and attempt to find an ITS-SIDS class for these two new staff members sooner than March 3, 2024. CONSULTATION: 1. Per sanitation rules for child care centers rule 15A NCAC 18A .2826(b), all rooms used by children should be heated, cooled, and ventilated to maintain an ambient temperature between 65 degrees Fahrenheit and 85 degrees Fahrenheit. When you experience an issue heating or cooling your facility, I advised you to call your Environmental Health Specialist to seek guidance in making a decision to remain open or close the facility temporarily. 2. The facility’s written safe sleep policy specifies that the temperature in the room where infants aged 12 months or younger are sleeping will be maintained at a temperature between 68- and 75-degrees Fahrenheit. To maintain compliance with this child care requirement, I advised you to place a working room thermometer in the infant room to assist in tracking the room temperature. I also advised you to provide a baby gate in the infant and toddler classrooms that can be placed in the hall doorway to allow the classroom door to be left open for additional ventilation and air circulation that would assist in heating and cooling the classrooms. 3. Per your request, you asked me to review your qualifications and the qualifications of an applicant as perspective candidates for the position of administrator at your 3-Star facility with an education standard of 4-points. After reviewing your WORKS status letter, I observed you had been evaluated by the WORKS Education Unit and qualified as a Level 1 Early Childhood Administrator. After reviewing the WORKS status letter of the applicant, I observed the candidate may meet the requirements for an administrator of a child care center and advised you to have the candidate be evaluated by the WORKS Education Unit as an Early Childhood Administrator. I advised you to complete the Preservice Requirements for an Administrator of a Child Care Center form and submit it to me along with your WORKS status letter. I suggested you consider hiring an assistant administrator that you could begin to train to step into the role of administrator at a later date. 4. Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. 5. Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings including, but not limited to, ITS-SIDS training and Emergency Preparedness and Response in Child Care training. COMPLIANCE PLAN: All violations cited must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature I advise you to be prepared to provide supporting documentation in the form of photos, documents, certificates, etc. should I request them in order to clarify or verify compliance. I must receive your compliance letter no later than February 2, 2024. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
G.S. 110-90 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 1/17/2024 Number Present: 45 Completed Date: 1/17/2024 Age: From 0 To 5 Total Minutes: 350 Time In: 09:25 AM Time Out: 03:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Unannounced Visit Follow-Up Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Bianca Gandhi, Owner and acting Interim Administrator, assisted me with today’s visit. Your program currently operates with a three-star license, issued on April 8, 2023, earning 4 points in staff education, 2 points in program standards, and one quality point for having a combined turnover rate of 20 percent or less for the administrator, program coordinator, lead teacher, teacher, and group leader positions over the last 12 months. Toddlers Cove Academy Inc, the owner of your facility, was viewed as current-active on the North Carolina Secretary of State website on January 16, 2024. Your program’s compliance history was 87% as of January 16, 2024 and was reviewed with you today. Your last sanitation inspection was dated January 3, 2024 with a Superior classification and 4 demerits. Your last fire inspection was dated May 18, 2023. I visited each licensed indoor space today. Because of the extreme outdoor temperatures, I did not visit the outdoor spaces today. I observed Space 4 was not currently being used due to staffing. I observed infant children playing on the floor and one-year-old children playing in activity areas. I observed two-year-old children sitting at child-sized tables waiting to participate in a whole-group circle stamping free art activity. I observed three-year-old children participating in a teacher directed whole group activity. I observed four-year-old and five-year-old children participating in a teacher directed free art activity and playing in activity areas of choice. I observed children eating lunch in the classrooms, preparing for nap, and napping. Upon arrival and entering the classrooms where infant and one-year-old children were enrolled and attending, I noticed the rooms felt colder than usual. I observed the temperature was 62 degrees Fahrenheit on the thermostat display. I noticed there was not a room thermometer in use to verify the temperature in the classroom. I requested you bring a thermometer into the classroom so we could verify the temperature of the infant classroom. You brought a refrigerator thermometer into the classroom. The refrigerator thermometer registered a temperature of 58 degrees Fahrenheit. I took the refrigerator thermometer to the classroom where one-year-old children were enrolled and attending. I observed the refrigerator thermometer registered a temperature of 62 degrees in this classroom. You stated the repair service had been called and you were waiting on a return call. I observed you make several call attempts during the visit. I suggested you place a baby gate in the doorway of the infant classroom to allow some of the warm air from the lobby and kitchen area to drift into the infant classroom and raise the temperature of the classroom. I observed the temperature in the classroom rise to 62 degrees Fahrenheit. I explained to you and the teachers in the infant room that the facility’s safe sleep policy stated you would maintain a temperature of 68 to 75 degrees Fahrenheit in the room where infants were sleeping. I suggested the teachers carry out infant care as needed and hold sleeping children until my supervisor approved for the infants to sleep in the colder than expected classroom. At approximately 10:00am, the repair service returned your call and stated someone was on the way to your facility. At approximately 10:15am, the repair service arrived at the facility and began to investigate the issue with one side of the building not heating properly. In the meantime, I contacted my supervisor who approved for the infants to sleep in the colder than usual classroom and the repair service advised that the heating system needed an upgrade to a larger heating unit which would be repaired today. I advised you to remain operating today at a temperature of 62 degrees and higher as long as the unit is repaired today. If the heating unit is not to be repaired today, I advised you to send the children home early today and close the facility temporarily until the heating unit can be repaired. Please notify me by phone before 5pm or by email after 5pm to let me know that the heating system was repaired and/or your plans to operate tomorrow. I observed a current menu documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. I observed the current menu posted on a parent information board at the facility entrance door in the office area, the kitchen, and each classroom. I observed lunch prepared in the kitchen and served in the classrooms. I observed lunch included beans and hotdogs, corn, pears, whole wheat bread, and milk. I observed and cited no violations related to nutritional requirements or food preparation. I monitored daily schedules, activity plans, and materials in each classroom. I observed age-appropriate schedules and routines practiced in each classroom. I observed developmentally appropriate materials and equipment provided and used in each classroom. I observed activity plans with developmentally appropriate activities planned and carried out in each classroom. I observed and cited no violations. I observed teachers, administrators, and support staff interacting appropriately and meeting the developmental needs of the children. I observed and cited no violations. I observed children adequately supervised both indoors and outdoors during today’s visit. I observed voluntary enhanced staff-child ratios and group sizes maintained during today’s visit. I observed adequate approved space used during today’s visit. I observed minimum space capacity maintained throughout the center during today's visit. I observed permit restrictions including “Daytime care only” and “Meets enhanced ratios maintained during today’s visit. I reviewed four staff records for new staff members hired since your annual compliance visit on September 19, 2023. I reviewed eight staff records for returning staff members to monitor valid and current criminal background check (CBC) qualification letters, valid and current First Aid and CPR training, and valid and current ITS-SIDS training for applicable staff members. I observed and cited two violations. I observed and cited the following violations during today's visit: Violation Number Comment Rule 1041 Prior to employment a Criminal Background Check was not completed. New staff orientation training was started with three new staff members employed on 01/08/2024, 01/11/2024, and 01/16/2024 prior to receiving their Criminal Background Check qualification letters. G.S. 110-90.2(b) 1831 At least one child care provider, who has completed ITS-SIDS training was not present in the infant room, while children were in care. Two staff members with dates of employment of 01/08/2024 and 01/11/2024 were working alone in the infant room and had not completed ITS-SIDS training. .01102 (f) TECHNICAL ASSISTANCE: 1. Employee’s may not complete any training prior to your receiving a CBC qualification letter. Completing training shows an intent to hire and an employee cannot be hired prior to verifying the employee’s qualification as a child care provider. 2. Per child care rule 10A NCAC 09 .1102(f), at all times, one child care provider who has completed ITS-SIDS training shall be present in the infant room while children are in care. Today, I observed two new staff members who had not completed ITS-SIDS training working alone in the infant room. You stated these two new staff members were registered to take ITS-SIDS training on March 3, 2024. To maintain compliance with this child care requirement, I suggested you temporarily assign a staff member who had completed ITS-SIDS training to the infant room and attempt to find an ITS-SIDS class for these two new staff members sooner than March 3, 2024. CONSULTATION: 1. Per sanitation rules for child care centers rule 15A NCAC 18A .2826(b), all rooms used by children should be heated, cooled, and ventilated to maintain an ambient temperature between 65 degrees Fahrenheit and 85 degrees Fahrenheit. When you experience an issue heating or cooling your facility, I advised you to call your Environmental Health Specialist to seek guidance in making a decision to remain open or close the facility temporarily. 2. The facility’s written safe sleep policy specifies that the temperature in the room where infants aged 12 months or younger are sleeping will be maintained at a temperature between 68- and 75-degrees Fahrenheit. To maintain compliance with this child care requirement, I advised you to place a working room thermometer in the infant room to assist in tracking the room temperature. I also advised you to provide a baby gate in the infant and toddler classrooms that can be placed in the hall doorway to allow the classroom door to be left open for additional ventilation and air circulation that would assist in heating and cooling the classrooms. 3. Per your request, you asked me to review your qualifications and the qualifications of an applicant as perspective candidates for the position of administrator at your 3-Star facility with an education standard of 4-points. After reviewing your WORKS status letter, I observed you had been evaluated by the WORKS Education Unit and qualified as a Level 1 Early Childhood Administrator. After reviewing the WORKS status letter of the applicant, I observed the candidate may meet the requirements for an administrator of a child care center and advised you to have the candidate be evaluated by the WORKS Education Unit as an Early Childhood Administrator. I advised you to complete the Preservice Requirements for an Administrator of a Child Care Center form and submit it to me along with your WORKS status letter. I suggested you consider hiring an assistant administrator that you could begin to train to step into the role of administrator at a later date. 4. Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. 5. Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings including, but not limited to, ITS-SIDS training and Emergency Preparedness and Response in Child Care training. COMPLIANCE PLAN: All violations cited must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature I advise you to be prepared to provide supporting documentation in the form of photos, documents, certificates, etc. should I request them in order to clarify or verify compliance. I must receive your compliance letter no later than February 2, 2024. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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 .0302 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: 1123-268L Visit Date: 12/1/2023 Number Present: 48 Completed Date: 12/4/2023 Age: From 0 To 5 Total Minutes: 390 Time In: 09:05 AM Time Out: 01:55 PM Time In: 02:20 PM Time Out: 04:00 PM List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to look into allegations received in the Raleigh office that child care requirements are not being followed. You, Bianca Gandhi, Owner/Interim Administrator, assisted me with the visit. According to the report, the following allegations are a concern: 1. There is a concern that the posted staff/child ratio is not being followed in the early morning hours. 2. There is a concern of inadequate supervision. Children are left unattended while providers go to the kitchen and restroom. Children have also been left unattended on the playground. 3. There is a concern related to sanitation and health. The kitchen door is left open, hands are not being washed before food preparation, hairnets are not being worn, dishes are not being sanitized, and leftover food is being served. 4. There is a concern that a child was not attended to in a nurturing and appropriate manner or in keeping with the child’s developmental needs. A child was belittled in front their peers. 5. There is a concern related to materials and developmentally appropriate activities. I investigated the concern that the posted staff/child ratio is not being followed in the early morning hours. Upon arrival at 9:05am, I conducted a walk-through of each classroom to document staff to child ratios. In Space 1, I observed two teachers supervising eight infants and two one-year-old children with all arrival times recorded. In Space 2, I observed two teachers supervising nine one-year-old children with all arrival times recorded. In Space 3, I observed two teachers supervising nine two-year-old children with all arrival times recorded. In Space 4, I observed no teacher and no children present. You stated this classroom was temporarily closed due to staffing. In Space 5, I observed one teacher supervising thirteen four-year-old children with arrival times recorded for eleven out of the thirteen children. In Space 6, I observed one teacher supervising ten children including one two-year-old child and nine three-year-old children with all arrival times recorded. I interviewed ten out of twelve staff members. According to staff interviews, on numerous occasions in October 2023 and November 2023, the staff to child ratios are not maintained during the early morning hours. Staff members stated on at least one occasion in October, one teacher on-site from 6:00am to 7:00am opened the one-year-old classroom and supervised nine children ranging in age from zero to three years of age. Staff members stated in October 2023 additional teachers were scheduled to arrive at 7:00am to open additional classrooms and correct staff to child ratios. Staff members stated in November 2023 administration changed staff schedules to allow one additional teacher to arrive at 6:30am to take over the one-year-old room and allow the infant room to be opened. Staff members stated as on Monday, December 4, 2023, the facility will open at 6:30am instead of 6:00am. Ms. Gandhi stated parents were notified of this operating procedure change in October 2023. Staff members stated the 6:30am opening time will allow the infant room, one-year-old room, and three-year-old room to open for the first hour of the day. Staff members stated this new operating schedule will allow infants to arrive and be cared for in their classroom for the entire day. With this new operating schedule, staff members stated the one-year-old and two-year-old children will be cared for in the one-year-old classroom until 7:00am when an additional staff member will arrive and open the two-year-old classroom. With this new operating schedule, staff members stated the cook and/or Ms. Gandhi will care for the three-year-old through five-year-old children from 6:30am to 7:30am together in either the three-year-old classroom or the four and five-year-old classroom until the teachers for these two groups arrive at 7:30am and split these two groups into their designated classrooms. Staff members stated, in Space 6, one newly enrolled two-year-old child has been allowed stay in the three-year-old classroom with the sibling until the ninth three-year-old child arrives later in the morning and puts the classroom out of staff to child ratio for two-year-old children. Staff members stated they are aware that administration needs to be alerted as the group attendance in Space 6 reaches nine children with the two-year-old child in the classroom so the administrator can move the two-year-old child to their classroom. Staff members stated a miscount of children was made during today’s visit resulting in the classroom being out of staff to child ratio this morning. Based on interviews with staff and my observations, the allegation regarding that the posted staff/child ratio is not being followed in the early morning hours is substantiated. I investigated the concern of inadequate supervision which included children being left unattended while providers go to the kitchen and restroom and left alone on the playground. I observed staff members go to the restroom during today’s visit. I observed the teachers relieved by a staff member to cover the supervision in the classroom to allow teachers to go to the restroom as needed. Due to the rain, the children did not go outside on the playground today. Therefore, outdoor supervision was not observed today. I interviewed ten out of twelve staff members. According to staff interviews, teachers are relieved by additional staff to go the kitchen or the restroom. Staff members stated they knew of one occasion on November 17, 2023 when one three-year-old child was left alone on the playground. Staff members stated they knew of one other occasion in November when a three-year-old child was being cared for in the two-year-old classroom and was left alone in the classroom for several minutes before the supervising staff member realized the child was missing and came back to the classroom to get the missing child. Staff members stated the incidents were reported to the administrator and to Ms. Gandhi but the incidents were not reported to DCDEE. Based on interviews with staff, the allegation regarding inadequate supervision is substantiated. I investigated the concern related to sanitation and health which included the kitchen door being left open, hands not being washed before food preparation, hairnets not being worn, dishes not being sanitized, and leftover food being served. I observed lunch being prepared and served today. I observed the kitchen door closed at all times including each time the cook left the kitchen. I observed the cook wearing a cloth visor during food preparation and service. I observed dishes washed by hand and then sanitized in the dishwasher and air dried. I observed food placed in serving bowls which were taken to the classrooms where the plates were prepared by the teachers who then served them to the children. I observed food served to the children but not eaten by the children discarded in a trash can in each classroom. I observed leftover food not taken to the classrooms placed in reusable plastic containers which were labeled with the name of the food and the date the food was prepared or opened. I observed one plastic reused Country Crock vegetable spread container placed in the refrigerator in the kitchen and labeled with “Peaches” and the date “11/30”. I observed one gallon zip-loc bag of shredded chicken in the freezer and labeled with “Chicken for Lasagna” but no date. I interviewed ten out of twelve staff members. According to staff interviews, the kitchen door is kept closed and locked at all times, hands are washed before food is prepared and served or gloves are worn during food service, the person preparing the food wears a hair restraint or pulls hair back, food not eaten by the children is discarded in the trash and never returned to the serving bowls or the kitchen. Staff members stated only the leftover food that is not served to the children is labeled and dated, stored in the refrigerator, and served again later in the week or frozen to be served later. Staff members stated canned fruit leftover through the week would occasionally be served as later in the week. I reviewed the menu dated November 27, 2023 through December 1, 2023. I observed substitutions written in on this menu documenting that substitutions were made or planned to be made prior to service. Based on my observations, interviews with staff and my review of the current week’s menu, the allegation related to sanitation and health is unsubstantiated. I investigated the concern that a child was not attended to in a nurturing and appropriate manner or in keeping with the child’s developmental needs which included a child being belittled in front their peers. I observed teacher interactions with children in each classroom. I observed teachers in each classroom make eye contact when speaking to a child; engage children in conversation to share experiences, ideas, and opinions; help children develop problem-solving skills; and facilitate learning by providing positive reinforcement, encouraging efforts, and recognizing accomplishments. I observed no child yelled at, shamed, humiliated, frightened, threatened, or bullied by teachers. I observed Ms. Gandhi’s interactions with children in each classroom. I observed Ms. Gandhi make eye contact when speaking to a child; engage children in conversation to share experiences, ideas, and opinions; help children develop problem-solving skills; and facilitate learning by providing positive reinforcement, encouraging efforts, and recognizing accomplishments. I observed no child yelled at, shamed, humiliated, frightened, threatened, or bullied by Ms. Gandhi. I interviewed ten out of twelve staff members. According to staff interviews, children are treated in a nurturing and caring manner by each staff member. Staff members could not recall a time when children were yelled at, shamed, humiliated, frightened, threatened, or bullied by teachers, administrators, or Ms. Gandhi. Based on my observations and interviews with staff, the allegation related to a child not being attended to in a nurturing and appropriate manner or in keeping with the child’s developmental needs is unsubstantiated. I investigated the concern related to materials and developmentally appropriate activities. I observed materials in sufficient quantities accessible to the children in each classroom. I observed activities planned and documented on the current and posted activity plans in each classroom. I observed the activity plans in Spaces 2, 3, and 6 were written by the administrator. I observed the activity plans in Spaces 1 and 5 were written by the classroom teachers. In Space 2, I observed art activities planned daily but not carried out. In Space 5, I observed sensory and science activities planned but not carried out. In Space 6, I observed black-line worksheets planned and used as “art work” in the classroom. I observed some materials necessary to carry out the planned activities were not available in the classrooms. I interviewed ten out of twelve staff members. According to staff interviews, materials and toys are provided in each classroom according to the developmental needs of the children. Staff members stated activities are carried out in each classroom on a daily basis and materials to carry out these activities are available most of the time but not all the time. Based on my observations and interviews with staff, the allegation related to materials and developmentally appropriate activities is substantiated. The following violations were cited during today’s visit: Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. In Space 5, an arrival time was not recorded for two children in attendance. The teacher recorded the arrival times during the visit. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. On one occasion in November 2023, one three-year-old child was left unattended in the two-year-old classroom for an unknown period of time while the teacher and the rest of the children were outside on the playground. On November 17, 2023, one three-year-old child was left outside on the playground for an unknown period of time while the teacher and the rest of the children went inside the classroom. .1801(a)(1-5) 316 Children under one year of age were not kept separate from children two years and older. During the months of October and November, children zero, one, two, and three years of age were grouped together for longer than the first hour of operation during the early morning arrival hours of 6:00am and 7:30am. 10A NCAC 09 .0713(a)(5) 429 The activity plan was not designed to stimulate emotional and social, health and physical, approaches to play and learning, language development and communication, and cognitive development for each group of children in care. In Space 2, daily art activities were planned but were not carried out. In Space 5, snow-theme sensory and science materials were not available to carry out the planned activities. In Space 6, farm-theme materials and toys were not available to carry out the planned activities. In Space 6, black-line worksheets were planned daily as "art work". .0508(b)(1-5) 611 All beds,cots, or mats with individual linen were not provided for each child. One three-year-old child was allowed to sleep on the floor during the early morning arrival hours instead of being given their cot on which to sleep. 