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Home › NC › West Jefferson › Learning Thru Play TOO Child Development Center
406 School Avenue, West Jefferson NC 28694 · License #05000067 · Center · Child Care Center
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10A NCAC 09 .0604 · Violation
Name of Operation: LEARNING THRU PLAY TOO CHILD DEVELOPMENT CENTER Facility ID: 05000067 Consultant: TAMMY CHILDRESS Operation Type: Center Case Number: 0426-414L Visit Date: 5/7/2026 Number Present: 58 Completed Date: 5/7/2026 Age: From 0 To 5 Total Minutes: 175 Time In: 10:20 AM Time Out: 01:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to obtain information regarding alleged violations of child care requirements. The assistant director assisted me with today's visit. The allegations are as follows: There are concerns that children are not being provided with adequate supervision. There are also concerns regarding inappropriate discipline and unsafe environment. Staff/child ratio, group size, supervision, use of licensed space, space capacity, license restrictions, and the outdoor environment were monitored. The license and emergency care plan were posted. Fire drills, medication administration, and storage of hazardous products were also monitored. No new staff have been hired since the last monitoring visit conducted on February 11, 2026. Additionally, I observed the indoor and outdoor space used by the children. Children in care were observed to be engaged in outdoor play, personal care routines, lunch and rest time. Younger children were served chicken and rice, green beans and apple sauce. Preschool children were served a pork patty, green beans, and oranges. Based on information provided, approximately three to four weeks age, a specific date could not be provided, a three-year-old child was left unattended on the bottom playground. Two caregivers were providing care for fifteen children aged three and four years old. I interviewed the two caregivers present at the time of the alleged incident. They both stated that one of the caregivers counted the children before they left the playground and there were 15 children. They walked up the hill, down the sidewalk and returned to their classroom with the group of children around 9:35a.m. They closed the classroom door and began assisting children with taking off their coats, washing hands and directing the children to sit on the carpet. The assistant director came into the classroom one to two minutes later with the three-year-old child and said that the child was at the playground gate at the sidewalk waving at her. The caregiver who counted the children stated during the interview that she miscounted the children and that the child was hiding on the playground equipment. Proper supervision of children was observed today in each space. Based on information received from staff interviewed, the finding regarding this allegation of inadequate supervision was substantiated. It was also alleged that staff use cell phones while caring for children. Four staff members and the assistant director were interviewed. All staff interviewed stated that they usually use their cell phones during nap time, will check their phone if there has been a call, check on their own children, check for messages from enrolled children, or check security cameras at their homes. All staff denied that cell phone use affects the supervision of children in their care. Based upon information received during staff interviews and my observations, there was not enough information to conclude that staff members used cell phones and could not see or hear the children in their care. The allegation was unsubstantiated. It was also alleged that children have received injuries and staff did not notify parents of incidents resulting in injuries. Two caregivers denied that there had been injuries that were not documented on incident reports that were given to parents. I observed the incident report log with documented incidents. Based upon staff interviews and my observations this allegation was unsubstantiated. It was alleged that a staff member uses a vape in the classroom while caring for children. I interviewed the administrator and four staff members, and all denied that they had used a vape or smoked tobacco on the premises, nor that they had witnessed any other staff member vape or smoke in classrooms or on the premises. The facility’s personnel policies were reviewed and Child Care Rule 10A NCAC 09 .0604 regarding a smoke and tobacco free environment is documented in the policy and signed and dated by each staff member. Based on the information received during staff interviews, this allegation was unsubstantiated. It was alleged that children are yelled at by caregivers and that the caregivers yank things from children’s hands. In interviewed the assistant director and two staff members. When asked how three and four-year-old children are disciplined in the classroom and both stated time out. One caregiver stated that if there was an issue involving a toy and she asked the child to hand it to her and the child did not, she will “take it and grabs the toy and pulls it” away from the child. The other staff member interviewed stated that she has observed the staff member grab toys away from children. The assistant director denied ever witnessing the staff member engage in this behavior. Both caregivers and the director denied yelling at children. Based on the information received from staff interviews the allegation regarding inappropriate discipline was unsubstantiated. However, a violation regarding attending to children in a nurturing and appropriate manner will be documented. The following violations were documented: Violation Number Comment Rule 303 Children were not adequately supervised at all times. A three-year-old child was left on the playground alone for approximately two minutes after staff members miscounted the children in their care and returned to their classroom. .1801(a)(1-5) 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. A caregiver stated that the caregiver grabs and pulls toys away from three and four year old children when the children do not give the caregiver toys when they are asked to do so. G.S. 110-91(10) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violations documented may impact the compliance history score. The violations documented must be corrected immediately. On or before May 21, 2026, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is considered legal documentation. Please email the compliance letter to me at tammy.childress@dhhs.nc.gov. Technical Assistance Provided During Today’s Visit: Violations regarding inadequate supervision of children and not attending to children in a nurturing and appropriate manner were documented today. Violations of this nature directly impact the safety of the children while in your care. In addition, these types of violations have the greatest negative impact on your compliance history. During the visit, we discussed that a follow-up visit may be conducted in the near future to monitor compliance with child care requirements. You stated that you currently do not have a written supervision policy but do go over supervision procedures during staff orientation when staff are hired. Each staff member is required to count children before exiting the classroom and when returning to the classroom and to take their sign-in/sign-out sheets for children when they leave the classroom to verify which children are present. There are video cameras at the facility, but there are no cameras at the playgrounds. Neither the assistant director or the caregivers notified the parents of the child about the incident. You stated today that you were already working on a written supervision policy. We discussed that the current procedures for counting children did not work in this instance and that you should review the procedure/policy, revise the procedure/policy if needed, and review again with staff. You stated that you planned to notify the parent of the three-year-old child about the supervision incident today. You stated today that you conduct staff/classroom observations and have not witnessed any issues that were alleged to have occurred. We discussed that my observations and interviews with staff today identified specific staff members that may need more frequent observations and additional training regarding supervision and attending to children in a nurturing and appropriate manner. The facility’s personnel policies were reviewed regarding the use of “Personal Technological Devices” including cellphones, iPad, Kindle Fire, or other personal technological device and that these devices may not be in use while supervising children in the classroom. We discussed that upon my arrival at the facility I observed two staff members on the center playground with a group of children and that both were sitting down and on their cell phones. I interviewed both staff members and they stated that they were aware that there was a policy regarding no cell phone use and that they were on their cell phones today while on the playground. We discussed that staff should be moving about the indoor and outdoor environments and interacting with children at all times. You stated that there needed to be consequences for staff who were not following policies and we discussed written warnings or reprimands, and that the current policy prohibited use of devices “in the classroom” but outdoor environments should be added. At the completion of the visit, I was unable to gain access to the Division’s Regulatory System to enter the visit summary. I completed a handwritten visit summary that was reviewed by you and a copy was received. Once I can access the Regulatory System, a computer-generated visit summary will be reviewed with you by telephone and a copy emailed to you. Contact me at tammy.childress@dhhs.nc.gov or by telephone at (336)317-6436 or Pamela Hauser, Licensing Supervisor, at pamela.hauser@dhhs.nc.gov or by telephone at (336)317-5003 if you have questions. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
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.