15A NCAC 18A .2821(c) 1756 Enhanced staff/child ratios and group sizes were not met. The enhanced staff to child ratio was not maintained for the youngest child in the group. During the visit, nine three-year-old children and one two-year-old child were grouped together in Space 6. On numerous occasions in October 2023 and November 2023, the staff to child ratios were not maintained during the early morning hours. On at least one occasion in October, one teacher on-site from 6:00am to 7:00am opened the one-year-old classroom and supervised nine children ranging in age from zero to three years of age. 10A NCAC 09 .2818 Technical Assistance: 1. Per child care rule 10A NCAC 09 .2818 (b), a center with a star-rated license should maintain enhanced staff to child ratios and maximum group sizes. Per child care rule 10A NCAC 09 .0713 (a)(1), when age groups are combined, the staff to child ratio for the youngest child in the group should be maintained for the entire group. To maintain compliance with these child care requirements, I suggested you retrain your teachers to notify an administrator when the child attendance in their classroom reaches one less than the maximum staff to child ratio. When the maximum number children have arrived in the classroom, request for an additional teacher has been made, and the additional teacher has not made it to the classroom, I suggested you train your teachers to request the parent stay in the classroom or lobby area with their child until the additional teacher arrives in the classroom. 2. Per child care rule 10A NCAC 09 .0713 (a)(2), children of all ages may be cared for together for only the first and last operating hour of the day as long as the staff to child ratio for the youngest child in the group is maintained. To maintain compliance with this child care requirement, I suggested you carry through with your plan to adjust staffing schedules effective December 4, 2023 to provide additional staff in the early morning operating hours that will accommodate the ages and number of children scheduled to arrive early daily. 3. Per child care rule 10A NCAC 09 .0713 (a)(3), a child two years of age or older may be cared for with children under one year of age when a physician certifies that the developmental age of the child makes this placement appropriate. To maintain compliance with this child care requirement, I suggested you place all children with their same age peers during early morning arrival and throughout the day rather than with younger children unless it’s the first or last hour of the day or you have a physician’s statement certifying the placement with a younger age group and parents agree to the placement. 4. Per child care rule 10A NCAC 09 .1801(a)(1-5), children should be adequately supervised at all times. As discussed today, no child should be left alone in a classroom or on the playground without direct adult supervision. To maintain compliance with this child care requirement, I suggested you consider reviewing your facility’s expectations and procedures for adequately supervising children and consider arranging for additional staff training regarding supervision practices. I also suggested you consider creating a supervision policy that you add to your facility’s written operational procedures and policies. 5. Per sanitation rule 15A NCAC 18A.2821(c), beds, cots, and mats used in a child care center shall be assigned and labeled for use by an individual child and equipped with individual linens. Child care centers should make a bed, cot, or mat available to each child on which the child may sleep including during the early morning arrival hours. To maintain compliance with this child care requirement, When you have a child that routinely arrives during the early morning hours and wishes to sleep, I suggested you either open that child’s classroom so the child has immediate access to their cot or retrieve the child’s cot from the child’s classroom and place it in the classroom to which the child arrives. You stated one child in particular has refused the cot during the early morning hours which is why the child had been allowed to sleep on the floor with their blanket covering them. In this situation, I suggested you have the parent provide a sleeping bag or you provide a sleeping bag and place the sleeping bag on the cot as a means of providing a softer more sensory pleasing sleep environment for the child. I reminded you to store the sleeping bag in a plastic bag away from the cots when not in use, label the sleeping bag and cot with the child’s name, and launder the sleeping bag at least weekly and more often if soiled. 6. Per child care rule 10A NCAC 09 .0302(d)(4), daily records of arrival and departure times for children enrolled at the center should be maintained as children arrive and depart. To maintain compliance with this child care requirement, I suggest you review with your teaching staff the expectation for recording arrival and departure times. 7. Per child care rule 10A NCAC 09 .0508(b)(1-5), for each group of children in care, the activity plan should include activities intended to stimulate the developmental domains, in accordance with North Carolina Foundations for Early Learning and Development. These developmental domains should include emotional and social development, health and physical development, approaches to play and learning, language development and communication, and cognitive development. The intention of this rule is to not only plan for these developmentally appropriate activities but to also provide the materials and equipment necessary to carry out these planned activities. To maintain compliance with this child care requirement, I suggested you develop a plan to correct the breakdown in communication between the written activity plan and the expectation for carrying out these written activity plans. I suggested you consider allowing each teacher to write their own weekly activity plan with administrative oversight and approval. I also suggested you consider giving each teacher a weekly supply allowance to obtain the materials necessary to carry out their planned activities. Consultation: 1. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license based on the substantiation of one or more violations as a result of a complaint. 2. Adequate supervision includes the following expectations: a) staff should be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (b) staff should interact with the children while moving about the indoor or outdoor area; (c) staff should know where each child is located and be aware of the children's activities at all times; (d) staff should provide supervision appropriate to the individual age, needs, and capabilities of each child; and (e) staff should be able to see and hear children aged birth to five years old while the children are eating. 3. As discussed today, I suggest you reach out to your local resource and referral agency for additional resources, technical assistance, and training for your staff. Compliance Plan: All violations cited must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. Your letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Provide any documentation that will show compliance with the violation. 7. Your signature Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your letter may be sent by email to: kimberly.crane@dhhs.nc.gov I must receive your compliance letter no later than December 15, 2023. Please Note: If you state in your letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Compliance History: You are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past 18 months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, at erin.pickard@dhhs.nc.gov if you have any questions. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
10A NCAC 09 .0508 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: 1123-268L Visit Date: 12/1/2023 Number Present: 48 Completed Date: 12/4/2023 Age: From 0 To 5 Total Minutes: 390 Time In: 09:05 AM Time Out: 01:55 PM Time In: 02:20 PM Time Out: 04:00 PM List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to look into allegations received in the Raleigh office that child care requirements are not being followed. You, Bianca Gandhi, Owner/Interim Administrator, assisted me with the visit. According to the report, the following allegations are a concern: 1. There is a concern that the posted staff/child ratio is not being followed in the early morning hours. 2. There is a concern of inadequate supervision. Children are left unattended while providers go to the kitchen and restroom. Children have also been left unattended on the playground. 3. There is a concern related to sanitation and health. The kitchen door is left open, hands are not being washed before food preparation, hairnets are not being worn, dishes are not being sanitized, and leftover food is being served. 4. There is a concern that a child was not attended to in a nurturing and appropriate manner or in keeping with the child’s developmental needs. A child was belittled in front their peers. 5. There is a concern related to materials and developmentally appropriate activities. I investigated the concern that the posted staff/child ratio is not being followed in the early morning hours. Upon arrival at 9:05am, I conducted a walk-through of each classroom to document staff to child ratios. In Space 1, I observed two teachers supervising eight infants and two one-year-old children with all arrival times recorded. In Space 2, I observed two teachers supervising nine one-year-old children with all arrival times recorded. In Space 3, I observed two teachers supervising nine two-year-old children with all arrival times recorded. In Space 4, I observed no teacher and no children present. You stated this classroom was temporarily closed due to staffing. In Space 5, I observed one teacher supervising thirteen four-year-old children with arrival times recorded for eleven out of the thirteen children. In Space 6, I observed one teacher supervising ten children including one two-year-old child and nine three-year-old children with all arrival times recorded. I interviewed ten out of twelve staff members. According to staff interviews, on numerous occasions in October 2023 and November 2023, the staff to child ratios are not maintained during the early morning hours. Staff members stated on at least one occasion in October, one teacher on-site from 6:00am to 7:00am opened the one-year-old classroom and supervised nine children ranging in age from zero to three years of age. Staff members stated in October 2023 additional teachers were scheduled to arrive at 7:00am to open additional classrooms and correct staff to child ratios. Staff members stated in November 2023 administration changed staff schedules to allow one additional teacher to arrive at 6:30am to take over the one-year-old room and allow the infant room to be opened. Staff members stated as on Monday, December 4, 2023, the facility will open at 6:30am instead of 6:00am. Ms. Gandhi stated parents were notified of this operating procedure change in October 2023. Staff members stated the 6:30am opening time will allow the infant room, one-year-old room, and three-year-old room to open for the first hour of the day. Staff members stated this new operating schedule will allow infants to arrive and be cared for in their classroom for the entire day. With this new operating schedule, staff members stated the one-year-old and two-year-old children will be cared for in the one-year-old classroom until 7:00am when an additional staff member will arrive and open the two-year-old classroom. With this new operating schedule, staff members stated the cook and/or Ms. Gandhi will care for the three-year-old through five-year-old children from 6:30am to 7:30am together in either the three-year-old classroom or the four and five-year-old classroom until the teachers for these two groups arrive at 7:30am and split these two groups into their designated classrooms. Staff members stated, in Space 6, one newly enrolled two-year-old child has been allowed stay in the three-year-old classroom with the sibling until the ninth three-year-old child arrives later in the morning and puts the classroom out of staff to child ratio for two-year-old children. Staff members stated they are aware that administration needs to be alerted as the group attendance in Space 6 reaches nine children with the two-year-old child in the classroom so the administrator can move the two-year-old child to their classroom. Staff members stated a miscount of children was made during today’s visit resulting in the classroom being out of staff to child ratio this morning. Based on interviews with staff and my observations, the allegation regarding that the posted staff/child ratio is not being followed in the early morning hours is substantiated. I investigated the concern of inadequate supervision which included children being left unattended while providers go to the kitchen and restroom and left alone on the playground. I observed staff members go to the restroom during today’s visit. I observed the teachers relieved by a staff member to cover the supervision in the classroom to allow teachers to go to the restroom as needed. Due to the rain, the children did not go outside on the playground today. Therefore, outdoor supervision was not observed today. I interviewed ten out of twelve staff members. According to staff interviews, teachers are relieved by additional staff to go the kitchen or the restroom. Staff members stated they knew of one occasion on November 17, 2023 when one three-year-old child was left alone on the playground. Staff members stated they knew of one other occasion in November when a three-year-old child was being cared for in the two-year-old classroom and was left alone in the classroom for several minutes before the supervising staff member realized the child was missing and came back to the classroom to get the missing child. Staff members stated the incidents were reported to the administrator and to Ms. Gandhi but the incidents were not reported to DCDEE. Based on interviews with staff, the allegation regarding inadequate supervision is substantiated. I investigated the concern related to sanitation and health which included the kitchen door being left open, hands not being washed before food preparation, hairnets not being worn, dishes not being sanitized, and leftover food being served. I observed lunch being prepared and served today. I observed the kitchen door closed at all times including each time the cook left the kitchen. I observed the cook wearing a cloth visor during food preparation and service. I observed dishes washed by hand and then sanitized in the dishwasher and air dried. I observed food placed in serving bowls which were taken to the classrooms where the plates were prepared by the teachers who then served them to the children. I observed food served to the children but not eaten by the children discarded in a trash can in each classroom. I observed leftover food not taken to the classrooms placed in reusable plastic containers which were labeled with the name of the food and the date the food was prepared or opened. I observed one plastic reused Country Crock vegetable spread container placed in the refrigerator in the kitchen and labeled with “Peaches” and the date “11/30”. I observed one gallon zip-loc bag of shredded chicken in the freezer and labeled with “Chicken for Lasagna” but no date. I interviewed ten out of twelve staff members. According to staff interviews, the kitchen door is kept closed and locked at all times, hands are washed before food is prepared and served or gloves are worn during food service, the person preparing the food wears a hair restraint or pulls hair back, food not eaten by the children is discarded in the trash and never returned to the serving bowls or the kitchen. Staff members stated only the leftover food that is not served to the children is labeled and dated, stored in the refrigerator, and served again later in the week or frozen to be served later. Staff members stated canned fruit leftover through the week would occasionally be served as later in the week. I reviewed the menu dated November 27, 2023 through December 1, 2023. I observed substitutions written in on this menu documenting that substitutions were made or planned to be made prior to service. Based on my observations, interviews with staff and my review of the current week’s menu, the allegation related to sanitation and health is unsubstantiated. I investigated the concern that a child was not attended to in a nurturing and appropriate manner or in keeping with the child’s developmental needs which included a child being belittled in front their peers. I observed teacher interactions with children in each classroom. I observed teachers in each classroom make eye contact when speaking to a child; engage children in conversation to share experiences, ideas, and opinions; help children develop problem-solving skills; and facilitate learning by providing positive reinforcement, encouraging efforts, and recognizing accomplishments. I observed no child yelled at, shamed, humiliated, frightened, threatened, or bullied by teachers. I observed Ms. Gandhi’s interactions with children in each classroom. I observed Ms. Gandhi make eye contact when speaking to a child; engage children in conversation to share experiences, ideas, and opinions; help children develop problem-solving skills; and facilitate learning by providing positive reinforcement, encouraging efforts, and recognizing accomplishments. I observed no child yelled at, shamed, humiliated, frightened, threatened, or bullied by Ms. Gandhi. I interviewed ten out of twelve staff members. According to staff interviews, children are treated in a nurturing and caring manner by each staff member. Staff members could not recall a time when children were yelled at, shamed, humiliated, frightened, threatened, or bullied by teachers, administrators, or Ms. Gandhi. Based on my observations and interviews with staff, the allegation related to a child not being attended to in a nurturing and appropriate manner or in keeping with the child’s developmental needs is unsubstantiated. I investigated the concern related to materials and developmentally appropriate activities. I observed materials in sufficient quantities accessible to the children in each classroom. I observed activities planned and documented on the current and posted activity plans in each classroom. I observed the activity plans in Spaces 2, 3, and 6 were written by the administrator. I observed the activity plans in Spaces 1 and 5 were written by the classroom teachers. In Space 2, I observed art activities planned daily but not carried out. In Space 5, I observed sensory and science activities planned but not carried out. In Space 6, I observed black-line worksheets planned and used as “art work” in the classroom. I observed some materials necessary to carry out the planned activities were not available in the classrooms. I interviewed ten out of twelve staff members. According to staff interviews, materials and toys are provided in each classroom according to the developmental needs of the children. Staff members stated activities are carried out in each classroom on a daily basis and materials to carry out these activities are available most of the time but not all the time. Based on my observations and interviews with staff, the allegation related to materials and developmentally appropriate activities is substantiated. The following violations were cited during today’s visit: Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. In Space 5, an arrival time was not recorded for two children in attendance. The teacher recorded the arrival times during the visit. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. On one occasion in November 2023, one three-year-old child was left unattended in the two-year-old classroom for an unknown period of time while the teacher and the rest of the children were outside on the playground. On November 17, 2023, one three-year-old child was left outside on the playground for an unknown period of time while the teacher and the rest of the children went inside the classroom. .1801(a)(1-5) 316 Children under one year of age were not kept separate from children two years and older. During the months of October and November, children zero, one, two, and three years of age were grouped together for longer than the first hour of operation during the early morning arrival hours of 6:00am and 7:30am. 10A NCAC 09 .0713(a)(5) 429 The activity plan was not designed to stimulate emotional and social, health and physical, approaches to play and learning, language development and communication, and cognitive development for each group of children in care. In Space 2, daily art activities were planned but were not carried out. In Space 5, snow-theme sensory and science materials were not available to carry out the planned activities. In Space 6, farm-theme materials and toys were not available to carry out the planned activities. In Space 6, black-line worksheets were planned daily as "art work". .0508(b)(1-5) 611 All beds,cots, or mats with individual linen were not provided for each child. One three-year-old child was allowed to sleep on the floor during the early morning arrival hours instead of being given their cot on which to sleep. 15A NCAC 18A .2821(c) 1756 Enhanced staff/child ratios and group sizes were not met. The enhanced staff to child ratio was not maintained for the youngest child in the group. During the visit, nine three-year-old children and one two-year-old child were grouped together in Space 6. On numerous occasions in October 2023 and November 2023, the staff to child ratios were not maintained during the early morning hours. On at least one occasion in October, one teacher on-site from 6:00am to 7:00am opened the one-year-old classroom and supervised nine children ranging in age from zero to three years of age. 10A NCAC 09 .2818 Technical Assistance: 1. Per child care rule 10A NCAC 09 .2818 (b), a center with a star-rated license should maintain enhanced staff to child ratios and maximum group sizes. Per child care rule 10A NCAC 09 .0713 (a)(1), when age groups are combined, the staff to child ratio for the youngest child in the group should be maintained for the entire group. To maintain compliance with these child care requirements, I suggested you retrain your teachers to notify an administrator when the child attendance in their classroom reaches one less than the maximum staff to child ratio. When the maximum number children have arrived in the classroom, request for an additional teacher has been made, and the additional teacher has not made it to the classroom, I suggested you train your teachers to request the parent stay in the classroom or lobby area with their child until the additional teacher arrives in the classroom. 2. Per child care rule 10A NCAC 09 .0713 (a)(2), children of all ages may be cared for together for only the first and last operating hour of the day as long as the staff to child ratio for the youngest child in the group is maintained. To maintain compliance with this child care requirement, I suggested you carry through with your plan to adjust staffing schedules effective December 4, 2023 to provide additional staff in the early morning operating hours that will accommodate the ages and number of children scheduled to arrive early daily. 3. Per child care rule 10A NCAC 09 .0713 (a)(3), a child two years of age or older may be cared for with children under one year of age when a physician certifies that the developmental age of the child makes this placement appropriate. To maintain compliance with this child care requirement, I suggested you place all children with their same age peers during early morning arrival and throughout the day rather than with younger children unless it’s the first or last hour of the day or you have a physician’s statement certifying the placement with a younger age group and parents agree to the placement. 4. Per child care rule 10A NCAC 09 .1801(a)(1-5), children should be adequately supervised at all times. As discussed today, no child should be left alone in a classroom or on the playground without direct adult supervision. To maintain compliance with this child care requirement, I suggested you consider reviewing your facility’s expectations and procedures for adequately supervising children and consider arranging for additional staff training regarding supervision practices. I also suggested you consider creating a supervision policy that you add to your facility’s written operational procedures and policies. 5. Per sanitation rule 15A NCAC 18A.2821(c), beds, cots, and mats used in a child care center shall be assigned and labeled for use by an individual child and equipped with individual linens. Child care centers should make a bed, cot, or mat available to each child on which the child may sleep including during the early morning arrival hours. To maintain compliance with this child care requirement, When you have a child that routinely arrives during the early morning hours and wishes to sleep, I suggested you either open that child’s classroom so the child has immediate access to their cot or retrieve the child’s cot from the child’s classroom and place it in the classroom to which the child arrives. You stated one child in particular has refused the cot during the early morning hours which is why the child had been allowed to sleep on the floor with their blanket covering them. In this situation, I suggested you have the parent provide a sleeping bag or you provide a sleeping bag and place the sleeping bag on the cot as a means of providing a softer more sensory pleasing sleep environment for the child. I reminded you to store the sleeping bag in a plastic bag away from the cots when not in use, label the sleeping bag and cot with the child’s name, and launder the sleeping bag at least weekly and more often if soiled. 6. Per child care rule 10A NCAC 09 .0302(d)(4), daily records of arrival and departure times for children enrolled at the center should be maintained as children arrive and depart. To maintain compliance with this child care requirement, I suggest you review with your teaching staff the expectation for recording arrival and departure times. 7. Per child care rule 10A NCAC 09 .0508(b)(1-5), for each group of children in care, the activity plan should include activities intended to stimulate the developmental domains, in accordance with North Carolina Foundations for Early Learning and Development. These developmental domains should include emotional and social development, health and physical development, approaches to play and learning, language development and communication, and cognitive development. The intention of this rule is to not only plan for these developmentally appropriate activities but to also provide the materials and equipment necessary to carry out these planned activities. To maintain compliance with this child care requirement, I suggested you develop a plan to correct the breakdown in communication between the written activity plan and the expectation for carrying out these written activity plans. I suggested you consider allowing each teacher to write their own weekly activity plan with administrative oversight and approval. I also suggested you consider giving each teacher a weekly supply allowance to obtain the materials necessary to carry out their planned activities. Consultation: 1. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license based on the substantiation of one or more violations as a result of a complaint. 2. Adequate supervision includes the following expectations: a) staff should be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (b) staff should interact with the children while moving about the indoor or outdoor area; (c) staff should know where each child is located and be aware of the children's activities at all times; (d) staff should provide supervision appropriate to the individual age, needs, and capabilities of each child; and (e) staff should be able to see and hear children aged birth to five years old while the children are eating. 3. As discussed today, I suggest you reach out to your local resource and referral agency for additional resources, technical assistance, and training for your staff. Compliance Plan: All violations cited must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. Your letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Provide any documentation that will show compliance with the violation. 7. Your signature Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your letter may be sent by email to: kimberly.crane@dhhs.nc.gov I must receive your compliance letter no later than December 15, 2023. Please Note: If you state in your letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Compliance History: You are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past 18 months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, at erin.pickard@dhhs.nc.gov if you have any questions. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .0713 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: 1123-268L Visit Date: 12/1/2023 Number Present: 48 Completed Date: 12/4/2023 Age: From 0 To 5 Total Minutes: 390 Time In: 09:05 AM Time Out: 01:55 PM Time In: 02:20 PM Time Out: 04:00 PM List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to look into allegations received in the Raleigh office that child care requirements are not being followed. You, Bianca Gandhi, Owner/Interim Administrator, assisted me with the visit. According to the report, the following allegations are a concern: 1. There is a concern that the posted staff/child ratio is not being followed in the early morning hours. 2. There is a concern of inadequate supervision. Children are left unattended while providers go to the kitchen and restroom. Children have also been left unattended on the playground. 3. There is a concern related to sanitation and health. The kitchen door is left open, hands are not being washed before food preparation, hairnets are not being worn, dishes are not being sanitized, and leftover food is being served. 4. There is a concern that a child was not attended to in a nurturing and appropriate manner or in keeping with the child’s developmental needs. A child was belittled in front their peers. 5. There is a concern related to materials and developmentally appropriate activities. I investigated the concern that the posted staff/child ratio is not being followed in the early morning hours. Upon arrival at 9:05am, I conducted a walk-through of each classroom to document staff to child ratios. In Space 1, I observed two teachers supervising eight infants and two one-year-old children with all arrival times recorded. In Space 2, I observed two teachers supervising nine one-year-old children with all arrival times recorded. In Space 3, I observed two teachers supervising nine two-year-old children with all arrival times recorded. In Space 4, I observed no teacher and no children present. You stated this classroom was temporarily closed due to staffing. In Space 5, I observed one teacher supervising thirteen four-year-old children with arrival times recorded for eleven out of the thirteen children. In Space 6, I observed one teacher supervising ten children including one two-year-old child and nine three-year-old children with all arrival times recorded. I interviewed ten out of twelve staff members. According to staff interviews, on numerous occasions in October 2023 and November 2023, the staff to child ratios are not maintained during the early morning hours. Staff members stated on at least one occasion in October, one teacher on-site from 6:00am to 7:00am opened the one-year-old classroom and supervised nine children ranging in age from zero to three years of age. Staff members stated in October 2023 additional teachers were scheduled to arrive at 7:00am to open additional classrooms and correct staff to child ratios. Staff members stated in November 2023 administration changed staff schedules to allow one additional teacher to arrive at 6:30am to take over the one-year-old room and allow the infant room to be opened. Staff members stated as on Monday, December 4, 2023, the facility will open at 6:30am instead of 6:00am. Ms. Gandhi stated parents were notified of this operating procedure change in October 2023. Staff members stated the 6:30am opening time will allow the infant room, one-year-old room, and three-year-old room to open for the first hour of the day. Staff members stated this new operating schedule will allow infants to arrive and be cared for in their classroom for the entire day. With this new operating schedule, staff members stated the one-year-old and two-year-old children will be cared for in the one-year-old classroom until 7:00am when an additional staff member will arrive and open the two-year-old classroom. With this new operating schedule, staff members stated the cook and/or Ms. Gandhi will care for the three-year-old through five-year-old children from 6:30am to 7:30am together in either the three-year-old classroom or the four and five-year-old classroom until the teachers for these two groups arrive at 7:30am and split these two groups into their designated classrooms. Staff members stated, in Space 6, one newly enrolled two-year-old child has been allowed stay in the three-year-old classroom with the sibling until the ninth three-year-old child arrives later in the morning and puts the classroom out of staff to child ratio for two-year-old children. Staff members stated they are aware that administration needs to be alerted as the group attendance in Space 6 reaches nine children with the two-year-old child in the classroom so the administrator can move the two-year-old child to their classroom. Staff members stated a miscount of children was made during today’s visit resulting in the classroom being out of staff to child ratio this morning. Based on interviews with staff and my observations, the allegation regarding that the posted staff/child ratio is not being followed in the early morning hours is substantiated. I investigated the concern of inadequate supervision which included children being left unattended while providers go to the kitchen and restroom and left alone on the playground. I observed staff members go to the restroom during today’s visit. I observed the teachers relieved by a staff member to cover the supervision in the classroom to allow teachers to go to the restroom as needed. Due to the rain, the children did not go outside on the playground today. Therefore, outdoor supervision was not observed today. I interviewed ten out of twelve staff members. According to staff interviews, teachers are relieved by additional staff to go the kitchen or the restroom. Staff members stated they knew of one occasion on November 17, 2023 when one three-year-old child was left alone on the playground. Staff members stated they knew of one other occasion in November when a three-year-old child was being cared for in the two-year-old classroom and was left alone in the classroom for several minutes before the supervising staff member realized the child was missing and came back to the classroom to get the missing child. Staff members stated the incidents were reported to the administrator and to Ms. Gandhi but the incidents were not reported to DCDEE. Based on interviews with staff, the allegation regarding inadequate supervision is substantiated. I investigated the concern related to sanitation and health which included the kitchen door being left open, hands not being washed before food preparation, hairnets not being worn, dishes not being sanitized, and leftover food being served. I observed lunch being prepared and served today. I observed the kitchen door closed at all times including each time the cook left the kitchen. I observed the cook wearing a cloth visor during food preparation and service. I observed dishes washed by hand and then sanitized in the dishwasher and air dried. I observed food placed in serving bowls which were taken to the classrooms where the plates were prepared by the teachers who then served them to the children. I observed food served to the children but not eaten by the children discarded in a trash can in each classroom. I observed leftover food not taken to the classrooms placed in reusable plastic containers which were labeled with the name of the food and the date the food was prepared or opened. I observed one plastic reused Country Crock vegetable spread container placed in the refrigerator in the kitchen and labeled with “Peaches” and the date “11/30”. I observed one gallon zip-loc bag of shredded chicken in the freezer and labeled with “Chicken for Lasagna” but no date. I interviewed ten out of twelve staff members. According to staff interviews, the kitchen door is kept closed and locked at all times, hands are washed before food is prepared and served or gloves are worn during food service, the person preparing the food wears a hair restraint or pulls hair back, food not eaten by the children is discarded in the trash and never returned to the serving bowls or the kitchen. Staff members stated only the leftover food that is not served to the children is labeled and dated, stored in the refrigerator, and served again later in the week or frozen to be served later. Staff members stated canned fruit leftover through the week would occasionally be served as later in the week. I reviewed the menu dated November 27, 2023 through December 1, 2023. I observed substitutions written in on this menu documenting that substitutions were made or planned to be made prior to service. Based on my observations, interviews with staff and my review of the current week’s menu, the allegation related to sanitation and health is unsubstantiated. I investigated the concern that a child was not attended to in a nurturing and appropriate manner or in keeping with the child’s developmental needs which included a child being belittled in front their peers. I observed teacher interactions with children in each classroom. I observed teachers in each classroom make eye contact when speaking to a child; engage children in conversation to share experiences, ideas, and opinions; help children develop problem-solving skills; and facilitate learning by providing positive reinforcement, encouraging efforts, and recognizing accomplishments. I observed no child yelled at, shamed, humiliated, frightened, threatened, or bullied by teachers. I observed Ms. Gandhi’s interactions with children in each classroom. I observed Ms. Gandhi make eye contact when speaking to a child; engage children in conversation to share experiences, ideas, and opinions; help children develop problem-solving skills; and facilitate learning by providing positive reinforcement, encouraging efforts, and recognizing accomplishments. I observed no child yelled at, shamed, humiliated, frightened, threatened, or bullied by Ms. Gandhi. I interviewed ten out of twelve staff members. According to staff interviews, children are treated in a nurturing and caring manner by each staff member. Staff members could not recall a time when children were yelled at, shamed, humiliated, frightened, threatened, or bullied by teachers, administrators, or Ms. Gandhi. Based on my observations and interviews with staff, the allegation related to a child not being attended to in a nurturing and appropriate manner or in keeping with the child’s developmental needs is unsubstantiated. I investigated the concern related to materials and developmentally appropriate activities. I observed materials in sufficient quantities accessible to the children in each classroom. I observed activities planned and documented on the current and posted activity plans in each classroom. I observed the activity plans in Spaces 2, 3, and 6 were written by the administrator. I observed the activity plans in Spaces 1 and 5 were written by the classroom teachers. In Space 2, I observed art activities planned daily but not carried out. In Space 5, I observed sensory and science activities planned but not carried out. In Space 6, I observed black-line worksheets planned and used as “art work” in the classroom. I observed some materials necessary to carry out the planned activities were not available in the classrooms. I interviewed ten out of twelve staff members. According to staff interviews, materials and toys are provided in each classroom according to the developmental needs of the children. Staff members stated activities are carried out in each classroom on a daily basis and materials to carry out these activities are available most of the time but not all the time. Based on my observations and interviews with staff, the allegation related to materials and developmentally appropriate activities is substantiated. The following violations were cited during today’s visit: Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. In Space 5, an arrival time was not recorded for two children in attendance. The teacher recorded the arrival times during the visit. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. On one occasion in November 2023, one three-year-old child was left unattended in the two-year-old classroom for an unknown period of time while the teacher and the rest of the children were outside on the playground. On November 17, 2023, one three-year-old child was left outside on the playground for an unknown period of time while the teacher and the rest of the children went inside the classroom. .1801(a)(1-5) 316 Children under one year of age were not kept separate from children two years and older. During the months of October and November, children zero, one, two, and three years of age were grouped together for longer than the first hour of operation during the early morning arrival hours of 6:00am and 7:30am. 10A NCAC 09 .0713(a)(5) 429 The activity plan was not designed to stimulate emotional and social, health and physical, approaches to play and learning, language development and communication, and cognitive development for each group of children in care. In Space 2, daily art activities were planned but were not carried out. In Space 5, snow-theme sensory and science materials were not available to carry out the planned activities. In Space 6, farm-theme materials and toys were not available to carry out the planned activities. In Space 6, black-line worksheets were planned daily as "art work". .0508(b)(1-5) 611 All beds,cots, or mats with individual linen were not provided for each child. One three-year-old child was allowed to sleep on the floor during the early morning arrival hours instead of being given their cot on which to sleep. 15A NCAC 18A .2821(c) 1756 Enhanced staff/child ratios and group sizes were not met. The enhanced staff to child ratio was not maintained for the youngest child in the group. During the visit, nine three-year-old children and one two-year-old child were grouped together in Space 6. On numerous occasions in October 2023 and November 2023, the staff to child ratios were not maintained during the early morning hours. On at least one occasion in October, one teacher on-site from 6:00am to 7:00am opened the one-year-old classroom and supervised nine children ranging in age from zero to three years of age. 10A NCAC 09 .2818 Technical Assistance: 1. Per child care rule 10A NCAC 09 .2818 (b), a center with a star-rated license should maintain enhanced staff to child ratios and maximum group sizes. Per child care rule 10A NCAC 09 .0713 (a)(1), when age groups are combined, the staff to child ratio for the youngest child in the group should be maintained for the entire group. To maintain compliance with these child care requirements, I suggested you retrain your teachers to notify an administrator when the child attendance in their classroom reaches one less than the maximum staff to child ratio. When the maximum number children have arrived in the classroom, request for an additional teacher has been made, and the additional teacher has not made it to the classroom, I suggested you train your teachers to request the parent stay in the classroom or lobby area with their child until the additional teacher arrives in the classroom. 2. Per child care rule 10A NCAC 09 .0713 (a)(2), children of all ages may be cared for together for only the first and last operating hour of the day as long as the staff to child ratio for the youngest child in the group is maintained. To maintain compliance with this child care requirement, I suggested you carry through with your plan to adjust staffing schedules effective December 4, 2023 to provide additional staff in the early morning operating hours that will accommodate the ages and number of children scheduled to arrive early daily. 3. Per child care rule 10A NCAC 09 .0713 (a)(3), a child two years of age or older may be cared for with children under one year of age when a physician certifies that the developmental age of the child makes this placement appropriate. To maintain compliance with this child care requirement, I suggested you place all children with their same age peers during early morning arrival and throughout the day rather than with younger children unless it’s the first or last hour of the day or you have a physician’s statement certifying the placement with a younger age group and parents agree to the placement. 4. Per child care rule 10A NCAC 09 .1801(a)(1-5), children should be adequately supervised at all times. As discussed today, no child should be left alone in a classroom or on the playground without direct adult supervision. To maintain compliance with this child care requirement, I suggested you consider reviewing your facility’s expectations and procedures for adequately supervising children and consider arranging for additional staff training regarding supervision practices. I also suggested you consider creating a supervision policy that you add to your facility’s written operational procedures and policies. 5. Per sanitation rule 15A NCAC 18A.2821(c), beds, cots, and mats used in a child care center shall be assigned and labeled for use by an individual child and equipped with individual linens. Child care centers should make a bed, cot, or mat available to each child on which the child may sleep including during the early morning arrival hours. To maintain compliance with this child care requirement, When you have a child that routinely arrives during the early morning hours and wishes to sleep, I suggested you either open that child’s classroom so the child has immediate access to their cot or retrieve the child’s cot from the child’s classroom and place it in the classroom to which the child arrives. You stated one child in particular has refused the cot during the early morning hours which is why the child had been allowed to sleep on the floor with their blanket covering them. In this situation, I suggested you have the parent provide a sleeping bag or you provide a sleeping bag and place the sleeping bag on the cot as a means of providing a softer more sensory pleasing sleep environment for the child. I reminded you to store the sleeping bag in a plastic bag away from the cots when not in use, label the sleeping bag and cot with the child’s name, and launder the sleeping bag at least weekly and more often if soiled. 6. Per child care rule 10A NCAC 09 .0302(d)(4), daily records of arrival and departure times for children enrolled at the center should be maintained as children arrive and depart. To maintain compliance with this child care requirement, I suggest you review with your teaching staff the expectation for recording arrival and departure times. 7. Per child care rule 10A NCAC 09 .0508(b)(1-5), for each group of children in care, the activity plan should include activities intended to stimulate the developmental domains, in accordance with North Carolina Foundations for Early Learning and Development. These developmental domains should include emotional and social development, health and physical development, approaches to play and learning, language development and communication, and cognitive development. The intention of this rule is to not only plan for these developmentally appropriate activities but to also provide the materials and equipment necessary to carry out these planned activities. To maintain compliance with this child care requirement, I suggested you develop a plan to correct the breakdown in communication between the written activity plan and the expectation for carrying out these written activity plans. I suggested you consider allowing each teacher to write their own weekly activity plan with administrative oversight and approval. I also suggested you consider giving each teacher a weekly supply allowance to obtain the materials necessary to carry out their planned activities. Consultation: 1. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license based on the substantiation of one or more violations as a result of a complaint. 2. Adequate supervision includes the following expectations: a) staff should be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (b) staff should interact with the children while moving about the indoor or outdoor area; (c) staff should know where each child is located and be aware of the children's activities at all times; (d) staff should provide supervision appropriate to the individual age, needs, and capabilities of each child; and (e) staff should be able to see and hear children aged birth to five years old while the children are eating. 3. As discussed today, I suggest you reach out to your local resource and referral agency for additional resources, technical assistance, and training for your staff. Compliance Plan: All violations cited must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. Your letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Provide any documentation that will show compliance with the violation. 7. Your signature Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your letter may be sent by email to: kimberly.crane@dhhs.nc.gov I must receive your compliance letter no later than December 15, 2023. Please Note: If you state in your letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Compliance History: You are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past 18 months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, at erin.pickard@dhhs.nc.gov if you have any questions. Thank you for your time today. 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 .1801 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: 1123-268L Visit Date: 12/1/2023 Number Present: 48 Completed Date: 12/4/2023 Age: From 0 To 5 Total Minutes: 390 Time In: 09:05 AM Time Out: 01:55 PM Time In: 02:20 PM Time Out: 04:00 PM List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to look into allegations received in the Raleigh office that child care requirements are not being followed. You, Bianca Gandhi, Owner/Interim Administrator, assisted me with the visit. According to the report, the following allegations are a concern: 1. There is a concern that the posted staff/child ratio is not being followed in the early morning hours. 2. There is a concern of inadequate supervision. Children are left unattended while providers go to the kitchen and restroom. Children have also been left unattended on the playground. 3. There is a concern related to sanitation and health. The kitchen door is left open, hands are not being washed before food preparation, hairnets are not being worn, dishes are not being sanitized, and leftover food is being served. 4. There is a concern that a child was not attended to in a nurturing and appropriate manner or in keeping with the child’s developmental needs. A child was belittled in front their peers. 