G.S. 110-91 · Violation
Name of Operation: LEARNING THRU PLAY TOO CHILD DEVELOPMENT CENTER Facility ID: 05000067 Consultant: TAMMY CHILDRESS Operation Type: Center Case Number: 0426-414L Visit Date: 5/7/2026 Number Present: 58 Completed Date: 5/7/2026 Age: From 0 To 5 Total Minutes: 175 Time In: 10:20 AM Time Out: 01:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to obtain information regarding alleged violations of child care requirements. The assistant director assisted me with today's visit. The allegations are as follows: There are concerns that children are not being provided with adequate supervision. There are also concerns regarding inappropriate discipline and unsafe environment. Staff/child ratio, group size, supervision, use of licensed space, space capacity, license restrictions, and the outdoor environment were monitored. The license and emergency care plan were posted. Fire drills, medication administration, and storage of hazardous products were also monitored. No new staff have been hired since the last monitoring visit conducted on February 11, 2026. Additionally, I observed the indoor and outdoor space used by the children. Children in care were observed to be engaged in outdoor play, personal care routines, lunch and rest time. Younger children were served chicken and rice, green beans and apple sauce. Preschool children were served a pork patty, green beans, and oranges. Based on information provided, approximately three to four weeks age, a specific date could not be provided, a three-year-old child was left unattended on the bottom playground. Two caregivers were providing care for fifteen children aged three and four years old. I interviewed the two caregivers present at the time of the alleged incident. They both stated that one of the caregivers counted the children before they left the playground and there were 15 children. They walked up the hill, down the sidewalk and returned to their classroom with the group of children around 9:35a.m. They closed the classroom door and began assisting children with taking off their coats, washing hands and directing the children to sit on the carpet. The assistant director came into the classroom one to two minutes later with the three-year-old child and said that the child was at the playground gate at the sidewalk waving at her. The caregiver who counted the children stated during the interview that she miscounted the children and that the child was hiding on the playground equipment. Proper supervision of children was observed today in each space. Based on information received from staff interviewed, the finding regarding this allegation of inadequate supervision was substantiated. It was also alleged that staff use cell phones while caring for children. Four staff members and the assistant director were interviewed. All staff interviewed stated that they usually use their cell phones during nap time, will check their phone if there has been a call, check on their own children, check for messages from enrolled children, or check security cameras at their homes. All staff denied that cell phone use affects the supervision of children in their care. Based upon information received during staff interviews and my observations, there was not enough information to conclude that staff members used cell phones and could not see or hear the children in their care. The allegation was unsubstantiated. It was also alleged that children have received injuries and staff did not notify parents of incidents resulting in injuries. Two caregivers denied that there had been injuries that were not documented on incident reports that were given to parents. I observed the incident report log with documented incidents. Based upon staff interviews and my observations this allegation was unsubstantiated. It was alleged that a staff member uses a vape in the classroom while caring for children. I interviewed the administrator and four staff members, and all denied that they had used a vape or smoked tobacco on the premises, nor that they had witnessed any other staff member vape or smoke in classrooms or on the premises. The facility’s personnel policies were reviewed and Child Care Rule 10A NCAC 09 .0604 regarding a smoke and tobacco free environment is documented in the policy and signed and dated by each staff member. Based on the information received during staff interviews, this allegation was unsubstantiated. It was alleged that children are yelled at by caregivers and that the caregivers yank things from children’s hands. In interviewed the assistant director and two staff members. When asked how three and four-year-old children are disciplined in the classroom and both stated time out. One caregiver stated that if there was an issue involving a toy and she asked the child to hand it to her and the child did not, she will “take it and grabs the toy and pulls it” away from the child. The other staff member interviewed stated that she has observed the staff member grab toys away from children. The assistant director denied ever witnessing the staff member engage in this behavior. Both caregivers and the director denied yelling at children. Based on the information received from staff interviews the allegation regarding inappropriate discipline was unsubstantiated. However, a violation regarding attending to children in a nurturing and appropriate manner will be documented. The following violations were documented: Violation Number Comment Rule 303 Children were not adequately supervised at all times. A three-year-old child was left on the playground alone for approximately two minutes after staff members miscounted the children in their care and returned to their classroom. .1801(a)(1-5) 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. A caregiver stated that the caregiver grabs and pulls toys away from three and four year old children when the children do not give the caregiver toys when they are asked to do so. G.S. 110-91(10) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violations documented may impact the compliance history score. The violations documented must be corrected immediately. On or before May 21, 2026, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is considered legal documentation. Please email the compliance letter to me at tammy.childress@dhhs.nc.gov. Technical Assistance Provided During Today’s Visit: Violations regarding inadequate supervision of children and not attending to children in a nurturing and appropriate manner were documented today. Violations of this nature directly impact the safety of the children while in your care. In addition, these types of violations have the greatest negative impact on your compliance history. During the visit, we discussed that a follow-up visit may be conducted in the near future to monitor compliance with child care requirements. You stated that you currently do not have a written supervision policy but do go over supervision procedures during staff orientation when staff are hired. Each staff member is required to count children before exiting the classroom and when returning to the classroom and to take their sign-in/sign-out sheets for children when they leave the classroom to verify which children are present. There are video cameras at the facility, but there are no cameras at the playgrounds. Neither the assistant director or the caregivers notified the parents of the child about the incident. You stated today that you were already working on a written supervision policy. We discussed that the current procedures for counting children did not work in this instance and that you should review the procedure/policy, revise the procedure/policy if needed, and review again with staff. You stated that you planned to notify the parent of the three-year-old child about the supervision incident today. You stated today that you conduct staff/classroom observations and have not witnessed any issues that were alleged to have occurred. We discussed that my observations and interviews with staff today identified specific staff members that may need more frequent observations and additional training regarding supervision and attending to children in a nurturing and appropriate manner. The facility’s personnel policies were reviewed regarding the use of “Personal Technological Devices” including cellphones, iPad, Kindle Fire, or other personal technological device and that these devices may not be in use while supervising children in the classroom. We discussed that upon my arrival at the facility I observed two staff members on the center playground with a group of children and that both were sitting down and on their cell phones. I interviewed both staff members and they stated that they were aware that there was a policy regarding no cell phone use and that they were on their cell phones today while on the playground. We discussed that staff should be moving about the indoor and outdoor environments and interacting with children at all times. You stated that there needed to be consequences for staff who were not following policies and we discussed written warnings or reprimands, and that the current policy prohibited use of devices “in the classroom” but outdoor environments should be added. At the completion of the visit, I was unable to gain access to the Division’s Regulatory System to enter the visit summary. I completed a handwritten visit summary that was reviewed by you and a copy was received. Once I can access the Regulatory System, a computer-generated visit summary will be reviewed with you by telephone and a copy emailed to you. Contact me at tammy.childress@dhhs.nc.gov or by telephone at (336)317-6436 or Pamela Hauser, Licensing Supervisor, at pamela.hauser@dhhs.nc.gov or by telephone at (336)317-5003 if you have questions. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
NC GS 110-90 · Violation
Name of Operation: LEARNING THRU PLAY TOO CHILD DEVELOPMENT CENTER Facility ID: 05000067 Consultant: TAMMY CHILDRESS Operation Type: Center Case Number: 0426-414L Visit Date: 5/7/2026 Number Present: 58 Completed Date: 5/7/2026 Age: From 0 To 5 Total Minutes: 175 Time In: 10:20 AM Time Out: 01:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to obtain information regarding alleged violations of child care requirements. The assistant director assisted me with today's visit. The allegations are as follows: There are concerns that children are not being provided with adequate supervision. There are also concerns regarding inappropriate discipline and unsafe environment. Staff/child ratio, group size, supervision, use of licensed space, space capacity, license restrictions, and the outdoor environment were monitored. The license and emergency care plan were posted. Fire drills, medication administration, and storage of hazardous products were also monitored. No new staff have been hired since the last monitoring visit conducted on February 11, 2026. Additionally, I observed the indoor and outdoor space used by the children. Children in care were observed to be engaged in outdoor play, personal care routines, lunch and rest time. Younger children were served chicken and rice, green beans and apple sauce. Preschool children were served a pork patty, green beans, and oranges. Based on information provided, approximately three to four weeks age, a specific date could not be provided, a three-year-old child was left unattended on the bottom playground. Two caregivers were providing care for fifteen children aged three and four years old. I interviewed the two caregivers present at the time of the alleged incident. They both stated that one of the caregivers counted the children before they left the playground and there were 15 children. They walked up the hill, down the sidewalk and returned to their classroom with the group of children around 9:35a.m. They closed the classroom door and began assisting children with taking off their coats, washing hands and directing the children to sit on the carpet. The assistant director came into the classroom one to two minutes later with the three-year-old child and said that the child was at the playground gate at the sidewalk waving at her. The caregiver who counted the children stated during the interview that she miscounted the children and that the child was hiding on the playground equipment. Proper supervision of children was observed today in each space. Based on information received from staff interviewed, the finding regarding this allegation of inadequate supervision was substantiated. It was also alleged that staff use cell phones while caring for children. Four staff members and the assistant director were interviewed. All staff interviewed