5. There is a concern related to materials and developmentally appropriate activities. I investigated the concern that the posted staff/child ratio is not being followed in the early morning hours. Upon arrival at 9:05am, I conducted a walk-through of each classroom to document staff to child ratios. In Space 1, I observed two teachers supervising eight infants and two one-year-old children with all arrival times recorded. In Space 2, I observed two teachers supervising nine one-year-old children with all arrival times recorded. In Space 3, I observed two teachers supervising nine two-year-old children with all arrival times recorded. In Space 4, I observed no teacher and no children present. You stated this classroom was temporarily closed due to staffing. In Space 5, I observed one teacher supervising thirteen four-year-old children with arrival times recorded for eleven out of the thirteen children. In Space 6, I observed one teacher supervising ten children including one two-year-old child and nine three-year-old children with all arrival times recorded. I interviewed ten out of twelve staff members. According to staff interviews, on numerous occasions in October 2023 and November 2023, the staff to child ratios are not maintained during the early morning hours. Staff members stated on at least one occasion in October, one teacher on-site from 6:00am to 7:00am opened the one-year-old classroom and supervised nine children ranging in age from zero to three years of age. Staff members stated in October 2023 additional teachers were scheduled to arrive at 7:00am to open additional classrooms and correct staff to child ratios. Staff members stated in November 2023 administration changed staff schedules to allow one additional teacher to arrive at 6:30am to take over the one-year-old room and allow the infant room to be opened. Staff members stated as on Monday, December 4, 2023, the facility will open at 6:30am instead of 6:00am. Ms. Gandhi stated parents were notified of this operating procedure change in October 2023. Staff members stated the 6:30am opening time will allow the infant room, one-year-old room, and three-year-old room to open for the first hour of the day. Staff members stated this new operating schedule will allow infants to arrive and be cared for in their classroom for the entire day. With this new operating schedule, staff members stated the one-year-old and two-year-old children will be cared for in the one-year-old classroom until 7:00am when an additional staff member will arrive and open the two-year-old classroom. With this new operating schedule, staff members stated the cook and/or Ms. Gandhi will care for the three-year-old through five-year-old children from 6:30am to 7:30am together in either the three-year-old classroom or the four and five-year-old classroom until the teachers for these two groups arrive at 7:30am and split these two groups into their designated classrooms. Staff members stated, in Space 6, one newly enrolled two-year-old child has been allowed stay in the three-year-old classroom with the sibling until the ninth three-year-old child arrives later in the morning and puts the classroom out of staff to child ratio for two-year-old children. Staff members stated they are aware that administration needs to be alerted as the group attendance in Space 6 reaches nine children with the two-year-old child in the classroom so the administrator can move the two-year-old child to their classroom. Staff members stated a miscount of children was made during today’s visit resulting in the classroom being out of staff to child ratio this morning. Based on interviews with staff and my observations, the allegation regarding that the posted staff/child ratio is not being followed in the early morning hours is substantiated. I investigated the concern of inadequate supervision which included children being left unattended while providers go to the kitchen and restroom and left alone on the playground. I observed staff members go to the restroom during today’s visit. I observed the teachers relieved by a staff member to cover the supervision in the classroom to allow teachers to go to the restroom as needed. Due to the rain, the children did not go outside on the playground today. Therefore, outdoor supervision was not observed today. I interviewed ten out of twelve staff members. According to staff interviews, teachers are relieved by additional staff to go the kitchen or the restroom. Staff members stated they knew of one occasion on November 17, 2023 when one three-year-old child was left alone on the playground. Staff members stated they knew of one other occasion in November when a three-year-old child was being cared for in the two-year-old classroom and was left alone in the classroom for several minutes before the supervising staff member realized the child was missing and came back to the classroom to get the missing child. Staff members stated the incidents were reported to the administrator and to Ms. Gandhi but the incidents were not reported to DCDEE. Based on interviews with staff, the allegation regarding inadequate supervision is substantiated. I investigated the concern related to sanitation and health which included the kitchen door being left open, hands not being washed before food preparation, hairnets not being worn, dishes not being sanitized, and leftover food being served. I observed lunch being prepared and served today. I observed the kitchen door closed at all times including each time the cook left the kitchen. I observed the cook wearing a cloth visor during food preparation and service. I observed dishes washed by hand and then sanitized in the dishwasher and air dried. I observed food placed in serving bowls which were taken to the classrooms where the plates were prepared by the teachers who then served them to the children. I observed food served to the children but not eaten by the children discarded in a trash can in each classroom. I observed leftover food not taken to the classrooms placed in reusable plastic containers which were labeled with the name of the food and the date the food was prepared or opened. I observed one plastic reused Country Crock vegetable spread container placed in the refrigerator in the kitchen and labeled with “Peaches” and the date “11/30”. I observed one gallon zip-loc bag of shredded chicken in the freezer and labeled with “Chicken for Lasagna” but no date. I interviewed ten out of twelve staff members. According to staff interviews, the kitchen door is kept closed and locked at all times, hands are washed before food is prepared and served or gloves are worn during food service, the person preparing the food wears a hair restraint or pulls hair back, food not eaten by the children is discarded in the trash and never returned to the serving bowls or the kitchen. Staff members stated only the leftover food that is not served to the children is labeled and dated, stored in the refrigerator, and served again later in the week or frozen to be served later. Staff members stated canned fruit leftover through the week would occasionally be served as later in the week. I reviewed the menu dated November 27, 2023 through December 1, 2023. I observed substitutions written in on this menu documenting that substitutions were made or planned to be made prior to service. Based on my observations, interviews with staff and my review of the current week’s menu, the allegation related to sanitation and health is unsubstantiated. I investigated the concern that a child was not attended to in a nurturing and appropriate manner or in keeping with the child’s developmental needs which included a child being belittled in front their peers. I observed teacher interactions with children in each classroom. I observed teachers in each classroom make eye contact when speaking to a child; engage children in conversation to share experiences, ideas, and opinions; help children develop problem-solving skills; and facilitate learning by providing positive reinforcement, encouraging efforts, and recognizing accomplishments. I observed no child yelled at, shamed, humiliated, frightened, threatened, or bullied by teachers. I observed Ms. Gandhi’s interactions with children in each classroom. I observed Ms. Gandhi make eye contact when speaking to a child; engage children in conversation to share experiences, ideas, and opinions; help children develop problem-solving skills; and facilitate learning by providing positive reinforcement, encouraging efforts, and recognizing accomplishments. I observed no child yelled at, shamed, humiliated, frightened, threatened, or bullied by Ms. Gandhi. I interviewed ten out of twelve staff members. According to staff interviews, children are treated in a nurturing and caring manner by each staff member. Staff members could not recall a time when children were yelled at, shamed, humiliated, frightened, threatened, or bullied by teachers, administrators, or Ms. Gandhi. Based on my observations and interviews with staff, the allegation related to a child not being attended to in a nurturing and appropriate manner or in keeping with the child’s developmental needs is unsubstantiated. I investigated the concern related to materials and developmentally appropriate activities. I observed materials in sufficient quantities accessible to the children in each classroom. I observed activities planned and documented on the current and posted activity plans in each classroom. I observed the activity plans in Spaces 2, 3, and 6 were written by the administrator. I observed the activity plans in Spaces 1 and 5 were written by the classroom teachers. In Space 2, I observed art activities planned daily but not carried out. In Space 5, I observed sensory and science activities planned but not carried out. In Space 6, I observed black-line worksheets planned and used as “art work” in the classroom. I observed some materials necessary to carry out the planned activities were not available in the classrooms. I interviewed ten out of twelve staff members. According to staff interviews, materials and toys are provided in each classroom according to the developmental needs of the children. Staff members stated activities are carried out in each classroom on a daily basis and materials to carry out these activities are available most of the time but not all the time. Based on my observations and interviews with staff, the allegation related to materials and developmentally appropriate activities is substantiated. The following violations were cited during today’s visit: Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. In Space 5, an arrival time was not recorded for two children in attendance. The teacher recorded the arrival times during the visit. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. On one occasion in November 2023, one three-year-old child was left unattended in the two-year-old classroom for an unknown period of time while the teacher and the rest of the children were outside on the playground. On November 17, 2023, one three-year-old child was left outside on the playground for an unknown period of time while the teacher and the rest of the children went inside the classroom. .1801(a)(1-5) 316 Children under one year of age were not kept separate from children two years and older. During the months of October and November, children zero, one, two, and three years of age were grouped together for longer than the first hour of operation during the early morning arrival hours of 6:00am and 7:30am. 10A NCAC 09 .0713(a)(5) 429 The activity plan was not designed to stimulate emotional and social, health and physical, approaches to play and learning, language development and communication, and cognitive development for each group of children in care. In Space 2, daily art activities were planned but were not carried out. In Space 5, snow-theme sensory and science materials were not available to carry out the planned activities. In Space 6, farm-theme materials and toys were not available to carry out the planned activities. In Space 6, black-line worksheets were planned daily as "art work". .0508(b)(1-5) 611 All beds,cots, or mats with individual linen were not provided for each child. One three-year-old child was allowed to sleep on the floor during the early morning arrival hours instead of being given their cot on which to sleep. 15A NCAC 18A .2821(c) 1756 Enhanced staff/child ratios and group sizes were not met. The enhanced staff to child ratio was not maintained for the youngest child in the group. During the visit, nine three-year-old children and one two-year-old child were grouped together in Space 6. On numerous occasions in October 2023 and November 2023, the staff to child ratios were not maintained during the early morning hours. On at least one occasion in October, one teacher on-site from 6:00am to 7:00am opened the one-year-old classroom and supervised nine children ranging in age from zero to three years of age. 10A NCAC 09 .2818 Technical Assistance: 1. Per child care rule 10A NCAC 09 .2818 (b), a center with a star-rated license should maintain enhanced staff to child ratios and maximum group sizes. Per child care rule 10A NCAC 09 .0713 (a)(1), when age groups are combined, the staff to child ratio for the youngest child in the group should be maintained for the entire group. To maintain compliance with these child care requirements, I suggested you retrain your teachers to notify an administrator when the child attendance in their classroom reaches one less than the maximum staff to child ratio. When the maximum number children have arrived in the classroom, request for an additional teacher has been made, and the additional teacher has not made it to the classroom, I suggested you train your teachers to request the parent stay in the classroom or lobby area with their child until the additional teacher arrives in the classroom. 2. Per child care rule 10A NCAC 09 .0713 (a)(2), children of all ages may be cared for together for only the first and last operating hour of the day as long as the staff to child ratio for the youngest child in the group is maintained. To maintain compliance with this child care requirement, I suggested you carry through with your plan to adjust staffing schedules effective December 4, 2023 to provide additional staff in the early morning operating hours that will accommodate the ages and number of children scheduled to arrive early daily. 3. Per child care rule 10A NCAC 09 .0713 (a)(3), a child two years of age or older may be cared for with children under one year of age when a physician certifies that the developmental age of the child makes this placement appropriate. To maintain compliance with this child care requirement, I suggested you place all children with their same age peers during early morning arrival and throughout the day rather than with younger children unless it’s the first or last hour of the day or you have a physician’s statement certifying the placement with a younger age group and parents agree to the placement. 4. Per child care rule 10A NCAC 09 .1801(a)(1-5), children should be adequately supervised at all times. As discussed today, no child should be left alone in a classroom or on the playground without direct adult supervision. To maintain compliance with this child care requirement, I suggested you consider reviewing your facility’s expectations and procedures for adequately supervising children and consider arranging for additional staff training regarding supervision practices. I also suggested you consider creating a supervision policy that you add to your facility’s written operational procedures and policies. 5. Per sanitation rule 15A NCAC 18A.2821(c), beds, cots, and mats used in a child care center shall be assigned and labeled for use by an individual child and equipped with individual linens. Child care centers should make a bed, cot, or mat available to each child on which the child may sleep including during the early morning arrival hours. To maintain compliance with this child care requirement, When you have a child that routinely arrives during the early morning hours and wishes to sleep, I suggested you either open that child’s classroom so the child has immediate access to their cot or retrieve the child’s cot from the child’s classroom and place it in the classroom to which the child arrives. You stated one child in particular has refused the cot during the early morning hours which is why the child had been allowed to sleep on the floor with their blanket covering them. In this situation, I suggested you have the parent provide a sleeping bag or you provide a sleeping bag and place the sleeping bag on the cot as a means of providing a softer more sensory pleasing sleep environment for the child. I reminded you to store the sleeping bag in a plastic bag away from the cots when not in use, label the sleeping bag and cot with the child’s name, and launder the sleeping bag at least weekly and more often if soiled. 6. Per child care rule 10A NCAC 09 .0302(d)(4), daily records of arrival and departure times for children enrolled at the center should be maintained as children arrive and depart. To maintain compliance with this child care requirement, I suggest you review with your teaching staff the expectation for recording arrival and departure times. 7. Per child care rule 10A NCAC 09 .0508(b)(1-5), for each group of children in care, the activity plan should include activities intended to stimulate the developmental domains, in accordance with North Carolina Foundations for Early Learning and Development. These developmental domains should include emotional and social development, health and physical development, approaches to play and learning, language development and communication, and cognitive development. The intention of this rule is to not only plan for these developmentally appropriate activities but to also provide the materials and equipment necessary to carry out these planned activities. To maintain compliance with this child care requirement, I suggested you develop a plan to correct the breakdown in communication between the written activity plan and the expectation for carrying out these written activity plans. I suggested you consider allowing each teacher to write their own weekly activity plan with administrative oversight and approval. I also suggested you consider giving each teacher a weekly supply allowance to obtain the materials necessary to carry out their planned activities. Consultation: 1. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license based on the substantiation of one or more violations as a result of a complaint. 2. Adequate supervision includes the following expectations: a) staff should be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (b) staff should interact with the children while moving about the indoor or outdoor area; (c) staff should know where each child is located and be aware of the children's activities at all times; (d) staff should provide supervision appropriate to the individual age, needs, and capabilities of each child; and (e) staff should be able to see and hear children aged birth to five years old while the children are eating. 3. As discussed today, I suggest you reach out to your local resource and referral agency for additional resources, technical assistance, and training for your staff. Compliance Plan: All violations cited must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. Your letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Provide any documentation that will show compliance with the violation. 7. Your signature Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your letter may be sent by email to: kimberly.crane@dhhs.nc.gov I must receive your compliance letter no later than December 15, 2023. Please Note: If you state in your letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Compliance History: You are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past 18 months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, at erin.pickard@dhhs.nc.gov if you have any questions. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .2818 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: 1123-268L Visit Date: 12/1/2023 Number Present: 48 Completed Date: 12/4/2023 Age: From 0 To 5 Total Minutes: 390 Time In: 09:05 AM Time Out: 01:55 PM Time In: 02:20 PM Time Out: 04:00 PM List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to look into allegations received in the Raleigh office that child care requirements are not being followed. You, Bianca Gandhi, Owner/Interim Administrator, assisted me with the visit. According to the report, the following allegations are a concern: 1. There is a concern that the posted staff/child ratio is not being followed in the early morning hours. 2. There is a concern of inadequate supervision. Children are left unattended while providers go to the kitchen and restroom. Children have also been left unattended on the playground. 3. There is a concern related to sanitation and health. The kitchen door is left open, hands are not being washed before food preparation, hairnets are not being worn, dishes are not being sanitized, and leftover food is being served. 4. There is a concern that a child was not attended to in a nurturing and appropriate manner or in keeping with the child’s developmental needs. A child was belittled in front their peers. 5. There is a concern related to materials and developmentally appropriate activities. I investigated the concern that the posted staff/child ratio is not being followed in the early morning hours. Upon arrival at 9:05am, I conducted a walk-through of each classroom to document staff to child ratios. In Space 1, I observed two teachers supervising eight infants and two one-year-old children with all arrival times recorded. In Space 2, I observed two teachers supervising nine one-year-old children with all arrival times recorded. In Space 3, I observed two teachers supervising nine two-year-old children with all arrival times recorded. In Space 4, I observed no teacher and no children present. You stated this classroom was temporarily closed due to staffing. In Space 5, I observed one teacher supervising thirteen four-year-old children with arrival times recorded for eleven out of the thirteen children. In Space 6, I observed one teacher supervising ten children including one two-year-old child and nine three-year-old children with all arrival times recorded. I interviewed ten out of twelve staff members. According to staff interviews, on numerous occasions in October 2023 and November 2023, the staff to child ratios are not maintained during the early morning hours. Staff members stated on at least one occasion in October, one teacher on-site from 6:00am to 7:00am opened the one-year-old classroom and supervised nine children ranging in age from zero to three years of age. Staff members stated in October 2023 additional teachers were scheduled to arrive at 7:00am to open additional classrooms and correct staff to child ratios. Staff members stated in November 2023 administration changed staff schedules to allow one additional teacher to arrive at 6:30am to take over the one-year-old room and allow the infant room to be opened. Staff members stated as on Monday, December 4, 2023, the facility will open at 6:30am instead of 6:00am. Ms. Gandhi stated parents were notified of this operating procedure change in October 2023. Staff members stated the 6:30am opening time will allow the infant room, one-year-old room, and three-year-old room to open for the first hour of the day. Staff members stated this new operating schedule will allow infants to arrive and be cared for in their classroom for the entire day. With this new operating schedule, staff members stated the one-year-old and two-year-old children will be cared for in the one-year-old classroom until 7:00am when an additional staff member will arrive and open the two-year-old classroom. With this new operating schedule, staff members stated the cook and/or Ms. Gandhi will care for the three-year-old through five-year-old children from 6:30am to 7:30am together in either the three-year-old classroom or the four and five-year-old classroom until the teachers for these two groups arrive at 7:30am and split these two groups into their designated classrooms. Staff members stated, in Space 6, one newly enrolled two-year-old child has been allowed stay in the three-year-old classroom with the sibling until the ninth three-year-old child arrives later in the morning and puts the classroom out of staff to child ratio for two-year-old children. Staff members stated they are aware that administration needs to be alerted as the group attendance in Space 6 reaches nine children with the two-year-old child in the classroom so the administrator can move the two-year-old child to their classroom. Staff members stated a miscount of children was made during today’s visit resulting in the classroom being out of staff to child ratio this morning. Based on interviews with staff and my observations, the allegation regarding that the posted staff/child ratio is not being followed in the early morning hours is substantiated. I investigated the concern of inadequate supervision which included children being left unattended while providers go to the kitchen and restroom and left alone on the playground. I observed staff members go to the restroom during today’s visit. I observed the teachers relieved by a staff member to cover the supervision in the classroom to allow teachers to go to the restroom as needed. Due to the rain, the children did not go outside on the playground today. Therefore, outdoor supervision was not observed today. I interviewed ten out of twelve staff members. According to staff interviews, teachers are relieved by additional staff to go the kitchen or the restroom. Staff members stated they knew of one occasion on November 17, 2023 when one three-year-old child was left alone on the playground. Staff members stated they knew of one other occasion in November when a three-year-old child was being cared for in the two-year-old classroom and was left alone in the classroom for several minutes before the supervising staff member realized the child was missing and came back to the classroom to get the missing child. Staff members stated the incidents were reported to the administrator and to Ms. Gandhi but the incidents were not reported to DCDEE. Based on interviews with staff, the allegation regarding inadequate supervision is substantiated. I investigated the concern related to sanitation and health which included the kitchen door being left open, hands not being washed before food preparation, hairnets not being worn, dishes not being sanitized, and leftover food being served. I observed lunch being prepared and served today. I observed the kitchen door closed at all times including each time the cook left the kitchen. I observed the cook wearing a cloth visor during food preparation and service. I observed dishes washed by hand and then sanitized in the dishwasher and air dried. I observed food placed in serving bowls which were taken to the classrooms where the plates were prepared by the teachers who then served them to the children. I observed food served to the children but not eaten by the children discarded in a trash can in each classroom. I observed leftover food not taken to the classrooms placed in reusable plastic containers which were labeled with the name of the food and the date the food was prepared or opened. I observed one plastic reused Country Crock vegetable spread container placed in the refrigerator in the kitchen and labeled with “Peaches” and the date “11/30”. I observed one gallon zip-loc bag of shredded chicken in the freezer and labeled with “Chicken for Lasagna” but no date. I interviewed ten out of twelve staff members. According to staff interviews, the kitchen door is kept closed and locked at all times, hands are washed before food is prepared and served or gloves are worn during food service, the person preparing the food wears a hair restraint or pulls hair back, food not eaten by the children is discarded in the trash and never returned to the serving bowls or the kitchen. Staff members stated only the leftover food that is not served to the children is labeled and dated, stored in the refrigerator, and served again later in the week or frozen to be served later. Staff members stated canned fruit leftover through the week would occasionally be served as later in the week. I reviewed the menu dated November 27, 2023 through December 1, 2023. I observed substitutions written in on this menu documenting that substitutions were made or planned to be made prior to service. Based on my observations, interviews with staff and my review of the current week’s menu, the allegation related to sanitation and health is unsubstantiated. I investigated the concern that a child was not attended to in a nurturing and appropriate manner or in keeping with the child’s developmental needs which included a child being belittled in front their peers. I observed teacher interactions with children in each classroom. I observed teachers in each classroom make eye contact when speaking to a child; engage children in conversation to share experiences, ideas, and opinions; help children develop problem-solving skills; and facilitate learning by providing positive reinforcement, encouraging efforts, and recognizing accomplishments. I observed no child yelled at, shamed, humiliated, frightened, threatened, or bullied by teachers. I observed Ms. Gandhi’s interactions with children in each classroom. I observed Ms. Gandhi make eye contact when speaking to a child; engage children in conversation to share experiences, ideas, and opinions; help children develop problem-solving skills; and facilitate learning by providing positive reinforcement, encouraging efforts, and recognizing accomplishments. I observed no child yelled at, shamed, humiliated, frightened, threatened, or bullied by Ms. Gandhi. I interviewed ten out of twelve staff members. According to staff interviews, children are treated in a nurturing and caring manner by each staff member. Staff members could not recall a time when children were yelled at, shamed, humiliated, frightened, threatened, or bullied by teachers, administrators, or Ms. Gandhi. Based on my observations and interviews with staff, the allegation related to a child not being attended to in a nurturing and appropriate manner or in keeping with the child’s developmental needs is unsubstantiated. I investigated the concern related to materials and developmentally appropriate activities. I observed materials in sufficient quantities accessible to the children in each classroom. I observed activities planned and documented on the current and posted activity plans in each classroom. I observed the activity plans in Spaces 2, 3, and 6 were written by the administrator. I observed the activity plans in Spaces 1 and 5 were written by the classroom teachers. In Space 2, I observed art activities planned daily but not carried out. In Space 5, I observed sensory and science activities planned but not carried out. In Space 6, I observed black-line worksheets planned and used as “art work” in the classroom. I observed some materials necessary to carry out the planned activities were not available in the classrooms. I interviewed ten out of twelve staff members. According to staff interviews, materials and toys are provided in each classroom according to the developmental needs of the children. Staff members stated activities are carried out in each classroom on a daily basis and materials to carry out these activities are available most of the time but not all the time. Based on my observations and interviews with staff, the allegation related to materials and developmentally appropriate activities is substantiated. The following violations were cited during today’s visit: Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. In Space 5, an arrival time was not recorded for two children in attendance. The teacher recorded the arrival times during the visit. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. On one occasion in November 2023, one three-year-old child was left unattended in the two-year-old classroom for an unknown period of time while the teacher and the rest of the children were outside on the playground. On November 17, 2023, one three-year-old child was left outside on the playground for an unknown period of time while the teacher and the rest of the children went inside the classroom. .1801(a)(1-5) 316 Children under one year of age were not kept separate from children two years and older. During the months of October and November, children zero, one, two, and three years of age were grouped together for longer than the first hour of operation during the early morning arrival hours of 6:00am and 7:30am. 10A NCAC 09 .0713(a)(5) 429 The activity plan was not designed to stimulate emotional and social, health and physical, approaches to play and learning, language development and communication, and cognitive development for each group of children in care. In Space 2, daily art activities were planned but were not carried out. In Space 5, snow-theme sensory and science materials were not available to carry out the planned activities. In Space 6, farm-theme materials and toys were not available to carry out the planned activities. In Space 6, black-line worksheets were planned daily as "art work". .0508(b)(1-5) 611 All beds,cots, or mats with individual linen were not provided for each child. One three-year-old child was allowed to sleep on the floor during the early morning arrival hours instead of being given their cot on which to sleep. 15A NCAC 18A .2821(c) 1756 Enhanced staff/child ratios and group sizes were not met. The enhanced staff to child ratio was not maintained for the youngest child in the group. During the visit, nine three-year-old children and one two-year-old child were grouped together in Space 6. On numerous occasions in October 2023 and November 2023, the staff to child ratios were not maintained during the early morning hours. On at least one occasion in October, one teacher on-site from 6:00am to 7:00am opened the one-year-old classroom and supervised nine children ranging in age from zero to three years of age. 10A NCAC 09 .2818 Technical Assistance: 1. Per child care rule 10A NCAC 09 .2818 (b), a center with a star-rated license should maintain enhanced staff to child ratios and maximum group sizes. Per child care rule 10A NCAC 09 .0713 (a)(1), when age groups are combined, the staff to child ratio for the youngest child in the group should be maintained for the entire group. To maintain compliance with these child care requirements, I suggested you retrain your teachers to notify an administrator when the child attendance in their classroom reaches one less than the maximum staff to child ratio. When the maximum number children have arrived in the classroom, request for an additional teacher has been made, and the additional teacher has not made it to the classroom, I suggested you train your teachers to request the parent stay in the classroom or lobby area with their child until the additional teacher arrives in the classroom. 2. Per child care rule 10A NCAC 09 .0713 (a)(2), children of all ages may be cared for together for only the first and last operating hour of the day as long as the staff to child ratio for the youngest child in the group is maintained. To maintain compliance with this child care requirement, I suggested you carry through with your plan to adjust staffing schedules effective December 4, 2023 to provide additional staff in the early morning operating hours that will accommodate the ages and number of children scheduled to arrive early daily. 3. Per child care rule 10A NCAC 09 .0713 (a)(3), a child two years of age or older may be cared for with children under one year of age when a physician certifies that the developmental age of the child makes this placement appropriate. To maintain compliance with this child care requirement, I suggested you place all children with their same age peers during early morning arrival and throughout the day rather than with younger children unless it’s the first or last hour of the day or you have a physician’s statement certifying the placement with a younger age group and parents agree to the placement. 4. Per child care rule 10A NCAC 09 .1801(a)(1-5), children should be adequately supervised at all times. As discussed today, no child should be left alone in a classroom or on the playground without direct adult supervision. To maintain compliance with this child care requirement, I suggested you consider reviewing your facility’s expectations and procedures for adequately supervising children and consider arranging for additional staff training regarding supervision practices. I also suggested you consider creating a supervision policy that you add to your facility’s written operational procedures and policies. 5. Per sanitation rule 15A NCAC 18A.2821(c), beds, cots, and mats used in a child care center shall be assigned and labeled for use by an individual child and equipped with individual linens. Child care centers should make a bed, cot, or mat available to each child on which the child may sleep including during the early morning arrival hours. To maintain compliance with this child care requirement, When you have a child that routinely arrives during the early morning hours and wishes to sleep, I suggested you either open that child’s classroom so the child has immediate access to their cot or retrieve the child’s cot from the child’s classroom and place it in the classroom to which the child arrives. You stated one child in particular has refused the cot during the early morning hours which is why the child had been allowed to sleep on the floor with their blanket covering them. In this situation, I suggested you have the parent provide a sleeping bag or you provide a sleeping bag and place the sleeping bag on the cot as a means of providing a softer more sensory pleasing sleep environment for the child. I reminded you to store the sleeping bag in a plastic bag away from the cots when not in use, label the sleeping bag and cot with the child’s name, and launder the sleeping bag at least weekly and more often if soiled. 6. Per child care rule 10A NCAC 09 .0302(d)(4), daily records of arrival and departure times for children enrolled at the center should be maintained as children arrive and depart. To maintain compliance with this child care requirement, I suggest you review with your teaching staff the expectation for recording arrival and departure times. 7. Per child care rule 10A NCAC 09 .0508(b)(1-5), for each group of children in care, the activity plan should include activities intended to stimulate the developmental domains, in accordance with North Carolina Foundations for Early Learning and Development. These developmental domains should include emotional and social development, health and physical development, approaches to play and learning, language development and communication, and cognitive development. The intention of this rule is to not only plan for these developmentally appropriate activities but to also provide the materials and equipment necessary to carry out these planned activities. To maintain compliance with this child care requirement, I suggested you develop a plan to correct the breakdown in communication between the written activity plan and the expectation for carrying out these written activity plans. I suggested you consider allowing each teacher to write their own weekly activity plan with administrative oversight and approval. I also suggested you consider giving each teacher a weekly supply allowance to obtain the materials necessary to carry out their planned activities. Consultation: 1. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license based on the substantiation of one or more violations as a result of a complaint. 2. Adequate supervision includes the following expectations: a) staff should be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (b) staff should interact with the children while moving about the indoor or outdoor area; (c) staff should know where each child is located and be aware of the children's activities at all times; (d) staff should provide supervision appropriate to the individual age, needs, and capabilities of each child; and (e) staff should be able to see and hear children aged birth to five years old while the children are eating. 3. As discussed today, I suggest you reach out to your local resource and referral agency for additional resources, technical assistance, and training for your staff. Compliance Plan: All violations cited must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. Your letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Provide any documentation that will show compliance with the violation. 7. Your signature Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your letter may be sent by email to: kimberly.crane@dhhs.nc.gov I must receive your compliance letter no later than December 15, 2023. Please Note: If you state in your letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Compliance History: You are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past 18 months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, at erin.pickard@dhhs.nc.gov if you have any questions. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .0803 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 9/19/2023 Number Present: 48 Completed Date: 9/19/2023 Age: From 0 To 4 Total Minutes: 423 Time In: 09:12 AM Time Out: 04:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Bianca Gandhi, Owner and acting Interim Administrator, assisted me with today’s visit. Your temporary license was issued on October 7, 2022. Your program currently operates with a three-star license, issued on April 8, 2023, earning 4 points in staff education, 2 points in program standards, and one quality point for having a combined turnover rate of 20 percent or less for the administrator, program coordinator, lead teacher, teacher, and group leader positions over the last 12 months. Toddlers Cove Academy Inc, the owner of your facility, was viewed as current-active on the North Carolina Secretary of State website on September 18, 2023. Your program’s compliance history was 96% as of September 18, 2023 and was reviewed with you today. Your last sanitation inspection was dated June 27, 2023 with a Superior classification and 4 demerits. Your last fire inspection was dated November 14, 2022. I visited each licensed indoor space and outdoor space with you today. You stated Space 6 was currently unused due to staffing. You stated Space 7 (lobby area) was not used for child care at this time. I observed children playing in activity areas, transitioning from outdoor to indoor play, washing hands, napping and eating lunch. I observed children adequately supervised during today’s visit. I observed voluntary enhanced staff-child ratios maintained during today’s visit. I observed adequate approved space used during today’s visit. I observed minimum space capacity maintained throughout the center during today's visit. I observed permit restrictions including “Daytime care only” and “Meets enhanced ratios” maintained during today’s visit. I reviewed program records, children’s records, and staff records today. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. I observed and cited the following violations during today's visit: Violation Number Comment Rule 475 Sand and water play activities were not available weekly to each group. In Space 4, sand and water play activities were not available indoors or outdoors to the three-year-old children at least weekly. .0510(c)(3) 721 All equipment and furnishings were not in good repair. On Playground 3, the set of steps on the castle climber were broken and the piece of equipment was not removed or repaired. G.S. 110-91(6); .0601(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In Space 2, one container of sunscreen was stored in an unlocked drawer. The teacher locked the medication drawer. 15A NCAC 18A .2820(d) 846 Over-the-counter medicines were not in their original containers or administered as authorized in writing by parent, physician or authorized health professional. In Space 2, one container of over the counter diaper ointment was not labeled with the name of the child. The interim administrator labeled the container of diaper ointment with the name of the child. 10A NCAC 09 .0803(4) 847 Parent's medication authorization did not include required information. In Space 2, one permission to administer form was missing the information for when and how to apply a diaper ointment. The parent added the missing information when the child was picked up. In Space 3, one permission to administer form was missing the valid dates a diaper ointment could be administered. The parent added the missing valid dates when the child was picked up. 10A NCAC 09 .0803(4)(6-9) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In Space 2, a ziploc bag was used to store extra clothing for each child in a basket on top of each cubby which was unlocked and below five feet. The interim administrator removed the ziploc bag from each basket. In Space 3, a bag of used grocery bags was stored below five feet on the handle of a hanging cabinet in an unlocked sick room. The interim administrator removed the bags from the unlocked sick room and placed them in a locked cabinet. .0604(q) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. New staff orientation training for all employees included six health and safety training courses. Health and safety training should be completed in addition to new staff orientation training. .1101(a) 1230 Personnel policies were not discussed with each staff at employment and a copy was not available to all staff. Two staff members with a dates of employment of 08/15/2023 and 09/05/2023 did not have acknowledgement statements on file to document the personnel policies had been discussed with the staff members. 10A NCAC 09 .0514(e) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One child application indicated the child had a food allergy but no medical action plan was attached or on file in the center. .0801(b) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Staff medical records for all the employees were stored in the staff record file with all the other personnel records. .0701(d) Compliance Plan: All violations cited must be corrected immediately. Please submit written, signed, and dated compliance documentation to me at the email/address below detailing the steps taken to correct each violation. Your compliance documentation must include the following: 1) A compliance letter including the following: 1. The name of your facility 2. The ID number of your facility 3. The date you write the letter 4. A corrective action statement for each violation stating how you corrected the violation and are now in compliance. 5. A compliance plan statement for each violation stating how you plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than October 3, 2023. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 During today’s visit, I provided the following technical assistance: 1) Per child care rule 10A NCAC 09 .0803(4), over-the-counter diaper creams should be labeled with the name of the child. 2) Per child care rule 10A NCAC 09 .0604(q), plastic bags including opened teacher supply bags, Ziploc bags, grocery bags, and diaper wipe refill bags must be stored inaccessible to children above five (5) feet or in a locked cabinet, closet, or drawer. 3) Per child care rule 10A NCAC 09. 601(b), all indoor and outdoor equipment and materials should be kept in good repair. I suggested you use caution tape to make the broken climber on Playground 3 inaccessible to the children until you can have it repaired or removed. 4) Only items related to toileting needs should be stored in bathrooms. 5) When screen-time is logged on an activity plan, the number of minutes, the name of the activity, the name of the website or app, and the name(s) of the children or whole group participating in the screen-time viewing should be documented on the activity plan. 6) Per child care rule 10A NCAC 09 .0803 (7), a parent may give standing authorization for up to 12 months to apply over the counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization should be in writing and should contain: (a) the child's name; (b) the name of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) when and the amount to administer the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) how to apply the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. 7) Be reminded popular genre music such as country music, pop music, rap music, etc. would not be considered acceptable for the child care setting. Children’s songs, instrumental, classical, and lullaby music would be considered appropriate for the child care setting. 8) Per child care rule 10A NCAC 09 .0304(a), the original copy of the most recently approved fire inspection report should be sent to me by email within one week of completion. 9) Per sanitation rule 15A NCAC 18A .2820(d), diaper creams and sunscreen may be kept out of the reach of children and stored inaccessible to children above five feet as long as the topical ointment label does not include additional warnings. If the topical ointment label contains additional warnings, the topical ointment should be stored in a locked cabinet, drawer, or closet. 10) New staff orientation training should be completed by the administrator or assigned responsible staff member and should be training focused on the center’s procedures, policies, and expectations. Health and safety training courses should not be used as new staff orientation training but should be in addition to health and safety training. 11) Staff medical records should be stored separately from the other personnel records. 12) Each trash can used to store food trash should be fitted with a tight lid. 13) Age-appropriate sand and water play should be made available to each group of children at least weekly. 14) Any child with a chronic illness including but not limited to food allergy, anaphylaxis allergy, diabetes, seizures, or asthma should have a medical action plan on file which is completed by the parent or the health care provider. This medical action plan should be attached to the child’s application and updated annually. 15) The activity plans for infants and toddlers should be individualized, include the five learning domains, include the name and age of each child, and be updated at least monthly. 16) Per G.S. 110-90.2(b) & (d) & 10A NCAC 09 .2703(e), each child care provider should have a valid Criminal Background Check qualification letter on file in their staff records. This includes therapists who visit your facility and are contracted to work with a child enrolled in your facility. When the therapist provides therapy services within the classroom with the teacher present, the therapist does not have to have a CBC qualification letter because the teacher is supervising the child and monitoring the therapy session. However, when the therapist takes the child out of the classroom to another part of the building and is left alone with the child, then the therapist has to have CBC qualification letter on file. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. We appreciate all you are doing to serve the children and families in your community. Thank you for your time today. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or our lead consultant and interim supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