stated that they usually use their cell phones during nap time, will check their phone if there has been a call, check on their own children, check for messages from enrolled children, or check security cameras at their homes. All staff denied that cell phone use affects the supervision of children in their care. Based upon information received during staff interviews and my observations, there was not enough information to conclude that staff members used cell phones and could not see or hear the children in their care. The allegation was unsubstantiated. It was also alleged that children have received injuries and staff did not notify parents of incidents resulting in injuries. Two caregivers denied that there had been injuries that were not documented on incident reports that were given to parents. I observed the incident report log with documented incidents. Based upon staff interviews and my observations this allegation was unsubstantiated. It was alleged that a staff member uses a vape in the classroom while caring for children. I interviewed the administrator and four staff members, and all denied that they had used a vape or smoked tobacco on the premises, nor that they had witnessed any other staff member vape or smoke in classrooms or on the premises. The facility’s personnel policies were reviewed and Child Care Rule 10A NCAC 09 .0604 regarding a smoke and tobacco free environment is documented in the policy and signed and dated by each staff member. Based on the information received during staff interviews, this allegation was unsubstantiated. It was alleged that children are yelled at by caregivers and that the caregivers yank things from children’s hands. In interviewed the assistant director and two staff members. When asked how three and four-year-old children are disciplined in the classroom and both stated time out. One caregiver stated that if there was an issue involving a toy and she asked the child to hand it to her and the child did not, she will “take it and grabs the toy and pulls it” away from the child. The other staff member interviewed stated that she has observed the staff member grab toys away from children. The assistant director denied ever witnessing the staff member engage in this behavior. Both caregivers and the director denied yelling at children. Based on the information received from staff interviews the allegation regarding inappropriate discipline was unsubstantiated. However, a violation regarding attending to children in a nurturing and appropriate manner will be documented. The following violations were documented: Violation Number Comment Rule 303 Children were not adequately supervised at all times. A three-year-old child was left on the playground alone for approximately two minutes after staff members miscounted the children in their care and returned to their classroom. .1801(a)(1-5) 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. A caregiver stated that the caregiver grabs and pulls toys away from three and four year old children when the children do not give the caregiver toys when they are asked to do so. G.S. 110-91(10) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violations documented may impact the compliance history score. The violations documented must be corrected immediately. On or before May 21, 2026, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is considered legal documentation. Please email the compliance letter to me at tammy.childress@dhhs.nc.gov. Technical Assistance Provided During Today’s Visit: Violations regarding inadequate supervision of children and not attending to children in a nurturing and appropriate manner were documented today. Violations of this nature directly impact the safety of the children while in your care. In addition, these types of violations have the greatest negative impact on your compliance history. During the visit, we discussed that a follow-up visit may be conducted in the near future to monitor compliance with child care requirements. You stated that you currently do not have a written supervision policy but do go over supervision procedures during staff orientation when staff are hired. Each staff member is required to count children before exiting the classroom and when returning to the classroom and to take their sign-in/sign-out sheets for children when they leave the classroom to verify which children are present. There are video cameras at the facility, but there are no cameras at the playgrounds. Neither the assistant director or the caregivers notified the parents of the child about the incident. You stated today that you were already working on a written supervision policy. We discussed that the current procedures for counting children did not work in this instance and that you should review the procedure/policy, revise the procedure/policy if needed, and review again with staff. You stated that you planned to notify the parent of the three-year-old child about the supervision incident today. You stated today that you conduct staff/classroom observations and have not witnessed any issues that were alleged to have occurred. We discussed that my observations and interviews with staff today identified specific staff members that may need more frequent observations and additional training regarding supervision and attending to children in a nurturing and appropriate manner. The facility’s personnel policies were reviewed regarding the use of “Personal Technological Devices” including cellphones, iPad, Kindle Fire, or other personal technological device and that these devices may not be in use while supervising children in the classroom. We discussed that upon my arrival at the facility I observed two staff members on the center playground with a group of children and that both were sitting down and on their cell phones. I interviewed both staff members and they stated that they were aware that there was a policy regarding no cell phone use and that they were on their cell phones today while on the playground. We discussed that staff should be moving about the indoor and outdoor environments and interacting with children at all times. You stated that there needed to be consequences for staff who were not following policies and we discussed written warnings or reprimands, and that the current policy prohibited use of devices “in the classroom” but outdoor environments should be added. At the completion of the visit, I was unable to gain access to the Division’s Regulatory System to enter the visit summary. I completed a handwritten visit summary that was reviewed by you and a copy was received. Once I can access the Regulatory System, a computer-generated visit summary will be reviewed with you by telephone and a copy emailed to you. Contact me at tammy.childress@dhhs.nc.gov or by telephone at (336)317-6436 or Pamela Hauser, Licensing Supervisor, at pamela.hauser@dhhs.nc.gov or by telephone at (336)317-5003 if you have questions. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
10A NCAC 09 .0601 · Violation
Name of Operation: LEARNING THRU PLAY TOO CHILD DEVELOPMENT CENTER Facility ID: 05000067 Consultant: KAREN YOUNG Operation Type: Center Case Number: 1225-042L Visit Date: 12/16/2025 Number Present: 14 Completed Date: 12/16/2025 Age: From 2 To 3 Total Minutes: 215 Time In: 09:45 AM Time Out: 01:20 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to obtain information regarding alleged violations of childcare requirements and to approve a new outdoor infant toddler playground area. This visit was conducted with Donna Wilkinson, Director and Tisha Thomas, Assistant Director. The allegations are as follows: There are allegations of violations of childcare requirements. The allegations involve interaction, developmentally appropriate activities, and children receiving the required amount of outdoor gross motor play time. During today’s visit, the allegations were discussed with you. You had the opportunity to respond. Information shared during this visit is documented in this visit summary. Your program currently operates with a Five (5) Star Rated License effective 3/19/25. Restrictions include 1st shift daytime care; meets enhanced ratios; meets enhanced space; children under 2.5 years in rooms with direct exits only. The NC Secretary of State website was reviewed on 12/8/25 and Learning Thru Play, Inc. was listed as current and active. The program’s compliance history was 94% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • Adequate / Approved Space • License Posted • Permit Restrictions Allegation #1: There is concern regarding violations of childcare requirements. There is concern of appropriate interaction with the two-year-old children. Observation #1: During today’s visit, I observed the two-and three-year-old classroom from 10:00 to 10:45 am. I asked to see the center’s discipline policy. I observed the lead teacher and the teacher assistant. The teacher assistant today is not the same teacher assistant as was on the report. While in the classroom, I observed children having free choice center play from 10:00 am to 10:35 am. At 10:35 am the children were instructed to clean up along with the staff helping the children to clean up the classroom. Today I observed teachers speaking appropriately with the children and asking open ended questions while the children played and while one teacher was helping children paint a wreath. No children were spoken to in an inappropriate manner nor sent to time out today. The teacher assistant in the classroom moved about from center to center starting in the home living area and moving to the block area and then moving to the rug area asking questions to the children and talking to them the entire time. When interviewing the lead teacher in the classroom, she stated the teacher assistant that was formerly with her did not seem to enjoy the two- and three-year-old age group. She stated that children were put in time out if they misbehaved or did not listen. The lead teacher stated the assistant did speak harshly to the children. This teacher now has a new teacher assistant and the room flowed very smoothly today and children were engaged during the visit today. I observed video from December 5, 2025, from 10 am until 11:39 am. This is the farthest back the tape went per the assistant director. I observed the former teacher assistant, listed in the report, in the room alone with six (6) children. While watching the tape I observed the staff member doing chores such as putting sheets on the cots with her back to the children in her care, while the children were sitting at the table eating. I also observed the staff member on her phone while caring for the children as well as turning her back to a child who was waiting on the changing table for a diaper change. I discussed with the director and assistant director the concerns of viewing the tape. There was no interaction with the children viewed in the tape. She did do movement activities on the tape. Upon arrival, when discussing the report with the director and assistant director, the director provided me signed copies of the action plan that she put into place on December 5, 2025. The action plan has signatures of the two staff members mentioned in the report and it is dated December 4, 2025. I received a copy of this action plan during the visit today. The new staff member who is now serving as the teacher’s assistant has not yet signed the action plan. I requested that she receive a copy and that she sign, date and keep a copy as well as place a copy in their staff file. Conclusion #1: Based on interviews with administration and staff, and collateral contact, there was enough information to support the allegation of inappropriate interactions. This allegation was substantiated. Allegation #2: There is a concern regarding the two-year-old children participating in developmentally appropriate activities. Observation #2: During today’s visit, I observed the two-year-old children having free choice center play from 10:00 until 10:35 am, and at that time, the children were instructed to start cleaning up the toys for lunch time. The free choice areas of the room were stocked with developmentally appropriate toys, activities and books. Conclusion #2: Based on the above information and observations during today’s visit, there was not enough information to support the allegation. This allegation was not substantiated. Allegation #3: There is concern regarding the two (2) year old children not having the required outdoor time. Observation #3: During today’s visit, I observed the two (2) year old children not having the opportunity for outdoor time. The teacher in space 17 stated that the children had not