10A NCAC 09 .0304 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 9/19/2023 Number Present: 48 Completed Date: 9/19/2023 Age: From 0 To 4 Total Minutes: 423 Time In: 09:12 AM Time Out: 04:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Bianca Gandhi, Owner and acting Interim Administrator, assisted me with today’s visit. Your temporary license was issued on October 7, 2022. Your program currently operates with a three-star license, issued on April 8, 2023, earning 4 points in staff education, 2 points in program standards, and one quality point for having a combined turnover rate of 20 percent or less for the administrator, program coordinator, lead teacher, teacher, and group leader positions over the last 12 months. Toddlers Cove Academy Inc, the owner of your facility, was viewed as current-active on the North Carolina Secretary of State website on September 18, 2023. Your program’s compliance history was 96% as of September 18, 2023 and was reviewed with you today. Your last sanitation inspection was dated June 27, 2023 with a Superior classification and 4 demerits. Your last fire inspection was dated November 14, 2022. I visited each licensed indoor space and outdoor space with you today. You stated Space 6 was currently unused due to staffing. You stated Space 7 (lobby area) was not used for child care at this time. I observed children playing in activity areas, transitioning from outdoor to indoor play, washing hands, napping and eating lunch. I observed children adequately supervised during today’s visit. I observed voluntary enhanced staff-child ratios maintained during today’s visit. I observed adequate approved space used during today’s visit. I observed minimum space capacity maintained throughout the center during today's visit. I observed permit restrictions including “Daytime care only” and “Meets enhanced ratios” maintained during today’s visit. I reviewed program records, children’s records, and staff records today. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. I observed and cited the following violations during today's visit: Violation Number Comment Rule 475 Sand and water play activities were not available weekly to each group. In Space 4, sand and water play activities were not available indoors or outdoors to the three-year-old children at least weekly. .0510(c)(3) 721 All equipment and furnishings were not in good repair. On Playground 3, the set of steps on the castle climber were broken and the piece of equipment was not removed or repaired. G.S. 110-91(6); .0601(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In Space 2, one container of sunscreen was stored in an unlocked drawer. The teacher locked the medication drawer. 15A NCAC 18A .2820(d) 846 Over-the-counter medicines were not in their original containers or administered as authorized in writing by parent, physician or authorized health professional. In Space 2, one container of over the counter diaper ointment was not labeled with the name of the child. The interim administrator labeled the container of diaper ointment with the name of the child. 10A NCAC 09 .0803(4) 847 Parent's medication authorization did not include required information. In Space 2, one permission to administer form was missing the information for when and how to apply a diaper ointment. The parent added the missing information when the child was picked up. In Space 3, one permission to administer form was missing the valid dates a diaper ointment could be administered. The parent added the missing valid dates when the child was picked up. 10A NCAC 09 .0803(4)(6-9) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In Space 2, a ziploc bag was used to store extra clothing for each child in a basket on top of each cubby which was unlocked and below five feet. The interim administrator removed the ziploc bag from each basket. In Space 3, a bag of used grocery bags was stored below five feet on the handle of a hanging cabinet in an unlocked sick room. The interim administrator removed the bags from the unlocked sick room and placed them in a locked cabinet. .0604(q) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. New staff orientation training for all employees included six health and safety training courses. Health and safety training should be completed in addition to new staff orientation training. .1101(a) 1230 Personnel policies were not discussed with each staff at employment and a copy was not available to all staff. Two staff members with a dates of employment of 08/15/2023 and 09/05/2023 did not have acknowledgement statements on file to document the personnel policies had been discussed with the staff members. 10A NCAC 09 .0514(e) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One child application indicated the child had a food allergy but no medical action plan was attached or on file in the center. .0801(b) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Staff medical records for all the employees were stored in the staff record file with all the other personnel records. .0701(d) Compliance Plan: All violations cited must be corrected immediately. Please submit written, signed, and dated compliance documentation to me at the email/address below detailing the steps taken to correct each violation. Your compliance documentation must include the following: 1) A compliance letter including the following: 1. The name of your facility 2. The ID number of your facility 3. The date you write the letter 4. A corrective action statement for each violation stating how you corrected the violation and are now in compliance. 5. A compliance plan statement for each violation stating how you plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than October 3, 2023. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 During today’s visit, I provided the following technical assistance: 1) Per child care rule 10A NCAC 09 .0803(4), over-the-counter diaper creams should be labeled with the name of the child. 2) Per child care rule 10A NCAC 09 .0604(q), plastic bags including opened teacher supply bags, Ziploc bags, grocery bags, and diaper wipe refill bags must be stored inaccessible to children above five (5) feet or in a locked cabinet, closet, or drawer. 3) Per child care rule 10A NCAC 09. 601(b), all indoor and outdoor equipment and materials should be kept in good repair. I suggested you use caution tape to make the broken climber on Playground 3 inaccessible to the children until you can have it repaired or removed. 4) Only items related to toileting needs should be stored in bathrooms. 5) When screen-time is logged on an activity plan, the number of minutes, the name of the activity, the name of the website or app, and the name(s) of the children or whole group participating in the screen-time viewing should be documented on the activity plan. 6) Per child care rule 10A NCAC 09 .0803 (7), a parent may give standing authorization for up to 12 months to apply over the counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization should be in writing and should contain: (a) the child's name; (b) the name of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) when and the amount to administer the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) how to apply the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. 7) Be reminded popular genre music such as country music, pop music, rap music, etc. would not be considered acceptable for the child care setting. Children’s songs, instrumental, classical, and lullaby music would be considered appropriate for the child care setting. 8) Per child care rule 10A NCAC 09 .0304(a), the original copy of the most recently approved fire inspection report should be sent to me by email within one week of completion. 9) Per sanitation rule 15A NCAC 18A .2820(d), diaper creams and sunscreen may be kept out of the reach of children and stored inaccessible to children above five feet as long as the topical ointment label does not include additional warnings. If the topical ointment label contains additional warnings, the topical ointment should be stored in a locked cabinet, drawer, or closet. 10) New staff orientation training should be completed by the administrator or assigned responsible staff member and should be training focused on the center’s procedures, policies, and expectations. Health and safety training courses should not be used as new staff orientation training but should be in addition to health and safety training. 11) Staff medical records should be stored separately from the other personnel records. 12) Each trash can used to store food trash should be fitted with a tight lid. 13) Age-appropriate sand and water play should be made available to each group of children at least weekly. 14) Any child with a chronic illness including but not limited to food allergy, anaphylaxis allergy, diabetes, seizures, or asthma should have a medical action plan on file which is completed by the parent or the health care provider. This medical action plan should be attached to the child’s application and updated annually. 15) The activity plans for infants and toddlers should be individualized, include the five learning domains, include the name and age of each child, and be updated at least monthly. 16) Per G.S. 110-90.2(b) & (d) & 10A NCAC 09 .2703(e), each child care provider should have a valid Criminal Background Check qualification letter on file in their staff records. This includes therapists who visit your facility and are contracted to work with a child enrolled in your facility. When the therapist provides therapy services within the classroom with the teacher present, the therapist does not have to have a CBC qualification letter because the teacher is supervising the child and monitoring the therapy session. However, when the therapist takes the child out of the classroom to another part of the building and is left alone with the child, then the therapist has to have CBC qualification letter on file. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. We appreciate all you are doing to serve the children and families in your community. Thank you for your time today. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or our lead consultant and interim supervisor, Erin Pickard, by email at erin.pickard@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 .0514 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 9/19/2023 Number Present: 48 Completed Date: 9/19/2023 Age: From 0 To 4 Total Minutes: 423 Time In: 09:12 AM Time Out: 04:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Bianca Gandhi, Owner and acting Interim Administrator, assisted me with today’s visit. Your temporary license was issued on October 7, 2022. Your program currently operates with a three-star license, issued on April 8, 2023, earning 4 points in staff education, 2 points in program standards, and one quality point for having a combined turnover rate of 20 percent or less for the administrator, program coordinator, lead teacher, teacher, and group leader positions over the last 12 months. Toddlers Cove Academy Inc, the owner of your facility, was viewed as current-active on the North Carolina Secretary of State website on September 18, 2023. Your program’s compliance history was 96% as of September 18, 2023 and was reviewed with you today. Your last sanitation inspection was dated June 27, 2023 with a Superior classification and 4 demerits. Your last fire inspection was dated November 14, 2022. I visited each licensed indoor space and outdoor space with you today. You stated Space 6 was currently unused due to staffing. You stated Space 7 (lobby area) was not used for child care at this time. I observed children playing in activity areas, transitioning from outdoor to indoor play, washing hands, napping and eating lunch. I observed children adequately supervised during today’s visit. I observed voluntary enhanced staff-child ratios maintained during today’s visit. I observed adequate approved space used during today’s visit. I observed minimum space capacity maintained throughout the center during today's visit. I observed permit restrictions including “Daytime care only” and “Meets enhanced ratios” maintained during today’s visit. I reviewed program records, children’s records, and staff records today. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. I observed and cited the following violations during today's visit: Violation Number Comment Rule 475 Sand and water play activities were not available weekly to each group. In Space 4, sand and water play activities were not available indoors or outdoors to the three-year-old children at least weekly. .0510(c)(3) 721 All equipment and furnishings were not in good repair. On Playground 3, the set of steps on the castle climber were broken and the piece of equipment was not removed or repaired. G.S. 110-91(6); .0601(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In Space 2, one container of sunscreen was stored in an unlocked drawer. The teacher locked the medication drawer. 15A NCAC 18A .2820(d) 846 Over-the-counter medicines were not in their original containers or administered as authorized in writing by parent, physician or authorized health professional. In Space 2, one container of over the counter diaper ointment was not labeled with the name of the child. The interim administrator labeled the container of diaper ointment with the name of the child. 10A NCAC 09 .0803(4) 847 Parent's medication authorization did not include required information. In Space 2, one permission to administer form was missing the information for when and how to apply a diaper ointment. The parent added the missing information when the child was picked up. In Space 3, one permission to administer form was missing the valid dates a diaper ointment could be administered. The parent added the missing valid dates when the child was picked up. 10A NCAC 09 .0803(4)(6-9) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In Space 2, a ziploc bag was used to store extra clothing for each child in a basket on top of each cubby which was unlocked and below five feet. The interim administrator removed the ziploc bag from each basket. In Space 3, a bag of used grocery bags was stored below five feet on the handle of a hanging cabinet in an unlocked sick room. The interim administrator removed the bags from the unlocked sick room and placed them in a locked cabinet. .0604(q) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. New staff orientation training for all employees included six health and safety training courses. Health and safety training should be completed in addition to new staff orientation training. .1101(a) 1230 Personnel policies were not discussed with each staff at employment and a copy was not available to all staff. Two staff members with a dates of employment of 08/15/2023 and 09/05/2023 did not have acknowledgement statements on file to document the personnel policies had been discussed with the staff members. 10A NCAC 09 .0514(e) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One child application indicated the child had a food allergy but no medical action plan was attached or on file in the center. .0801(b) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Staff medical records for all the employees were stored in the staff record file with all the other personnel records. .0701(d) Compliance Plan: All violations cited must be corrected immediately. Please submit written, signed, and dated compliance documentation to me at the email/address below detailing the steps taken to correct each violation. Your compliance documentation must include the following: 1) A compliance letter including the following: 1. The name of your facility 2. The ID number of your facility 3. The date you write the letter 4. A corrective action statement for each violation stating how you corrected the violation and are now in compliance. 5. A compliance plan statement for each violation stating how you plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than October 3, 2023. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 During today’s visit, I provided the following technical assistance: 1) Per child care rule 10A NCAC 09 .0803(4), over-the-counter diaper creams should be labeled with the name of the child. 2) Per child care rule 10A NCAC 09 .0604(q), plastic bags including opened teacher supply bags, Ziploc bags, grocery bags, and diaper wipe refill bags must be stored inaccessible to children above five (5) feet or in a locked cabinet, closet, or drawer. 3) Per child care rule 10A NCAC 09. 601(b), all indoor and outdoor equipment and materials should be kept in good repair. I suggested you use caution tape to make the broken climber on Playground 3 inaccessible to the children until you can have it repaired or removed. 4) Only items related to toileting needs should be stored in bathrooms. 5) When screen-time is logged on an activity plan, the number of minutes, the name of the activity, the name of the website or app, and the name(s) of the children or whole group participating in the screen-time viewing should be documented on the activity plan. 6) Per child care rule 10A NCAC 09 .0803 (7), a parent may give standing authorization for up to 12 months to apply over the counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization should be in writing and should contain: (a) the child's name; (b) the name of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) when and the amount to administer the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) how to apply the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. 7) Be reminded popular genre music such as country music, pop music, rap music, etc. would not be considered acceptable for the child care setting. Children’s songs, instrumental, classical, and lullaby music would be considered appropriate for the child care setting. 8) Per child care rule 10A NCAC 09 .0304(a), the original copy of the most recently approved fire inspection report should be sent to me by email within one week of completion. 9) Per sanitation rule 15A NCAC 18A .2820(d), diaper creams and sunscreen may be kept out of the reach of children and stored inaccessible to children above five feet as long as the topical ointment label does not include additional warnings. If the topical ointment label contains additional warnings, the topical ointment should be stored in a locked cabinet, drawer, or closet. 10) New staff orientation training should be completed by the administrator or assigned responsible staff member and should be training focused on the center’s procedures, policies, and expectations. Health and safety training courses should not be used as new staff orientation training but should be in addition to health and safety training. 11) Staff medical records should be stored separately from the other personnel records. 12) Each trash can used to store food trash should be fitted with a tight lid. 13) Age-appropriate sand and water play should be made available to each group of children at least weekly. 14) Any child with a chronic illness including but not limited to food allergy, anaphylaxis allergy, diabetes, seizures, or asthma should have a medical action plan on file which is completed by the parent or the health care provider. This medical action plan should be attached to the child’s application and updated annually. 15) The activity plans for infants and toddlers should be individualized, include the five learning domains, include the name and age of each child, and be updated at least monthly. 16) Per G.S. 110-90.2(b) & (d) & 10A NCAC 09 .2703(e), each child care provider should have a valid Criminal Background Check qualification letter on file in their staff records. This includes therapists who visit your facility and are contracted to work with a child enrolled in your facility. When the therapist provides therapy services within the classroom with the teacher present, the therapist does not have to have a CBC qualification letter because the teacher is supervising the child and monitoring the therapy session. However, when the therapist takes the child out of the classroom to another part of the building and is left alone with the child, then the therapist has to have CBC qualification letter on file. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. We appreciate all you are doing to serve the children and families in your community. Thank you for your time today. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or our lead consultant and interim supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .0604 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 9/19/2023 Number Present: 48 Completed Date: 9/19/2023 Age: From 0 To 4 Total Minutes: 423 Time In: 09:12 AM Time Out: 04:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Bianca Gandhi, Owner and acting Interim Administrator, assisted me with today’s visit. Your temporary license was issued on October 7, 2022. Your program currently operates with a three-star license, issued on April 8, 2023, earning 4 points in staff education, 2 points in program standards, and one quality point for having a combined turnover rate of 20 percent or less for the administrator, program coordinator, lead teacher, teacher, and group leader positions over the last 12 months. Toddlers Cove Academy Inc, the owner of your facility, was viewed as current-active on the North Carolina Secretary of State website on September 18, 2023. Your program’s compliance history was 96% as of September 18, 2023 and was reviewed with you today. Your last sanitation inspection was dated June 27, 2023 with a Superior classification and 4 demerits. Your last fire inspection was dated November 14, 2022. I visited each licensed indoor space and outdoor space with you today. You stated Space 6 was currently unused due to staffing. You stated Space 7 (lobby area) was not used for child care at this time. I observed children playing in activity areas, transitioning from outdoor to indoor play, washing hands, napping and eating lunch. I observed children adequately supervised during today’s visit. I observed voluntary enhanced staff-child ratios maintained during today’s visit. I observed adequate approved space used during today’s visit. I observed minimum space capacity maintained throughout the center during today's visit. I observed permit restrictions including “Daytime care only” and “Meets enhanced ratios” maintained during today’s visit. I reviewed program records, children’s records, and staff records today. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. I observed and cited the following violations during today's visit: Violation Number Comment Rule 475 Sand and water play activities were not available weekly to each group. In Space 4, sand and water play activities were not available indoors or outdoors to the three-year-old children at least weekly. .0510(c)(3) 721 All equipment and furnishings were not in good repair. On Playground 3, the set of steps on the castle climber were broken and the piece of equipment was not removed or repaired. G.S. 110-91(6); .0601(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In Space 2, one container of sunscreen was stored in an unlocked drawer. The teacher locked the medication drawer. 15A NCAC 18A .2820(d) 846 Over-the-counter medicines were not in their original containers or administered as authorized in writing by parent, physician or authorized health professional. In Space 2, one container of over the counter diaper ointment was not labeled with the name of the child. The interim administrator labeled the container of diaper ointment with the name of the child. 10A NCAC 09 .0803(4) 847 Parent's medication authorization did not include required information. In Space 2, one permission to administer form was missing the information for when and how to apply a diaper ointment. The parent added the missing information when the child was picked up. In Space 3, one permission to administer form was missing the valid dates a diaper ointment could be administered. The parent added the missing valid dates when the child was picked up. 10A NCAC 09 .0803(4)(6-9) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In Space 2, a ziploc bag was used to store extra clothing for each child in a basket on top of each cubby which was unlocked and below five feet. The interim administrator removed the ziploc bag from each basket. In Space 3, a bag of used grocery bags was stored below five feet on the handle of a hanging cabinet in an unlocked sick room. The interim administrator removed the bags from the unlocked sick room and placed them in a locked cabinet. .0604(q) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. New staff orientation training for all employees included six health and safety training courses. Health and safety training should be completed in addition to new staff orientation training. .1101(a) 1230 Personnel policies were not discussed with each staff at employment and a copy was not available to all staff. Two staff members with a dates of employment of 08/15/2023 and 09/05/2023 did not have acknowledgement statements on file to document the personnel policies had been discussed with the staff members. 10A NCAC 09 .0514(e) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One child application indicated the child had a food allergy but no medical action plan was attached or on file in the center. .0801(b) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Staff medical records for all the employees were stored in the staff record file with all the other personnel records. .0701(d) Compliance Plan: All violations cited must be corrected immediately. Please submit written, signed, and dated compliance documentation to me at the email/address below detailing the steps taken to correct each violation. Your compliance documentation must include the following: 1) A compliance letter including the following: 1. The name of your facility 2. The ID number of your facility 3. The date you write the letter 4. A corrective action statement for each violation stating how you corrected the violation and are now in compliance. 5. A compliance plan statement for each violation stating how you plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than October 3, 2023. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 During today’s visit, I provided the following technical assistance: 1) Per child care rule 10A NCAC 09 .0803(4), over-the-counter diaper creams should be labeled with the name of the child. 2) Per child care rule 10A NCAC 09 .0604(q), plastic bags including opened teacher supply bags, Ziploc bags, grocery bags, and diaper wipe refill bags must be stored inaccessible to children above five (5) feet or in a locked cabinet, closet, or drawer. 3) Per child care rule 10A NCAC 09. 601(b), all indoor and outdoor equipment and materials should be kept in good repair. I suggested you use caution tape to make the broken climber on Playground 3 inaccessible to the children until you can have it repaired or removed. 4) Only items related to toileting needs should be stored in bathrooms. 5) When screen-time is logged on an activity plan, the number of minutes, the name of the activity, the name of the website or app, and the name(s) of the children or whole group participating in the screen-time viewing should be documented on the activity plan. 6) Per child care rule 10A NCAC 09 .0803 (7), a parent may give standing authorization for up to 12 months to apply over the counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization should be in writing and should contain: (a) the child's name; (b) the name of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) when and the amount to administer the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) how to apply the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. 7) Be reminded popular genre music such as country music, pop music, rap music, etc. would not be considered acceptable for the child care setting. Children’s songs, instrumental, classical, and lullaby music would be considered appropriate for the child care setting. 8) Per child care rule 10A NCAC 09 .0304(a), the original copy of the most recently approved fire inspection report should be sent to me by email within one week of completion. 9) Per sanitation rule 15A NCAC 18A .2820(d), diaper creams and sunscreen may be kept out of the reach of children and stored inaccessible to children above five feet as long as the topical ointment label does not include additional warnings. If the topical ointment label contains additional warnings, the topical ointment should be stored in a locked cabinet, drawer, or closet. 10) New staff orientation training should be completed by the administrator or assigned responsible staff member and should be training focused on the center’s procedures, policies, and expectations. Health and safety training courses should not be used as new staff orientation training but should be in addition to health and safety training. 11) Staff medical records should be stored separately from the other personnel records. 12) Each trash can used to store food trash should be fitted with a tight lid. 13) Age-appropriate sand and water play should be made available to each group of children at least weekly. 14) Any child with a chronic illness including but not limited to food allergy, anaphylaxis allergy, diabetes, seizures, or asthma should have a medical action plan on file which is completed by the parent or the health care provider. This medical action plan should be attached to the child’s application and updated annually. 15) The activity plans for infants and toddlers should be individualized, include the five learning domains, include the name and age of each child, and be updated at least monthly. 16) Per G.S. 110-90.2(b) & (d) & 10A NCAC 09 .2703(e), each child care provider should have a valid Criminal Background Check qualification letter on file in their staff records. This includes therapists who visit your facility and are contracted to work with a child enrolled in your facility. When the therapist provides therapy services within the classroom with the teacher present, the therapist does not have to have a CBC qualification letter because the teacher is supervising the child and monitoring the therapy session. However, when the therapist takes the child out of the classroom to another part of the building and is left alone with the child, then the therapist has to have CBC qualification letter on file. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. We appreciate all you are doing to serve the children and families in your community. Thank you for your time today. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or our lead consultant and interim supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .0803 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 9/19/2023 Number Present: 48 Completed Date: 9/19/2023 Age: From 0 To 4 Total Minutes: 423 Time In: 09:12 AM Time Out: 04:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Bianca Gandhi, Owner and acting Interim Administrator, assisted me with today’s visit. Your temporary license was issued on October 7, 2022. Your program currently operates with a three-star license, issued on April 8, 2023, earning 4 points in staff education, 2 points in program standards, and one quality point for having a combined turnover rate of 20 percent or less for the administrator, program coordinator, lead teacher, teacher, and group leader positions over the last 12 months. Toddlers Cove Academy Inc, the owner of your facility, was viewed as current-active on the North Carolina Secretary of State website on September 18, 2023. Your program’s compliance history was 96% as of September 18, 2023 and was reviewed with you today. Your last sanitation inspection was dated June 27, 2023 with a Superior classification and 4 demerits. Your last fire inspection was dated November 14, 2022. I visited each licensed indoor space and outdoor space with you today. You stated Space 6 was currently unused due to staffing. You stated Space 7 (lobby area) was not used for child care at this time. I observed children playing in activity areas, transitioning from outdoor to indoor play, washing hands, napping and eating lunch. I observed children adequately supervised during today’s visit. I observed voluntary enhanced staff-child ratios maintained during today’s visit. I observed adequate approved space used during today’s visit. I observed minimum space capacity maintained throughout the center during today's visit. I observed permit restrictions including “Daytime care only” and “Meets enhanced ratios” maintained during today’s visit. I reviewed program records, children’s records, and staff records today. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. I observed and cited the following violations during today's visit: Violation Number Comment Rule 475 Sand and water play activities were not available weekly to each group. In Space 4, sand and water play activities were not available indoors or outdoors to the three-year-old children at least weekly. .0510(c)(3) 721 All equipment and furnishings were not in good repair. On Playground 3, the set of steps on the castle climber were broken and the piece of equipment was not removed or repaired. G.S. 110-91(6); .0601(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In Space 2, one container of sunscreen was stored in an unlocked drawer. The teacher locked the medication drawer. 15A NCAC 18A .2820(d) 846 Over-the-counter medicines were not in their original containers or administered as authorized in writing by parent, physician or authorized health professional. In Space 2, one container of over the counter diaper ointment was not labeled with the name of the child. The interim administrator labeled the container of diaper ointment with the name of the child. 10A NCAC 09 .0803(4) 847 Parent's medication authorization did not include required information. In Space 2, one permission to administer form was missing the information for when and how to apply a diaper ointment. The parent added the missing information when the child was picked up. In Space 3, one permission to administer form was missing the valid dates a diaper ointment could be administered. The parent added the missing valid dates when the child was picked up. 10A NCAC 09 .0803(4)(6-9) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In Space 2, a ziploc bag was used to store extra clothing for each child in a basket on top of each cubby which was unlocked and below five feet. The interim administrator removed the ziploc bag from each basket. In Space 3, a bag of used grocery bags was stored below five feet on the handle of a hanging cabinet in an unlocked sick room. The interim administrator removed the bags from the unlocked sick room and placed them in a locked cabinet. .0604(q) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. New staff orientation training for all employees included six health and safety training courses. Health and safety training should be completed in addition to new staff orientation training. .1101(a) 1230 Personnel policies were not discussed with each staff at employment and a copy was not available to all staff. Two staff members with a dates of employment of 08/15/2023 and 09/05/2023 did not have acknowledgement statements on file to document the personnel policies had been discussed with the staff members. 10A NCAC 09 .0514(e) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One child application indicated the child had a food allergy but no medical action plan was attached or on file in the center. .0801(b) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Staff medical records for all the employees were stored in the staff record file with all the other personnel records. .0701(d) Compliance Plan: All violations cited must be corrected immediately. Please submit written, signed, and dated compliance documentation to me at the email/address below detailing the steps taken to correct each violation. Your compliance documentation must include the following: 1) A compliance letter including the following: 1. The name of your facility 2. The ID number of your facility 3. The date you write the letter 4. A corrective action statement for each violation stating how you corrected the violation and are now in compliance. 5. A compliance plan statement for each violation stating how you plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than October 3, 2023. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 During today’s visit, I provided the following technical assistance: 1) Per child care rule 10A NCAC 09 .0803(4), over-the-counter diaper creams should be labeled with the name of the child. 2) Per child care rule 10A NCAC 09 .0604(q), plastic bags including opened teacher supply bags, Ziploc bags, grocery bags, and diaper wipe refill bags must be stored inaccessible to children above five (5) feet or in a locked cabinet, closet, or drawer. 3) Per child care rule 10A NCAC 09. 601(b), all indoor and outdoor equipment and materials should be kept in good repair. I suggested you use caution tape to make the broken climber on Playground 3 inaccessible to the children until you can have it repaired or removed. 4) Only items related to toileting needs should be stored in bathrooms. 5) When screen-time is logged on an activity plan, the number of minutes, the name of the activity, the name of the website or app, and the name(s) of the children or whole group participating in the screen-time viewing should be documented on the activity plan. 6) Per child care rule 10A NCAC 09 .0803 (7), a parent may give standing authorization for up to 12 months to apply over the counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization should be in writing and should contain: (a) the child's name; (b) the name of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) when and the amount to administer the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) how to apply the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. 7) Be reminded popular genre music such as country music, pop music, rap music, etc. would not be considered acceptable for the child care setting. Children’s songs, instrumental, classical, and lullaby music would be considered appropriate for the child care setting. 8) Per child care rule 10A NCAC 09 .0304(a), the original copy of the most recently approved fire inspection report should be sent to me by email within one week of completion. 9) Per sanitation rule 15A NCAC 18A .2820(d), diaper creams and sunscreen may be kept out of the reach of children and stored inaccessible to children above five feet as long as the topical ointment label does not include additional warnings. If the topical ointment label contains additional warnings, the topical ointment should be stored in a locked cabinet, drawer, or closet. 10) New staff orientation training should be completed by the administrator or assigned responsible staff member and should be training focused on the center’s procedures, policies, and expectations. Health and safety training courses should not be used as new staff orientation training but should be in addition to health and safety training. 11) Staff medical records should be stored separately from the other personnel records. 12) Each trash can used to store food trash should be fitted with a tight lid. 13) Age-appropriate sand and water play should be made available to each group of children at least weekly. 14) Any child with a chronic illness including but not limited to food allergy, anaphylaxis allergy, diabetes, seizures, or asthma should have a medical action plan on file which is completed by the parent or the health care provider. This medical action plan should be attached to the child’s application and updated annually. 15) The activity plans for infants and toddlers should be individualized, include the five learning domains, include the name and age of each child, and be updated at least monthly. 16) Per G.S. 110-90.2(b) & (d) & 10A NCAC 09 .2703(e), each child care provider should have a valid Criminal Background Check qualification letter on file in their staff records. This includes therapists who visit your facility and are contracted to work with a child enrolled in your facility. When the therapist provides therapy services within the classroom with the teacher present, the therapist does not have to have a CBC qualification letter because the teacher is supervising the child and monitoring the therapy session. However, when the therapist takes the child out of the classroom to another part of the building and is left alone with the child, then the therapist has to have CBC qualification letter on file. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. We appreciate all you are doing to serve the children and families in your community. Thank you for your time today. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or our lead consultant and interim supervisor, Erin Pickard, by email at erin.pickard@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 .2703 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 9/19/2023 Number Present: 48 Completed Date: 9/19/2023 Age: From 0 To 4 Total Minutes: 423 Time In: 09:12 AM Time Out: 04:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Bianca Gandhi, Owner and acting Interim Administrator, assisted me with today’s visit. Your temporary license was issued on October 7, 2022. Your program currently operates with a three-star license, issued on April 8, 2023, earning 4 points in staff education, 2 points in program standards, and one quality point for having a combined turnover rate of 20 percent or less for the administrator, program coordinator, lead teacher, teacher, and group leader positions over the last 12 months. Toddlers Cove Academy Inc, the owner of your facility, was viewed as current-active on the North Carolina Secretary of State website on September 18, 2023. Your program’s compliance history was 96% as of September 18, 2023 and was reviewed with you today. Your last sanitation inspection was dated June 27, 2023 with a Superior classification and 4 demerits. Your last fire inspection was dated November 14, 2022. I visited each licensed indoor space and outdoor space with you today. You stated Space 6 was currently unused due to staffing. You stated Space 7 (lobby area) was not used for child care at this time. I observed children playing in activity areas, transitioning from outdoor to indoor play, washing hands, napping and eating lunch. I observed children adequately supervised during today’s visit. I observed voluntary enhanced staff-child ratios maintained during today’s visit. I observed adequate approved space used during today’s visit. I observed minimum space capacity maintained throughout the center during today's visit. I observed permit restrictions including “Daytime care only” and “Meets enhanced ratios” maintained during today’s visit. I reviewed program records, children’s records, and staff records today. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. I observed and cited the following violations during today's visit: Violation Number Comment Rule 475 Sand and water play activities were not available weekly to each group. In Space 4, sand and water play activities were not available indoors or outdoors to the three-year-old children at least weekly. .0510(c)(3) 721 All equipment and furnishings were not in good repair. On Playground 3, the set of steps on the castle climber were broken and the piece of equipment was not removed or repaired. G.S. 110-91(6); .0601(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In Space 2, one container of sunscreen was stored in an unlocked drawer. The teacher locked the medication drawer. 15A NCAC 18A .2820(d) 846 Over-the-counter medicines were not in their original containers or administered as authorized in writing by parent, physician or authorized health professional. In Space 2, one container of over the counter diaper ointment was not labeled with the name of the child. The interim administrator labeled the container of diaper ointment with the name of the child. 10A NCAC 09 .0803(4) 847 Parent's medication authorization did not include required information. In Space 2, one permission to administer form was missing the information for when and how to apply a diaper ointment. The parent added the missing information when the child was picked up. In Space 3, one permission to administer form was missing the valid dates a diaper ointment could be administered. The parent added the missing valid dates when the child was picked up. 10A NCAC 09 .0803(4)(6-9) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In Space 2, a ziploc bag was used to store extra clothing for each child in a basket on top of each cubby which was unlocked and below five feet. The interim administrator removed the ziploc bag from each basket. In Space 3, a bag of used grocery bags was stored below five feet on the handle of a hanging cabinet in an unlocked sick room. The interim administrator removed the bags from the unlocked sick room and placed them in a locked cabinet. .0604(q) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. New staff orientation training for all employees included six health and safety training courses. Health and safety training should be completed in addition to new staff orientation training. .1101(a) 1230 Personnel policies were not discussed with each staff at employment and a copy was not available to all staff. Two staff members with a dates of employment of 08/15/2023 and 09/05/2023 did not have acknowledgement statements on file to document the personnel policies had been discussed with the staff members. 10A NCAC 09 .0514(e) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One child application indicated the child had a food allergy but no medical action plan was attached or on file in the center. .0801(b) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Staff medical records for all the employees were stored in the staff record file with all the other personnel records. .0701(d) Compliance Plan: All violations cited must be corrected immediately. Please submit written, signed, and dated compliance documentation to me at the email/address below detailing the steps taken to correct each violation. Your compliance documentation must include the following: 1) A compliance letter including the following: 1. The name of your facility 2. The ID number of your facility 3. The date you write the letter 4. A corrective action statement for each violation stating how you corrected the violation and are now in compliance. 5. A compliance plan statement for each violation stating how you plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than October 3, 2023. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 During today’s visit, I provided the following technical assistance: 1) Per child care rule 10A NCAC 09 .0803(4), over-the-counter diaper creams should be labeled with the name of the child. 2) Per child care rule 10A NCAC 09 .0604(q), plastic bags including opened teacher supply bags, Ziploc bags, grocery bags, and diaper wipe refill bags must be stored inaccessible to children above five (5) feet or in a locked cabinet, closet, or drawer. 3) Per child care rule 10A NCAC 09. 601(b), all indoor and outdoor equipment and materials should be kept in good repair. I suggested you use caution tape to make the broken climber on Playground 3 inaccessible to the children until you can have it repaired or removed. 4) Only items related to toileting needs should be stored in bathrooms. 5) When screen-time is logged on an activity plan, the number of minutes, the name of the activity, the name of the website or app, and the name(s) of the children or whole group participating in the screen-time viewing should be documented on the activity plan. 6) Per child care rule 10A NCAC 09 .0803 (7), a parent may give standing authorization for up to 12 months to apply over the counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization should be in writing and should contain: (a) the child's name; (b) the name of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) when and the amount to administer the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) how to apply the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. 7) Be reminded popular genre music such as country music, pop music, rap music, etc. would not be considered acceptable for the child care setting. Children’s songs, instrumental, classical, and lullaby music would be considered appropriate for the child care setting. 8) Per child care rule 10A NCAC 09 .0304(a), the original copy of the most recently approved fire inspection report should be sent to me by email within one week of completion. 9) Per sanitation rule 15A NCAC 18A .2820(d), diaper creams and sunscreen may be kept out of the reach of children and stored inaccessible to children above five feet as long as the topical ointment label does not include additional warnings. If the topical ointment label contains additional warnings, the topical ointment should be stored in a locked cabinet, drawer, or closet. 10) New staff orientation training should be completed by the administrator or assigned responsible staff member and should be training focused on the center’s procedures, policies, and expectations. Health and safety training courses should not be used as new staff orientation training but should be in addition to health and safety training. 11) Staff medical records should be stored separately from the other personnel records. 12) Each trash can used to store food trash should be fitted with a tight lid. 13) Age-appropriate sand and water play should be made available to each group of children at least weekly. 14) Any child with a chronic illness including but not limited to food allergy, anaphylaxis allergy, diabetes, seizures, or asthma should have a medical action plan on file which is completed by the parent or the health care provider. This medical action plan should be attached to the child’s application and updated annually. 15) The activity plans for infants and toddlers should be individualized, include the five learning domains, include the name and age of each child, and be updated at least monthly. 16) Per G.S. 110-90.2(b) & (d) & 10A NCAC 09 .2703(e), each child care provider should have a valid Criminal Background Check qualification letter on file in their staff records. This includes therapists who visit your facility and are contracted to work with a child enrolled in your facility. When the therapist provides therapy services within the classroom with the teacher present, the therapist does not have to have a CBC qualification letter because the teacher is supervising the child and monitoring the therapy session. However, when the therapist takes the child out of the classroom to another part of the building and is left alone with the child, then the therapist has to have CBC qualification letter on file. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. We appreciate all you are doing to serve the children and families in your community. Thank you for your time today. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or our lead consultant and interim supervisor, Erin Pickard, by email at erin.pickard@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. 601 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 9/19/2023 Number Present: 48 Completed Date: 9/19/2023 Age: From 0 To 4 Total Minutes: 423 Time In: 09:12 AM Time Out: 04:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Bianca Gandhi, Owner and acting Interim Administrator, assisted me with today’s visit. Your temporary license was issued on October 7, 2022. Your program currently operates with a three-star license, issued on April 8, 2023, earning 4 points in staff education, 2 points in program standards, and one quality point for having a combined turnover rate of 20 percent or less for the administrator, program coordinator, lead teacher, teacher, and group leader positions over the last 12 months. Toddlers Cove Academy Inc, the owner of your facility, was viewed as current-active on the North Carolina Secretary of State website on September 18, 2023. Your program’s compliance history was 96% as of September 18, 2023 and was reviewed with you today. Your last sanitation inspection was dated June 27, 2023 with a Superior classification and 4 demerits. Your last fire inspection was dated November 14, 2022. I visited each licensed indoor space and outdoor space with you today. You stated Space 6 was currently unused due to staffing. You stated Space 7 (lobby area) was not used for child care at this time. I observed children playing in activity areas, transitioning from outdoor to indoor play, washing hands, napping and eating lunch. I observed children adequately supervised during today’s visit. I observed voluntary enhanced staff-child ratios maintained during today’s visit. I observed adequate approved space used during today’s visit. I observed minimum space capacity maintained throughout the center during today's visit. I observed permit restrictions including “Daytime care only” and “Meets enhanced ratios” maintained during today’s visit. I reviewed program records, children’s records, and staff records today. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. I observed and cited the following violations during today's visit: Violation Number Comment Rule 475 Sand and water play activities were not available weekly to each group. In Space 4, sand and water play activities were not available indoors or outdoors to the three-year-old children at least weekly. .0510(c)(3) 721 All equipment and furnishings were not in good repair. On Playground 3, the set of steps on the castle climber were broken and the piece of equipment was not removed or repaired. G.S. 110-91(6); .0601(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In Space 2, one container of sunscreen was stored in an unlocked drawer. The teacher locked the medication drawer. 15A NCAC 18A .2820(d) 846 Over-the-counter medicines were not in their original containers or administered as authorized in writing by parent, physician or authorized health professional. In Space 2, one container of over the counter diaper ointment was not labeled with the name of the child. The interim administrator labeled the container of diaper ointment with the name of the child. 10A NCAC 09 .0803(4) 847 Parent's medication authorization did not include required information. In Space 2, one permission to administer form was missing the information for when and how to apply a diaper ointment. The parent added the missing information when the child was picked up. In Space 3, one permission to administer form was missing the valid dates a diaper ointment could be administered. The parent added the missing valid dates when the child was picked up. 10A NCAC 09 .0803(4)(6-9) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In Space 2, a ziploc bag was used to store extra clothing for each child in a basket on top of each cubby which was unlocked and below five feet. The interim administrator removed the ziploc bag from each basket. In Space 3, a bag of used grocery bags was stored below five feet on the handle of a hanging cabinet in an unlocked sick room. The interim administrator removed the bags from the unlocked sick room and placed them in a locked cabinet. .0604(q) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. New staff orientation training for all employees included six health and safety training courses. Health and safety training should be completed in addition to new staff orientation training. .1101(a) 1230 Personnel policies were not discussed with each staff at employment and a copy was not available to all staff. Two staff members with a dates of employment of 08/15/2023 and 09/05/2023 did not have acknowledgement statements on file to document the personnel policies had been discussed with the staff members. 