been going outdoors since the playground was being worked on. There was no outdoor gross motor activity offered to the children in this classroom. The Assistant Director stated the children have scarves for use while dancing to music, balls and spinners for gross motor activity in the classroom to use. The children participated in free choice center play during the time I was observing in the classroom today. I did not observe any gross motor activities that were offered to the children today. The updated playground space for this age group was approved for use during the visit. Conclusion #3: Based on the interview with the teacher in space 17, administration, observations, and collateral contact during today’s visit, there was enough information to support the allegation. This allegation was substantiated. While on the visit today, I monitored the new outdoor infant/toddler play space. I observed the updated existing space that is in the outdoor center of the surrounding buildings The space has new equipment including a climber for children 6 to 23 months, 2 large, cushioned loungers, a new outdoor kitchen set, new trikes, and new cozy coups and trucks. This area was enclosed with a four (4) foot fence all around. There are two (2) gates going into this space. This space was approved for use during the visit today. The infant play area was observed today and there are two sections of the fence that exceed 3.5 inches. One area is at the bottom of the fence to the right as you enter the gate, and the other area was on the right of the gate as you enter the infant play area. The following violations were cited during today’s visit: Violation Number Comment Rule 303 Children were not adequately supervised at all times. I observed on the video, from December 5, 2025, a staff member with her back to the children, putting sheets on the cots, while two and three year old children were sitting at the table eating lunch. She was the only staff member in the room. .1801(a)(1-5) 325 Staff did not interact with children in positive ways by helping them feel welcome and comfortable, treating them with respect, listening to what they say, responding to them with acceptance and appreciation, and/or participating in activities with the children. On November 19, 2025 the teacher assistant was heard saying to a child, "Sit back down. We're not playing with other toys." On November 26, 2025, the teacher assistant was heard saying, "You do not get a choice. You get what I put in front of you." .1802 548 For children 2 years of age and older, a minimum of 60 minutes of outdoor time throughout the day was not provided. Children ages 0-12 in care for less than five hours per day was not provided at least 30 minutes of outdoor time throughout the day. Today I observed no outdoor gross motor was provided to the two and three year old children. A teacher in Space 17 stated to me the children had not been outside since the playground was being worked on. .0508(c) 807 A safe indoor and outdoor environment was not provided for the children. While viewing the video today, from December 5, 2025, I observed a child on the changing table while the staff member had her back turned to the child and was steps away from the child. 10A NCAC 09 .0601(a) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violations cited during today's visit immediately and send me documentation verifying compliance on or before Tuesday, December 30, 2025. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation You may email the letter to karen.young@dhhs.nc.gov or mail two copies of the letter to: Karen Young P.O. Box 1012 Lewisville, NC 27023 If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action being taken by the DCDEE. Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action being taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit: • Refer to childcare rules for staff/child interactions in childcare rule 10A NCAC 09 .1802. • Refer to Safety rules in .0601(a). • Refer to required gross motor time per age in childcare rule 10A NCAC 09 .0508(c). Additional Information/Consultation: • You must notify your consultant 30 days prior to changing the ownership status of your facility. • Be sure you continue adding and/or deleting staff to the ABCMS portal as they are hired or fired. • Familiarize yourself with the three (3) QRIS Pathways so that you will be ready to decide on a Pathway in 2028 when it is time for you to renew your permit. • Make frequent visits to the two-year-old classroom to observe teachers and children. Monitor lesson plans and times allotted for activities. • Today I shared the following resources with the Provider to share with her staff: 1- Promoting Healthy Social Behaviors by Acknowledging Positive Behaviors 2- Promoting Healthy Social Behaviors by Building Positive Teacher-Child Relationships 3- Challenging behaviors helpline 4- Promoting Healthy Social Behaviors by Creating Opportunities that Support Children’s Interactions 5- Promoting Healthy Social Behaviors through Environmental Strategies that Promote Positive Social Interactions 6- Promoting Healthy Social Behaviors by Expressing Warmth and Affection to Children 7- Promoting Healthy Social Behaviors by Helping Children Learn to Manage Their Own Behavior 8- Promoting Healthy Social Behaviors by Helping Children Make Transitions 9- NC CCR&R Regional System Healthy Social Behavior Specialists Map 10- Promoting Healthy Social Behaviors Through Promoting Positive Interactions Between Children 11- Child Care Resources contact information regarding Social Emotional Skills At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Karen Young, Child Care Consultant (336)207-2151 karen.young@dhhs.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.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 .0508 · Violation
Name of Operation: LEARNING THRU PLAY TOO CHILD DEVELOPMENT CENTER Facility ID: 05000067 Consultant: KAREN YOUNG Operation Type: Center Case Number: 1225-042L Visit Date: 12/16/2025 Number Present: 14 Completed Date: 12/16/2025 Age: From 2 To 3 Total Minutes: 215 Time In: 09:45 AM Time Out: 01:20 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to obtain information regarding alleged violations of childcare requirements and to approve a new outdoor infant toddler playground area. This visit was conducted with Donna Wilkinson, Director and Tisha Thomas, Assistant Director. The allegations are as follows: There are allegations of violations of childcare requirements. The allegations involve interaction, developmentally appropriate activities, and children receiving the required amount of outdoor gross motor play time. During today’s visit, the allegations were discussed with you. You had the opportunity to respond. Information shared during this visit is documented in this visit summary. Your program currently operates with a Five (5) Star Rated License effective 3/19/25. Restrictions include 1st shift daytime care; meets enhanced ratios; meets enhanced space; children under 2.5 years in rooms with direct exits only. The NC Secretary of State website was reviewed on 12/8/25 and Learning Thru Play, Inc. was listed as current and active. The program’s compliance history was 94% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • Adequate / Approved Space • License Posted • Permit Restrictions Allegation #1: There is concern regarding violations of childcare requirements. There is concern of appropriate interaction with the two-year-old children. Observation #1: During today’s visit, I observed the two-and three-year-old classroom from 10:00 to 10:45 am. I asked to see the center’s discipline policy. I observed the lead teacher and the teacher assistant. The teacher assistant today is not the same teacher assistant as was on the report. While in the classroom, I observed children having free choice center play from 10:00 am to 10:35 am. At 10:35 am the children were instructed to clean up along with the staff helping the children to clean up the classroom. Today I observed teachers speaking appropriately with the children and asking open ended questions while the children played and while one teacher was helping children paint a wreath. No children were spoken to in an inappropriate manner nor sent to time out today. The teacher assistant in the classroom moved about from center to center starting in the home living area and moving to the block area and then moving to the rug area asking questions to the children and talking to them the entire time. When interviewing the lead teacher in the classroom, she stated the teacher assistant that was formerly with her did not seem to enjoy the two- and three-year-old age group. She stated that children were put in time out if they misbehaved or did not listen. The lead teacher stated the assistant did speak harshly to the children. This teacher now has a new teacher assistant and the room flowed very smoothly today and children were engaged during the visit today. I observed video from December 5, 2025, from 10 am until 11:39 am. This is the farthest back the tape went per the assistant director. I observed the former teacher assistant, listed in the report, in the room alone with six (6) children. While watching the tape I observed the staff member doing chores such as putting sheets on the cots with her back to the children in her care, while the children were sitting at the table eating. I also observed the staff member on her phone while caring for the children as well as turning her back to a child who was waiting on the changing table for a diaper change. I discussed with the director and assistant director the concerns of viewing the tape. There was no interaction with the children viewed in the tape. She did do movement activities on the tape. Upon arrival, when discussing the report with the director and assistant director, the director provided me signed copies of the action plan that she put into place on December 5, 2025. The action plan has signatures of the two staff members mentioned in the report and it is dated December 4, 2025. I received a copy of this action plan during the visit today. The new staff member who is now serving as the teacher’s assistant has not yet signed the action plan. I requested that she receive a copy and that she sign, date and keep a copy as well as place a copy in their staff file. Conclusion #1: Based on interviews with administration and staff, and collateral contact, there was enough information to support the allegation of inappropriate interactions. This allegation was substantiated. Allegation #2: There is a concern regarding the two-year-old children participating in developmentally appropriate activities. Observation #2: During today’s visit, I observed the two-year-old children having free choice center play from 10:00 until 10:35 am, and at that time, the children were instructed to start cleaning up the toys for lunch time. The free choice areas of the room were stocked with developmentally appropriate toys, activities and books. Conclusion #2: Based on the above information and observations during today’s visit, there was not enough information to support the allegation. This allegation was not substantiated. Allegation #3: There is concern regarding the two (2) year old children not having the required outdoor time. Observation #3: During today’s visit, I observed the two (2) year old children not having the opportunity for outdoor time. The teacher in space 17 stated that the children had not been going outdoors since the playground was being worked on. There was no outdoor gross motor activity offered to the children in this classroom. The Assistant Director stated the children have scarves for use while dancing to music, balls and spinners for gross motor activity in the classroom to use. The children participated in free choice center play during the time I was observing in the classroom today. I did not observe any gross motor activities that were offered to the children today. The updated playground space for this age group was approved for use during the visit. Conclusion #3: Based on the interview with the teacher in space 17, administration, observations, and collateral contact during today’s visit, there was enough information to support the allegation. This allegation was substantiated. While on the visit today, I monitored the new outdoor infant/toddler play space. I observed the updated existing space that is in the outdoor center of the surrounding buildings The space has new equipment including a climber for children 6 to 23 months, 2 large, cushioned loungers, a new outdoor kitchen set, new trikes, and new cozy coups and trucks. This area was enclosed with