10A NCAC 09 .0514(e) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One child application indicated the child had a food allergy but no medical action plan was attached or on file in the center. .0801(b) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Staff medical records for all the employees were stored in the staff record file with all the other personnel records. .0701(d) Compliance Plan: All violations cited must be corrected immediately. Please submit written, signed, and dated compliance documentation to me at the email/address below detailing the steps taken to correct each violation. Your compliance documentation must include the following: 1) A compliance letter including the following: 1. The name of your facility 2. The ID number of your facility 3. The date you write the letter 4. A corrective action statement for each violation stating how you corrected the violation and are now in compliance. 5. A compliance plan statement for each violation stating how you plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than October 3, 2023. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 During today’s visit, I provided the following technical assistance: 1) Per child care rule 10A NCAC 09 .0803(4), over-the-counter diaper creams should be labeled with the name of the child. 2) Per child care rule 10A NCAC 09 .0604(q), plastic bags including opened teacher supply bags, Ziploc bags, grocery bags, and diaper wipe refill bags must be stored inaccessible to children above five (5) feet or in a locked cabinet, closet, or drawer. 3) Per child care rule 10A NCAC 09. 601(b), all indoor and outdoor equipment and materials should be kept in good repair. I suggested you use caution tape to make the broken climber on Playground 3 inaccessible to the children until you can have it repaired or removed. 4) Only items related to toileting needs should be stored in bathrooms. 5) When screen-time is logged on an activity plan, the number of minutes, the name of the activity, the name of the website or app, and the name(s) of the children or whole group participating in the screen-time viewing should be documented on the activity plan. 6) Per child care rule 10A NCAC 09 .0803 (7), a parent may give standing authorization for up to 12 months to apply over the counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization should be in writing and should contain: (a) the child's name; (b) the name of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) when and the amount to administer the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) how to apply the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. 7) Be reminded popular genre music such as country music, pop music, rap music, etc. would not be considered acceptable for the child care setting. Children’s songs, instrumental, classical, and lullaby music would be considered appropriate for the child care setting. 8) Per child care rule 10A NCAC 09 .0304(a), the original copy of the most recently approved fire inspection report should be sent to me by email within one week of completion. 9) Per sanitation rule 15A NCAC 18A .2820(d), diaper creams and sunscreen may be kept out of the reach of children and stored inaccessible to children above five feet as long as the topical ointment label does not include additional warnings. If the topical ointment label contains additional warnings, the topical ointment should be stored in a locked cabinet, drawer, or closet. 10) New staff orientation training should be completed by the administrator or assigned responsible staff member and should be training focused on the center’s procedures, policies, and expectations. Health and safety training courses should not be used as new staff orientation training but should be in addition to health and safety training. 11) Staff medical records should be stored separately from the other personnel records. 12) Each trash can used to store food trash should be fitted with a tight lid. 13) Age-appropriate sand and water play should be made available to each group of children at least weekly. 14) Any child with a chronic illness including but not limited to food allergy, anaphylaxis allergy, diabetes, seizures, or asthma should have a medical action plan on file which is completed by the parent or the health care provider. This medical action plan should be attached to the child’s application and updated annually. 15) The activity plans for infants and toddlers should be individualized, include the five learning domains, include the name and age of each child, and be updated at least monthly. 16) Per G.S. 110-90.2(b) & (d) & 10A NCAC 09 .2703(e), each child care provider should have a valid Criminal Background Check qualification letter on file in their staff records. This includes therapists who visit your facility and are contracted to work with a child enrolled in your facility. When the therapist provides therapy services within the classroom with the teacher present, the therapist does not have to have a CBC qualification letter because the teacher is supervising the child and monitoring the therapy session. However, when the therapist takes the child out of the classroom to another part of the building and is left alone with the child, then the therapist has to have CBC qualification letter on file. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. We appreciate all you are doing to serve the children and families in your community. Thank you for your time today. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or our lead consultant and interim supervisor, Erin Pickard, by email at erin.pickard@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: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 9/19/2023 Number Present: 48 Completed Date: 9/19/2023 Age: From 0 To 4 Total Minutes: 423 Time In: 09:12 AM Time Out: 04:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Bianca Gandhi, Owner and acting Interim Administrator, assisted me with today’s visit. Your temporary license was issued on October 7, 2022. Your program currently operates with a three-star license, issued on April 8, 2023, earning 4 points in staff education, 2 points in program standards, and one quality point for having a combined turnover rate of 20 percent or less for the administrator, program coordinator, lead teacher, teacher, and group leader positions over the last 12 months. Toddlers Cove Academy Inc, the owner of your facility, was viewed as current-active on the North Carolina Secretary of State website on September 18, 2023. Your program’s compliance history was 96% as of September 18, 2023 and was reviewed with you today. Your last sanitation inspection was dated June 27, 2023 with a Superior classification and 4 demerits. Your last fire inspection was dated November 14, 2022. I visited each licensed indoor space and outdoor space with you today. You stated Space 6 was currently unused due to staffing. You stated Space 7 (lobby area) was not used for child care at this time. I observed children playing in activity areas, transitioning from outdoor to indoor play, washing hands, napping and eating lunch. I observed children adequately supervised during today’s visit. I observed voluntary enhanced staff-child ratios maintained during today’s visit. I observed adequate approved space used during today’s visit. I observed minimum space capacity maintained throughout the center during today's visit. I observed permit restrictions including “Daytime care only” and “Meets enhanced ratios” maintained during today’s visit. I reviewed program records, children’s records, and staff records today. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. I observed and cited the following violations during today's visit: Violation Number Comment Rule 475 Sand and water play activities were not available weekly to each group. In Space 4, sand and water play activities were not available indoors or outdoors to the three-year-old children at least weekly. .0510(c)(3) 721 All equipment and furnishings were not in good repair. On Playground 3, the set of steps on the castle climber were broken and the piece of equipment was not removed or repaired. G.S. 110-91(6); .0601(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In Space 2, one container of sunscreen was stored in an unlocked drawer. The teacher locked the medication drawer. 15A NCAC 18A .2820(d) 846 Over-the-counter medicines were not in their original containers or administered as authorized in writing by parent, physician or authorized health professional. In Space 2, one container of over the counter diaper ointment was not labeled with the name of the child. The interim administrator labeled the container of diaper ointment with the name of the child. 10A NCAC 09 .0803(4) 847 Parent's medication authorization did not include required information. In Space 2, one permission to administer form was missing the information for when and how to apply a diaper ointment. The parent added the missing information when the child was picked up. In Space 3, one permission to administer form was missing the valid dates a diaper ointment could be administered. The parent added the missing valid dates when the child was picked up. 10A NCAC 09 .0803(4)(6-9) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In Space 2, a ziploc bag was used to store extra clothing for each child in a basket on top of each cubby which was unlocked and below five feet. The interim administrator removed the ziploc bag from each basket. In Space 3, a bag of used grocery bags was stored below five feet on the handle of a hanging cabinet in an unlocked sick room. The interim administrator removed the bags from the unlocked sick room and placed them in a locked cabinet. .0604(q) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. New staff orientation training for all employees included six health and safety training courses. Health and safety training should be completed in addition to new staff orientation training. .1101(a) 1230 Personnel policies were not discussed with each staff at employment and a copy was not available to all staff. Two staff members with a dates of employment of 08/15/2023 and 09/05/2023 did not have acknowledgement statements on file to document the personnel policies had been discussed with the staff members. 10A NCAC 09 .0514(e) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One child application indicated the child had a food allergy but no medical action plan was attached or on file in the center. .0801(b) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Staff medical records for all the employees were stored in the staff record file with all the other personnel records. .0701(d) Compliance Plan: All violations cited must be corrected immediately. Please submit written, signed, and dated compliance documentation to me at the email/address below detailing the steps taken to correct each violation. Your compliance documentation must include the following: 1) A compliance letter including the following: 1. The name of your facility 2. The ID number of your facility 3. The date you write the letter 4. A corrective action statement for each violation stating how you corrected the violation and are now in compliance. 5. A compliance plan statement for each violation stating how you plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than October 3, 2023. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 During today’s visit, I provided the following technical assistance: 1) Per child care rule 10A NCAC 09 .0803(4), over-the-counter diaper creams should be labeled with the name of the child. 2) Per child care rule 10A NCAC 09 .0604(q), plastic bags including opened teacher supply bags, Ziploc bags, grocery bags, and diaper wipe refill bags must be stored inaccessible to children above five (5) feet or in a locked cabinet, closet, or drawer. 3) Per child care rule 10A NCAC 09. 601(b), all indoor and outdoor equipment and materials should be kept in good repair. I suggested you use caution tape to make the broken climber on Playground 3 inaccessible to the children until you can have it repaired or removed. 4) Only items related to toileting needs should be stored in bathrooms. 5) When screen-time is logged on an activity plan, the number of minutes, the name of the activity, the name of the website or app, and the name(s) of the children or whole group participating in the screen-time viewing should be documented on the activity plan. 6) Per child care rule 10A NCAC 09 .0803 (7), a parent may give standing authorization for up to 12 months to apply over the counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization should be in writing and should contain: (a) the child's name; (b) the name of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) when and the amount to administer the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) how to apply the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. 7) Be reminded popular genre music such as country music, pop music, rap music, etc. would not be considered acceptable for the child care setting. Children’s songs, instrumental, classical, and lullaby music would be considered appropriate for the child care setting. 8) Per child care rule 10A NCAC 09 .0304(a), the original copy of the most recently approved fire inspection report should be sent to me by email within one week of completion. 9) Per sanitation rule 15A NCAC 18A .2820(d), diaper creams and sunscreen may be kept out of the reach of children and stored inaccessible to children above five feet as long as the topical ointment label does not include additional warnings. If the topical ointment label contains additional warnings, the topical ointment should be stored in a locked cabinet, drawer, or closet. 10) New staff orientation training should be completed by the administrator or assigned responsible staff member and should be training focused on the center’s procedures, policies, and expectations. Health and safety training courses should not be used as new staff orientation training but should be in addition to health and safety training. 11) Staff medical records should be stored separately from the other personnel records. 12) Each trash can used to store food trash should be fitted with a tight lid. 13) Age-appropriate sand and water play should be made available to each group of children at least weekly. 14) Any child with a chronic illness including but not limited to food allergy, anaphylaxis allergy, diabetes, seizures, or asthma should have a medical action plan on file which is completed by the parent or the health care provider. This medical action plan should be attached to the child’s application and updated annually. 15) The activity plans for infants and toddlers should be individualized, include the five learning domains, include the name and age of each child, and be updated at least monthly. 16) Per G.S. 110-90.2(b) & (d) & 10A NCAC 09 .2703(e), each child care provider should have a valid Criminal Background Check qualification letter on file in their staff records. This includes therapists who visit your facility and are contracted to work with a child enrolled in your facility. When the therapist provides therapy services within the classroom with the teacher present, the therapist does not have to have a CBC qualification letter because the teacher is supervising the child and monitoring the therapy session. However, when the therapist takes the child out of the classroom to another part of the building and is left alone with the child, then the therapist has to have CBC qualification letter on file. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. We appreciate all you are doing to serve the children and families in your community. Thank you for your time today. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or our lead consultant and interim supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
G.S. 110-91 · Violation
Name of Operation: THE PA-PAW PATCH Facility ID: 18000609 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 9/19/2023 Number Present: 48 Completed Date: 9/19/2023 Age: From 0 To 4 Total Minutes: 423 Time In: 09:12 AM Time Out: 04:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Bianca Gandhi, Owner and acting Interim Administrator, assisted me with today’s visit. Your temporary license was issued on October 7, 2022. Your program currently operates with a three-star license, issued on April 8, 2023, earning 4 points in staff education, 2 points in program standards, and one quality point for having a combined turnover rate of 20 percent or less for the administrator, program coordinator, lead teacher, teacher, and group leader positions over the last 12 months. Toddlers Cove Academy Inc, the owner of your facility, was viewed as current-active on the North Carolina Secretary of State website on September 18, 2023. Your program’s compliance history was 96% as of September 18, 2023 and was reviewed with you today. Your last sanitation inspection was dated June 27, 2023 with a Superior classification and 4 demerits. Your last fire inspection was dated November 14, 2022. I visited each licensed indoor space and outdoor space with you today. You stated Space 6 was currently unused due to staffing. You stated Space 7 (lobby area) was not used for child care at this time. I observed children playing in activity areas, transitioning from outdoor to indoor play, washing hands, napping and eating lunch. I observed children adequately supervised during today’s visit. I observed voluntary enhanced staff-child ratios maintained during today’s visit. I observed adequate approved space used during today’s visit. I observed minimum space capacity maintained throughout the center during today's visit. I observed permit restrictions including “Daytime care only” and “Meets enhanced ratios” maintained during today’s visit. I reviewed program records, children’s records, and staff records today. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. I observed and cited the following violations during today's visit: Violation Number Comment Rule 475 Sand and water play activities were not available weekly to each group. In Space 4, sand and water play activities were not available indoors or outdoors to the three-year-old children at least weekly. .0510(c)(3) 721 All equipment and furnishings were not in good repair. On Playground 3, the set of steps on the castle climber were broken and the piece of equipment was not removed or repaired. G.S. 110-91(6); .0601(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In Space 2, one container of sunscreen was stored in an unlocked drawer. The teacher locked the medication drawer. 15A NCAC 18A .2820(d) 846 Over-the-counter medicines were not in their original containers or administered as authorized in writing by parent, physician or authorized health professional. In Space 2, one container of over the counter diaper ointment was not labeled with the name of the child. The interim administrator labeled the container of diaper ointment with the name of the child. 10A NCAC 09 .0803(4) 847 Parent's medication authorization did not include required information. In Space 2, one permission to administer form was missing the information for when and how to apply a diaper ointment. The parent added the missing information when the child was picked up. In Space 3, one permission to administer form was missing the valid dates a diaper ointment could be administered. The parent added the missing valid dates when the child was picked up. 10A NCAC 09 .0803(4)(6-9) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In Space 2, a ziploc bag was used to store extra clothing for each child in a basket on top of each cubby which was unlocked and below five feet. The interim administrator removed the ziploc bag from each basket. In Space 3, a bag of used grocery bags was stored below five feet on the handle of a hanging cabinet in an unlocked sick room. The interim administrator removed the bags from the unlocked sick room and placed them in a locked cabinet. .0604(q) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. New staff orientation training for all employees included six health and safety training courses. Health and safety training should be completed in addition to new staff orientation training. .1101(a) 1230 Personnel policies were not discussed with each staff at employment and a copy was not available to all staff. Two staff members with a dates of employment of 08/15/2023 and 09/05/2023 did not have acknowledgement statements on file to document the personnel policies had been discussed with the staff members. 10A NCAC 09 .0514(e) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One child application indicated the child had a food allergy but no medical action plan was attached or on file in the center. .0801(b) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Staff medical records for all the employees were stored in the staff record file with all the other personnel records. .0701(d) Compliance Plan: All violations cited must be corrected immediately. Please submit written, signed, and dated compliance documentation to me at the email/address below detailing the steps taken to correct each violation. Your compliance documentation must include the following: 1) A compliance letter including the following: 1. The name of your facility 2. The ID number of your facility 3. The date you write the letter 4. A corrective action statement for each violation stating how you corrected the violation and are now in compliance. 5. A compliance plan statement for each violation stating how you plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than October 3, 2023. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 During today’s visit, I provided the following technical assistance: 1) Per child care rule 10A NCAC 09 .0803(4), over-the-counter diaper creams should be labeled with the name of the child. 2) Per child care rule 10A NCAC 09 .0604(q), plastic bags including opened teacher supply bags, Ziploc bags, grocery bags, and diaper wipe refill bags must be stored inaccessible to children above five (5) feet or in a locked cabinet, closet, or drawer. 3) Per child care rule 10A NCAC 09. 601(b), all indoor and outdoor equipment and materials should be kept in good repair. I suggested you use caution tape to make the broken climber on Playground 3 inaccessible to the children until you can have it repaired or removed. 4) Only items related to toileting needs should be stored in bathrooms. 5) When screen-time is logged on an activity plan, the number of minutes, the name of the activity, the name of the website or app, and the name(s) of the children or whole group participating in the screen-time viewing should be documented on the activity plan. 6) Per child care rule 10A NCAC 09 .0803 (7), a parent may give standing authorization for up to 12 months to apply over the counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization should be in writing and should contain: (a) the child's name; (b) the name of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) when and the amount to administer the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) how to apply the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. 7) Be reminded popular genre music such as country music, pop music, rap music, etc. would not be considered acceptable for the child care setting. Children’s songs, instrumental, classical, and lullaby music would be considered appropriate for the child care setting. 8) Per child care rule 10A NCAC 09 .0304(a), the original copy of the most recently approved fire inspection report should be sent to me by email within one week of completion. 9) Per sanitation rule 15A NCAC 18A .2820(d), diaper creams and sunscreen may be kept out of the reach of children and stored inaccessible to children above five feet as long as the topical ointment label does not include additional warnings. If the topical ointment label contains additional warnings, the topical ointment should be stored in a locked cabinet, drawer, or closet. 10) New staff orientation training should be completed by the administrator or assigned responsible staff member and should be training focused on the center’s procedures, policies, and expectations. Health and safety training courses should not be used as new staff orientation training but should be in addition to health and safety training. 11) Staff medical records should be stored separately from the other personnel records. 12) Each trash can used to store food trash should be fitted with a tight lid. 13) Age-appropriate sand and water play should be made available to each group of children at least weekly. 14) Any child with a chronic illness including but not limited to food allergy, anaphylaxis allergy, diabetes, seizures, or asthma should have a medical action plan on file which is completed by the parent or the health care provider. This medical action plan should be attached to the child’s application and updated annually. 15) The activity plans for infants and toddlers should be individualized, include the five learning domains, include the name and age of each child, and be updated at least monthly. 16) Per G.S. 110-90.2(b) & (d) & 10A NCAC 09 .2703(e), each child care provider should have a valid Criminal Background Check qualification letter on file in their staff records. This includes therapists who visit your facility and are contracted to work with a child enrolled in your facility. When the therapist provides therapy services within the classroom with the teacher present, the therapist does not have to have a CBC qualification letter because the teacher is supervising the child and monitoring the therapy session. However, when the therapist takes the child out of the classroom to another part of the building and is left alone with the child, then the therapist has to have CBC qualification letter on file. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. We appreciate all you are doing to serve the children and families in your community. Thank you for your time today. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or our lead consultant and interim supervisor, Erin Pickard, by email at erin.pickard@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
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