a four (4) foot fence all around. There are two (2) gates going into this space. This space was approved for use during the visit today. The infant play area was observed today and there are two sections of the fence that exceed 3.5 inches. One area is at the bottom of the fence to the right as you enter the gate, and the other area was on the right of the gate as you enter the infant play area. The following violations were cited during today’s visit: Violation Number Comment Rule 303 Children were not adequately supervised at all times. I observed on the video, from December 5, 2025, a staff member with her back to the children, putting sheets on the cots, while two and three year old children were sitting at the table eating lunch. She was the only staff member in the room. .1801(a)(1-5) 325 Staff did not interact with children in positive ways by helping them feel welcome and comfortable, treating them with respect, listening to what they say, responding to them with acceptance and appreciation, and/or participating in activities with the children. On November 19, 2025 the teacher assistant was heard saying to a child, "Sit back down. We're not playing with other toys." On November 26, 2025, the teacher assistant was heard saying, "You do not get a choice. You get what I put in front of you." .1802 548 For children 2 years of age and older, a minimum of 60 minutes of outdoor time throughout the day was not provided. Children ages 0-12 in care for less than five hours per day was not provided at least 30 minutes of outdoor time throughout the day. Today I observed no outdoor gross motor was provided to the two and three year old children. A teacher in Space 17 stated to me the children had not been outside since the playground was being worked on. .0508(c) 807 A safe indoor and outdoor environment was not provided for the children. While viewing the video today, from December 5, 2025, I observed a child on the changing table while the staff member had her back turned to the child and was steps away from the child. 10A NCAC 09 .0601(a) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violations cited during today's visit immediately and send me documentation verifying compliance on or before Tuesday, December 30, 2025. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation You may email the letter to karen.young@dhhs.nc.gov or mail two copies of the letter to: Karen Young P.O. Box 1012 Lewisville, NC 27023 If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action being taken by the DCDEE. Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action being taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit: • Refer to childcare rules for staff/child interactions in childcare rule 10A NCAC 09 .1802. • Refer to Safety rules in .0601(a). • Refer to required gross motor time per age in childcare rule 10A NCAC 09 .0508(c). Additional Information/Consultation: • You must notify your consultant 30 days prior to changing the ownership status of your facility. • Be sure you continue adding and/or deleting staff to the ABCMS portal as they are hired or fired. • Familiarize yourself with the three (3) QRIS Pathways so that you will be ready to decide on a Pathway in 2028 when it is time for you to renew your permit. • Make frequent visits to the two-year-old classroom to observe teachers and children. Monitor lesson plans and times allotted for activities. • Today I shared the following resources with the Provider to share with her staff: 1- Promoting Healthy Social Behaviors by Acknowledging Positive Behaviors 2- Promoting Healthy Social Behaviors by Building Positive Teacher-Child Relationships 3- Challenging behaviors helpline 4- Promoting Healthy Social Behaviors by Creating Opportunities that Support Children’s Interactions 5- Promoting Healthy Social Behaviors through Environmental Strategies that Promote Positive Social Interactions 6- Promoting Healthy Social Behaviors by Expressing Warmth and Affection to Children 7- Promoting Healthy Social Behaviors by Helping Children Learn to Manage Their Own Behavior 8- Promoting Healthy Social Behaviors by Helping Children Make Transitions 9- NC CCR&R Regional System Healthy Social Behavior Specialists Map 10- Promoting Healthy Social Behaviors Through Promoting Positive Interactions Between Children 11- Child Care Resources contact information regarding Social Emotional Skills At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Karen Young, Child Care Consultant (336)207-2151 karen.young@dhhs.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.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 .1802 · Violation
Name of Operation: LEARNING THRU PLAY TOO CHILD DEVELOPMENT CENTER Facility ID: 05000067 Consultant: KAREN YOUNG Operation Type: Center Case Number: 1225-042L Visit Date: 12/16/2025 Number Present: 14 Completed Date: 12/16/2025 Age: From 2 To 3 Total Minutes: 215 Time In: 09:45 AM Time Out: 01:20 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to obtain information regarding alleged violations of childcare requirements and to approve a new outdoor infant toddler playground area. This visit was conducted with Donna Wilkinson, Director and Tisha Thomas, Assistant Director. The allegations are as follows: There are allegations of violations of childcare requirements. The allegations involve interaction, developmentally appropriate activities, and children receiving the required amount of outdoor gross motor play time. During today’s visit, the allegations were discussed with you. You had the opportunity to respond. Information shared during this visit is documented in this visit summary. Your program currently operates with a Five (5) Star Rated License effective 3/19/25. Restrictions include 1st shift daytime care; meets enhanced ratios; meets enhanced space; children under 2.5 years in rooms with direct exits only. The NC Secretary of State website was reviewed on 12/8/25 and Learning Thru Play, Inc. was listed as current and active. The program’s compliance history was 94% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • Adequate / Approved Space • License Posted • Permit Restrictions Allegation #1: There is concern regarding violations of childcare requirements. There is concern of appropriate interaction with the two-year-old children. Observation #1: During today’s visit, I observed the two-and three-year-old classroom from 10:00 to 10:45 am. I asked to see the center’s discipline policy. I observed the lead teacher and the teacher assistant. The teacher assistant today is not the same teacher assistant as was on the report. While in the classroom, I observed children having free choice center play from 10:00 am to 10:35 am. At 10:35 am the children were instructed to clean up along with the staff helping the children to clean up the classroom. Today I observed teachers speaking appropriately with the children and asking open ended questions while the children played and while one teacher was helping children paint a wreath. No children were spoken to in an inappropriate manner nor sent to time out today. The teacher assistant in the classroom moved about from center to center starting in the home living area and moving to the block area and then moving to the rug area asking questions to the children and talking to them the entire time. When interviewing the lead teacher in the classroom, she stated the teacher assistant that was formerly with her did not seem to enjoy the two- and three-year-old age group. She stated that children were put in time out if they misbehaved or did not listen. The lead teacher stated the assistant did speak harshly to the children. This teacher now has a new teacher assistant and the room flowed very smoothly today and children were engaged during the visit today. I observed video from December 5, 2025, from 10 am until 11:39 am. This is the farthest back the tape went per the assistant director. I observed the former teacher assistant, listed in the report, in the room alone with six (6) children. While watching the tape I observed the staff member doing chores such as putting sheets on the cots with her back to the children in her care, while the children were sitting at the table eating. I also observed the staff member on her phone while caring for the children as well as turning her back to a child who was waiting on the changing table for a diaper change. I discussed with the director and assistant director the concerns of viewing the tape. There was no interaction with the children viewed in the tape. She did do movement activities on the tape. Upon arrival, when discussing the report with the director and assistant director, the director provided me signed copies of the action plan that she put into place on December 5, 2025. The action plan has signatures of the two staff members mentioned in the report and it is dated December 4, 2025. I received a copy of this action plan during the visit today. The new staff member who is now serving as the teacher’s assistant has not yet signed the action plan. I requested that she receive a copy and that she sign, date and keep a copy as well as place a copy in their staff file. Conclusion #1: Based on interviews with administration and staff, and collateral contact, there was enough information to support the allegation of inappropriate interactions. This allegation was substantiated. Allegation #2: There is a concern regarding the two-year-old children participating in developmentally appropriate activities. Observation #2: During today’s visit, I observed the two-year-old children having free choice center play from 10:00 until 10:35 am, and at that time, the children were instructed to start cleaning up the toys for lunch time. The free choice areas of the room were stocked with developmentally appropriate toys, activities and books. Conclusion #2: Based on the above information and observations during today’s visit, there was not enough information to support the allegation. This allegation was not substantiated. Allegation #3: There is concern regarding the two (2) year old children not having the required outdoor time. Observation #3: During today’s visit, I observed the two (2) year old children not having the opportunity for outdoor time. The teacher in space 17 stated that the children had not been going outdoors since the playground was being worked on. There was no outdoor gross motor activity offered to the children in this classroom. The Assistant Director stated the children have scarves for use while dancing to music, balls and spinners for gross motor activity in the classroom to use. The children participated in free choice center play during the time I was observing in the classroom today. I did not observe any gross motor activities that were offered to the children today. The updated playground space for this age group was approved for use during the visit. Conclusion #3: Based on the interview with the teacher in space 17, administration, observations, and collateral contact during today’s visit, there was enough information to support the allegation. This allegation was substantiated. While on the visit today, I monitored the new outdoor infant/toddler play space. I observed the updated existing space that is in the outdoor center of the surrounding buildings The space has new equipment including a climber for children 6 to 23 months, 2 large, cushioned loungers, a new outdoor kitchen set, new trikes, and new cozy coups and trucks. This area was enclosed with a four (4) foot fence all around. There are two (2) gates going into this space. This space was approved for use during the visit today. The infant play area was observed today and there are two sections of the fence that exceed 3.5 inches. One area is at the bottom of the fence to the right as you enter the gate, and the other area was on the right of the gate as you enter the infant play area. The following violations were cited during today’s visit: Violation Number Comment Rule 303 Children were not adequately supervised at all times. I observed on the video, from December 5, 2025, a staff member with her back to the children, putting sheets on the cots, while two and three year old children were sitting at the table eating lunch. She was the only staff member in the room. .1801(a)(1-5) 325 Staff did not interact with children in positive ways by helping them feel welcome and comfortable, treating them with respect, listening to what they say, responding to them with acceptance and appreciation, and/or participating in activities with the children. On November 19, 2025 the teacher assistant was heard saying to a child, "Sit back down. We're not playing with other toys." On November 26, 2025, the teacher assistant was heard saying, "You do not get a choice. You get what I put in front of you." .1802 548 For children 2 years of age and older, a minimum of 60 minutes of outdoor time throughout the day was not provided. Children ages 0-12 in care for less than five hours per day was not provided at least 30 minutes of outdoor time throughout the day. Today I observed no outdoor gross motor was provided to the two and three year old children. A teacher in Space 17 stated to me the children had not been outside since the playground was being worked on. .0508(c) 807 A safe indoor and outdoor environment was not provided for the children. While viewing the video today, from December 5, 2025, I observed a child on the changing table while the staff member had her back turned to the child and was steps away from the child. 10A NCAC 09 .0601(a) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violations cited during today's visit immediately and send me documentation verifying compliance on or before Tuesday, December 30, 2025. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation You may email the letter to karen.young@dhhs.nc.gov or mail two copies of the letter to: Karen Young P.O. Box 1012 Lewisville, NC 27023 If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action being taken by the DCDEE. Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action being taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit: • Refer to childcare rules for staff/child interactions in childcare rule 10A NCAC 09 .1802. • Refer to Safety rules in .0601(a). • Refer to required gross motor time per age in childcare rule 10A NCAC 09 .0508(c). Additional Information/Consultation: • You must notify your consultant 30 days prior to changing the ownership status of your facility. • Be sure you continue adding and/or deleting staff to the ABCMS portal as they are hired or fired. • Familiarize yourself with the three (3) QRIS Pathways so that you will be ready to decide on a Pathway in 2028 when it is time for you to renew your permit. • Make frequent visits to the two-year-old classroom to observe teachers and children. Monitor lesson plans and times allotted for activities. • Today I shared the following resources with the Provider to share with her staff: 1- Promoting Healthy Social Behaviors by Acknowledging Positive Behaviors 2- Promoting Healthy Social Behaviors by Building Positive Teacher-Child Relationships 3- Challenging behaviors helpline 4- Promoting Healthy Social Behaviors by Creating Opportunities that Support Children’s Interactions 5- Promoting Healthy Social Behaviors through Environmental Strategies that Promote Positive Social Interactions 6- Promoting Healthy Social Behaviors by Expressing Warmth and Affection to Children 7- Promoting Healthy Social Behaviors by Helping Children Learn to Manage Their Own Behavior 8- Promoting Healthy Social Behaviors by Helping Children Make Transitions 9- NC CCR&R Regional System Healthy Social Behavior Specialists Map 10- Promoting Healthy Social Behaviors Through Promoting Positive Interactions Between Children 11- Child Care Resources contact information regarding Social Emotional Skills At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Karen Young, Child Care Consultant (336)207-2151 karen.young@dhhs.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
NC GS 110-90 · Violation
Name of Operation: LEARNING THRU PLAY TOO CHILD DEVELOPMENT CENTER Facility ID: 05000067 Consultant: KAREN YOUNG Operation Type: Center Case Number: 1225-042L Visit Date: 12/16/2025 Number Present: 14 Completed Date: 12/16/2025 Age: From 2 To 3 Total Minutes: 215 Time In: 09:45 AM Time Out: 01:20 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to obtain information regarding alleged violations of childcare requirements and to approve a new outdoor infant toddler playground area. This visit was conducted with Donna Wilkinson, Director and Tisha Thomas, Assistant Director. The allegations are as follows: There are allegations of violations of childcare requirements. The allegations involve interaction, developmentally appropriate activities, and children receiving the required amount of outdoor gross motor play time. During today’s visit, the allegations were discussed with you. You had the opportunity to respond. Information shared during this visit is documented in this visit summary. Your program currently operates with a Five (5) Star Rated License effective 3/19/25. Restrictions include 1st shift daytime care; meets enhanced ratios; meets enhanced space; children under 2.5 years in rooms with direct exits only. The NC Secretary of State website was reviewed on 12/8/25 and Learning Thru Play, Inc. was listed as current and active. The program’s compliance history was 94% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • Adequate / Approved Space • License Posted • Permit Restrictions Allegation #1: There is concern regarding violations of childcare requirements. There is concern of appropriate interaction with the two-year-old children. Observation #1: During today’s visit, I observed the two-and three-year-old classroom from 10:00 to 10:45 am. I asked to see the center’s discipline policy. I observed the lead teacher and the teacher assistant. The teacher assistant today is not the same teacher assistant as was on the report. While in the classroom, I observed children having free choice center play from 10:00 am to 10:35 am. At 10:35 am the children were instructed to clean up along with the staff helping the children to clean up the classroom. Today I observed teachers speaking appropriately with the children and asking open ended questions while the children played and while one teacher was helping children paint a wreath. No children were spoken to in an inappropriate manner nor sent to time out today. The teacher assistant in the classroom moved about from center to center starting in the home living area and moving to the block area and then moving to the rug area asking questions to the children and talking to them the entire time. When interviewing the lead teacher in the classroom, she stated the teacher assistant that was formerly with her did not seem to enjoy the two- and three-year-old age group. She stated that children were put in time out if they misbehaved or did not listen. The lead teacher stated the assistant did speak harshly to the children. This teacher now has a new teacher assistant and the room flowed very smoothly today and children were engaged during the visit today. I observed video from December 5, 2025, from 10 am until 11:39 am. This is the farthest back the tape went per the assistant director. I observed the former teacher assistant, listed in the report, in the room alone with six (6) children. While watching the tape I observed the staff member doing chores such as putting sheets on the cots with her back to the children in her care, while the children were sitting at the table eating. I also observed the staff member on her phone while caring for the children as well as turning her back to a child who was waiting on the changing table for a diaper change. I discussed with the director and assistant director the concerns of viewing the tape. There was no interaction with the children viewed in the tape. She did do movement activities on the tape. Upon arrival, when discussing the report with the director and assistant director, the director provided me signed copies of the action plan that she put into place on December 5, 2025. The action plan has signatures of the two staff members mentioned in the report and it is dated December 4, 2025. I received a copy of this action plan during the visit today. The new staff member who is now serving as the teacher’s assistant has not yet signed the action plan. I requested that she receive a copy and that she sign, date and keep a copy as well as place a copy in their staff file. Conclusion #1: Based on interviews with administration and staff, and collateral contact, there was enough information to support the allegation of inappropriate interactions. This allegation was substantiated. Allegation #2: There is a concern regarding the two-year-old children participating in developmentally appropriate activities. Observation #2: During today’s visit, I observed the two-year-old children having free choice center play from 10:00 until 10:35 am, and at that time, the children were instructed to start cleaning up the toys for lunch time. The free choice areas of the room were stocked with developmentally appropriate toys, activities and books. Conclusion #2: Based on the above information and observations during today’s visit, there was not enough information to support the allegation. This allegation was not substantiated. Allegation #3: There is concern regarding the two (2) year old children not having the required outdoor time. Observation #3: During today’s visit, I observed the two (2) year old children not having the opportunity for outdoor time. The teacher in space 17 stated that the children had not been going outdoors since the playground was being worked on. There was no outdoor gross motor activity offered to the children in this classroom. The Assistant Director stated the children have scarves for use while dancing to music, balls and spinners for gross motor activity in the classroom to use. The children participated in free choice center play during the time I was observing in the classroom today. I did not observe any gross motor activities that were offered to the children today. The updated playground space for this age group was approved for use during the visit. Conclusion #3: Based on the interview with the teacher in space 17, administration, observations, and collateral contact during today’s visit, there was enough information to support the allegation. This allegation was substantiated. While on the visit today, I monitored the new outdoor infant/toddler play space. I observed the updated existing space that is in the outdoor center of the surrounding buildings The space has new equipment including a climber for children 6 to 23 months, 2 large, cushioned loungers, a new outdoor kitchen set, new trikes, and new cozy coups and trucks. This area was enclosed with a four (4) foot fence all around. There are two (2) gates going into this space. This space was approved for use during the visit today. The infant play area was observed today and there are two sections of the fence that exceed 3.5 inches. One area is at the bottom of the fence to the right as you enter the gate, and the other area was on the right of the gate as you enter the infant play area. The following violations were cited during today’s visit: Violation Number Comment Rule 303 Children were not adequately supervised at all times. I observed on the video, from December 5, 2025, a staff member with her back to the children, putting sheets on the cots, while two and three year old children were sitting at the table eating lunch. She was the only staff member in the room. .1801(a)(1-5) 325 Staff did not interact with children in positive ways by helping them feel welcome and comfortable, treating them with respect, listening to what they say, responding to them with acceptance and appreciation, and/or participating in activities with the children. On November 19, 2025 the teacher assistant was heard saying to a child, "Sit back down. We're not playing with other toys." On November 26, 2025, the teacher assistant was heard saying, "You do not get a choice. You get what I put in front of you." .1802 548 For children 2 years of age and older, a minimum of 60 minutes of outdoor time throughout the day was not provided. Children ages 0-12 in care for less than five hours per day was not provided at least 30 minutes of outdoor time throughout the day. Today I observed no outdoor gross motor was provided to the two and three year old children. A teacher in Space 17 stated to me the children had not been outside since the playground was being worked on. .0508(c) 807 A safe indoor and outdoor environment was not provided for the children. While viewing the video today, from December 5, 2025, I observed a child on the changing table while the staff member had her back turned to the child and was steps away from the child. 10A NCAC 09 .0601(a) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violations cited during today's visit immediately and send me documentation verifying compliance on or before Tuesday, December 30, 2025. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation You may email the letter to karen.young@dhhs.nc.gov or mail two copies of the letter to: Karen Young P.O. Box 1012 Lewisville, NC 27023 If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action being taken by the DCDEE. Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action being taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit: • Refer to childcare rules for staff/child interactions in childcare rule 10A NCAC 09 .1802. • Refer to Safety rules in .0601(a). • Refer to required gross motor time per age in childcare rule 10A NCAC 09 .0508(c). Additional Information/Consultation: • You must notify your consultant 30 days prior to changing the ownership status of your facility. • Be sure you continue adding and/or deleting staff to the ABCMS portal as they are hired or fired. • Familiarize yourself with the three (3) QRIS Pathways so that you will be ready to decide on a Pathway in 2028 when it is time for you to renew your permit. • Make frequent visits to the two-year-old classroom to observe teachers and children. Monitor lesson plans and times allotted for activities. • Today I shared the following resources with the Provider to share with her staff: 1- Promoting Healthy Social Behaviors by Acknowledging Positive Behaviors 2- Promoting Healthy Social Behaviors by Building Positive Teacher-Child Relationships 3- Challenging behaviors helpline 4- Promoting Healthy Social Behaviors by Creating Opportunities that Support Children’s Interactions 5- Promoting Healthy Social Behaviors through Environmental Strategies that Promote Positive Social Interactions 6- Promoting Healthy Social Behaviors by Expressing Warmth and Affection to Children 7- Promoting Healthy Social Behaviors by Helping Children Learn to Manage Their Own Behavior 8- Promoting Healthy Social Behaviors by Helping Children Make Transitions 9- NC CCR&R Regional System Healthy Social Behavior Specialists Map 10- Promoting Healthy Social Behaviors Through Promoting Positive Interactions Between Children 11- Child Care Resources contact information regarding Social Emotional Skills At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Karen Young, Child Care Consultant (336)207-2151 karen.young@dhhs.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
NC GS 110-90 · Violation
Name of Operation: LEARNING THRU PLAY TOO CHILD DEVELOPMENT CENTER Facility ID: 05000067 Consultant: KAREN YOUNG Operation Type: Center Case Number: Visit Date: 8/12/2025 Number Present: 54 Completed Date: 8/12/2025 Age: From 0 To 8 Total Minutes: 188 Time In: 10:22 AM Time Out: 01:30 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 childcare requirements for a routine unannounced visit. This visit was conducted with Tisha Thomas. Your program currently operates with a Five (5) Star Rated License effective 3/19/25. The NC Secretary of State website was reviewed on 8/8/25 and Learning Thru Play, Inc. was listed as current and active. The program’s compliance history was 95% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • CPR / First Aid • Special Training • CBC Qualification • ITS – SIDS • Emergency Medical Care Plan • Administration of Medication • Storage of Hazardous Products • Storage of Medication • General Safety • Discipline • Adequate / Approved Space • Program Records • License Posted • Permit Restrictions The license was observed, and the restrictions were found in compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. I observed staff/child interactions today. I observed children having outdoor playground play, eating lunch, and infants were having individual needs met. Six (6) new staff were reported at this program. Files for new staff were reviewed. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Storage and administration of medication were monitored. Medication authorization was monitored. Storage hazardous items was monitored today. Three (3) playground inspections were recorded on 7/31/25. A fire drill was recorded 7/7/25 at 11:10 am with four (4) minutes to evacuate seventy-nine (79) children and sixteen (16) adults by D. Wilkinson. A lockdown emergency drill for the facility was recorded on 6/10/25 at 9:45 am with three (3) minutes, thirty (30) seconds to lockdown. The most recent fire inspection was on 8/7/25 by Josh Steelman. I observed a sanitation inspection was last conducted on 11/27/24 earning an Approved classification with eighteen (18) demerits. The program does not provide transportation. The following violations were cited during today’s visit: Violation Number Comment Rule 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. I observed an opening at the bottom of the fence on the large preschool playground that was over 3.5 inches. The opening measured five (5) inches between the ground and the fence. This violation was corrected and filled in during the visit with dirt. .0605(g) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Two (2) children in Space 17 had permissions to administer over the counter medications that had expired. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violations cited during today's visit immediately and send me documentation verifying compliance on or before Tuesday, August 26, 2025. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action being taken by the DCDEE. You may email the letter to karen.young@dhhs.nc.gov or mail two copies of the letter to: Karen Young P.O. Box 1012 Lewisville, NC 27023 Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action being taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit: • Any opening at the bottom of the fence must be no larger than three (3) inches to prevent children from getting entrapped. See childcare rule 10A NCAC .09 .0605(g). This violation was corrected during the visit. • Permission to administer medication must be current within the last year. See childcare rule 10A NCAC .09 .0803(7)(a-g). Additional Information/Consultation: • The wheelbarrow outside the fenced in playground area is filled with water posing a mosquito breeding area. Please empty the wheelbarrow and turn it over to prevent water from filling up. • You must notify your consultant 30 days prior to changing the ownership status of your facility. • The new QRIS is being implemented. Go to the DCDEE website and click on the “What’s New?” tab, then click on QRIS modernization to read about QRIS. • You confirmed with me today that your email address is: ltpinc123@yahoo.com. • Go to the DCDEE website and sign up for updates to receive the Raise NC newsletter. You will receive the most recent information on the QRIS. At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Karen Young, Child Care Consultant (336) 207-2151 kaern.young@dhhs.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.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 .0901 · Violation
Name of Operation: LEARNING THRU PLAY TOO CHILD DEVELOPMENT CENTER Facility ID: 05000067 Consultant: KAREN YOUNG Operation Type: Center Case Number: 0225-200L Visit Date: 2/24/2025 Number Present: 15 Completed Date: 2/24/2025 Age: From 4 To 5 Total Minutes: 300 Time In: 11:15 AM Time Out: 04:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to obtain information regarding alleged violations of childcare requirements. This visit was conducted by Karen Young, childcare consultant with Donna Wilkinson, Director. The allegations are as follows: There is a concern related to nutrition. 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. During today’s visit, the allegations were discussed with you. You had the opportunity to respond. Information shared during this visit are documented in this visit summary. There are eighty-one (81) total children present in the program today. Your program currently operates with a Five (5) Star license effective 10/22/18. Restrictions include 1st shift day time care; meets enhanced ratios; meets enhanced space; children under 2.5 years in rooms with direct exits only. The owner is listed as Debbie L. Williams who is the sole proprietor of Learning Thru Play Too Child Development Center. The program’s compliance history was 95% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • Adequate / Approved Space • License Posted • Permit Restrictions Allegation #1: There is a concern related to nutrition. Observation #1: During today’s visit, I observed the NC pre-k classroom. I asked if there were any nutrition opt-out forms for any of the children in this classroom and I reviewed one opt -out form for the child in the Pre-K classroom during the visit today. I asked if parents were contacted if the child opts-out, but parents fail to send lunch, what happens next. Director Donna Wilkinson and assistant Director Tisha Thomas stated that they always order an extra plate from the school system in case they ever need an extra plate and they also have food that is prepared for the infant/toddler wing of the school. So, they always have two (2) extra plates available for children. Currently, they have two (2) children in the entire school who opt-out. Parents are not usually contacted to have an opportunity to bring lunch for their child, if they have forgotten lunch since two (2) plates are always extra. The child did have breakfast bread on February 14, 2025. Mom had brought in blueberries and blackberries for the afternoon Valentine party snack. When mom brought the child into the 3-year-old classroom for early arrival on the 14th of February, mom stated to the floater, A Price and to the cook M. Bare, who was in the room giving breakfast that she had not packed breakfast or lunch for that day thinking since it was a party day that food was provided for the party. M. Bare, cook, stated to the mother, per A. Price, floater, that she could not provide food for the child since she opts-out and was not in the food program. It was reported that mom looked surprised but went on to work. The child did have breakfast bread for breakfast, but the child refused the bread and pushed it away. The lead teacher and teacher in this classroom were not present on February 14, 2025 since it was an optional teacher work day for the NC Pre-K and Ashe County Public School. The staff in the room on this day was Mackenzie Price, floater. I interviewed M. Price over the phone today. She stated that the child did not have any lunch, so M. Price called the 3 year old classroom and A. Price, floater, made the child a plate of snack party food for the child’s lunch which consisted of chips and dip, cheese puffs, applesauce, a juice box, and the floater’s own oats and honey bar. A Price brought the snack plate over to the 4 year old classroom. A. Price stated she knew that child had no allergies and wanted the child to have food to eat. I observed the children having lunch today in the pre-k space today regarding the events that allegedly took place on February 14, 2025. I also interviewed the cook of the center to ask if she was asked to prepare a plate for the child in the pre-k classroom. The cook stated that she did not tell the mom she could not have a plate. I asked to view and then viewed the camera footage for February 14, 2025 in the pre-k classroom during lunch time on the date of February 14, 2025. Camera footage began at 11:19 am when cook, M. Bare starts serving food. In the film footage, at 11:25 am I was able to view an empty plate at the child’s space and the child go over to the space and sit down. At 11:26 I saw M. Price go over to the phone to make a call. At 11:28 I saw A. Price come into the room with a plate of items that I could not make out in the video. A. Price sated the items were chips and dip, cheese puffs, applesauce, juice box and an oats and honey bar. The child begins to eat the food and continues to eat until 12:01 when the child gets up from the table. I also reviewed the center’s operational policies related to nutrition. I also asked to see the menu from the week of February 14, 2025. I observed the camera footage for breakfast on February 14th, 2025. The child was offered breakfast bread for breakfast but pushed the plate away and refused. Donna Wilkinson and Tisha Thomas were not made aware that the child did not have lunch that day, or they would have provided a nutritious lunch for the child with the extra plates. The optout form for this child began 1/14/25. Prior to this date, the child was being provided a plate from the school but not eating anything. The child drinks only water. Conclusion #1: Based on the above information, observation, video footage viewed and interviews during today’s visit, the allegation was confirmed and substantiated. Allegation #2: 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. Observation #2: The child was viewed on the camera footage eating the plate of snack food provided to her by staff. The child was not crying or seemingly upset at anything. She was eating her food and sitting beside the other children. The child was not seen being mistreated in any manner. Conclusion #2: Based on the above information, observations, and video footage during today’s visit, the allegation regarding nurture care of children could not be confirmed. This allegation was unsubstantiated. The following violations were cited during today’s visit: Comments Section – Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violation cited during today's visit immediately and send me documentation verifying compliance on or before Monday, March 10, 2025. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation You may email the letter to karen.young@dhhs.nc.gov or mail two copies of the letter to: Karen Young P.O. Box 1012 Lewisville, NC 27023 If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action being taken by the DCDEE. Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action being taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit: Nutrition is vital for a child's healthy growth and development. It helps children build strong bones and muscles, develop their brains, and maintain a healthy weight. Nutrition is important for physical health and brain development. • 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS Meals and snacks served to children in a child care center shall comply with the Meal Patterns for Children in Child Care Programs from the United States Department of Agriculture (USDA) which are based on the recommended nutrient intake judged by the National Research Council to be adequate for maintaining good nutrition. The types of food, number and size of servings shall be appropriate for the ages and developmental levels of the children in care. The Meal Patterns for Children in Child Care Programs are incorporated by reference and include subsequent amendments. A copy of the Meal Patterns for Children in Child Care Programs is available online at https://www.fns.usda.gov/cacfp/meals-and-snacks. When food is prepared by or provided by the center, menus for nutritious meals and snacks shall be planned at least one week in advance. At least one dated copy of the current week's menu shall be posted where it can be seen by parents and food preparation staff when food is prepared or provided by the center. A variety of food shall be included in meals and snacks. Any substitution shall be of comparable food value and shall be recorded on the menu prior to the meal or snack being served. When children bring their own food for meals or snacks to the center, if the food does not meet the nutritional requirements specified in Paragraph (a) of this Rule, the center must provide additional food necessary to meet those requirements. A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. Drinking water shall be freely available to children of all ages. Drinking fountains or individual drinking utensils shall be provided. When a private water supply is used, it must be tested by and meet the requirements of the Commission for Public Health as set forth in 15A NCAC 18A .2800. The child care provider shall serve only the following beverages: (1) breast milk, as specified in Paragraph (k) of this Rule; (2) formula; (3) water; (4) unflavored whole milk, for children ages 12-23 months; (5) unflavored skim or lowfat milk for children 24 months through five years; (6) unflavored skim milk, unflavored low-fat milk, or flavored skim milk for children six years and older; or (7) 100 percent fruit juice, limited to 6 ounces per day, for all ages. Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. The food required by special diets for medical, religious, or cultural reasons, or parental preferences, may be provided by the center or may be brought to the center by the parents. If the diet is prescribed by a health care professional, a statement signed by the health care professional shall be on file at the center and written instructions shall be provided by the child's parent, health care professional, or a licensed dietitian/nutritionist. If the diet is not prescribed by a health care professional, written instructions shall be provided by the child's parent and shall be on file at the center. Food that does not meet the nutritional requirements specified in Paragraph (a) of this Rule, such as cupcakes, cakes, and donuts shall only be offered for special occasions such as holidays and birthdays. Staff shall role model appropriate eating behaviors by consuming only food or beverages that meet the nutritional requirements specified in Paragraph (a) of this Rule in the presence of children in care. • 10A NCAC 09 .2411 NUTRITION REQUIREMENTS Meals and snacks shall be provided in accordance with Section .0900 of this Chapter unless a child's individualized plan of care specifies otherwise. • 10A NCAC 09 .1722 PROHIBITED DISCIPLINE No child shall be subjected to any form of corporal punishment by the family child care home operator, additional caregiver, substitute provider, or any other person in the home, whether or not these persons reside in the home as follows: (1) No child shall be handled roughly in any way, including shaking, pushing, shoving, pinching, slapping, biting, kicking, or spanking; (2) No child shall ever be placed in a locked room, closet, or box, or be left alone in a room separated from staff; (3) No discipline shall ever be delegated to another child; (4) No food shall be withheld or given as a means of punishment or reward; (5) No child shall ever be disciplined for toileting accidents; (6) No child shall ever be disciplined for not sleeping during rest period; (7) No child shall be disciplined by assigning chores that require contact with or use (8) Physical activity, such as running laps and doing push-ups, shall not be withheld or required as punishment; (9) No child shall ever be yelled at, shamed, humiliated, frightened, threatened, or bullied; and (10) No child shall be restrained as a form of discipline unless the child's safety or the safety of others is at risk. For purposes of this Rule, "restraining" shall mean that a caregiver physically holds a child in a manner that restricts the child's movement, for a minimum amount of time necessary to ensure a safe environment. Children shall not be restrained through the use of heavy objects, including a caregiver's body, or any device such as straps, blankets, car seats, or cribs. of hazardous materials, such as cleaning bathrooms or floors, or emptying diaper pails; Discipline practices shall be age and developmentally appropriate. * § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (10) Each operator or staff member shall attend to any child in a nurturing and appropriate manner, and in keeping with the child's developmental needs. Each child care facility shall have a written policy on discipline, describing the methods and practices used to discipline children enrolled in that facility. This written policy shall be discussed with, and a copy given to, each child's parent prior to the first time the child attends the facility. Subsequently, any change in discipline methods or practices shall be communicated in writing to the parents prior to the effective date of the change. * Chapter 4: Nutrition and Food Service 4.2 General Requirements 4.2.0 4.2.0.8: Feeding Plans and Dietary Modifications Before a child enters an early care and education facility, the facility should obtain a written history that contains any special nutrition or feeding needs for the child, including use of human milk or any special feeding utensils. The staff should review this history with the child’s parents/guardians, clarifying and discussing how the parents’/guardians’ home feeding routines may differ from the facility’s planned routine. The child’s primary health care provider should provide written information to the parent/guardian about any dietary modifications or special feeding techniques that are required at the early care and education program so they can be shared with and implemented by the program. If dietary modifications are indicated, based on a child’s medical or special dietary needs, caregivers/teachers should modify or supplement the child’s diet to meet the individual child’s specific needs. Dietary modifications should be made in consultation with the parents/guardians and the child’s primary health care provider. Caregivers/teachers can consult with a nutritionist/registered dietitian. A child’s diet may be modified because of food sensitivity, a food allergy, or many other reasons. includes a range of conditions in which a child exhibits an adverse reaction to a food that, in some instances, can be life-threatening. Modification of a child’s diet may also be related to a food allergy, an inability to digest or to tolerate certain foods, a need for extra calories, a need for special positioning while eating, diabetes and the need to match food with insulin, food idiosyncrasies, and other identified feeding issues, including celiac disease, phenylketonuria, diabetes, and severe food allergy (anaphylaxis). In some cases, a child may become ill if he/she is unable to eat, so missing a meal could have a negative consequence, especially for children with diabetes. For a child with special health care needs who requires dietary modifications or special feeding techniques, written instructions from the child’s parent/guardian and the child’s primary health care provider should be provided in the child’s record and carried out accordingly. Dietary modifications should be recorded. These written instructions must identify a. The child’s full name and date of instructions b. The child’s special health care needs c. Any dietary restrictions based on those special needs d. Any special feeding or eating utensils e. Any foods to be omitted from the diet and any foods to be substituted f. Any other pertinent information about the child’s special health care needs g. What, if anything, needs to be done if the child is exposed to restricted foods The written history of special nutrition or feeding needs should be used to develop individual feeding plans and, collectively, to develop facility menus. Health care providers with experience in disciplines related to special nutrition needs, including nutrition, nursing, speech therapy, occupational therapy, and physical therapy, should participate when needed and/or when they are available to the facility. If available, the nutritionist/registered dietitian should approve menus that accommodate needed dietary modifications. The feeding plan should include steps to take when a situation arises that requires rapid response by the staff, such as a child choking during mealtime or a child with a known history of food allergies demonstrating signs and symptoms of anaphylaxis (severe allergic reaction), such as difficulty breathing and severe redness and swelling of the face or mouth. The completed plan should be on file and accessible to staff and available to parents/guardians on request. Food sensitivity RATIONALE Children with special health care needs may have individual requirements related to diet and swallowing, involving special feeding 4.2.0.8: Feeding Plans and Dietary Modifications 02/24/2025 1 Standards from Caring for Our Children Online Database Close collaboration between families and the facility is necessary for children on special diets. Parents/guardians may have to provide food on a temporary, or even permanent, basis, if the facility, after exploring all community resources, is unable to provide the special diet. Programs may consider using the American Academy of Pediatrics (AAP) Allergy and Anaphylaxis Emergency Plan, which is included in the AAP clinical report, (4). Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home Care Plan for Children with Special Health Care Needs Written Nutrition Plan Assessment and Planning of Nutrition for Individual Children Vegetarian/Vegan Diets Responsive Feeding of Infants by a Consistent Caregiver/Teacher Foods that Are Choking Hazards utensils and feeding needs that will necessitate the development of an individual plan prior to their entry into the facility (1). Many children with special health care needs have difficulty with feeding, including delayed attainment of basic chewing, swallowing, and independent feeding skills. Food, eating style, food utensils, and equipment, including furniture, may have to be adapted to meet the developmental and physical needs of individual children (2,3,). Some children have difficulty with slow weight gain and need their caloric intake monitored and supplemented. Others, such as those with diabetes, may need to have their diet matched to their medication (e.g., insulin, if they are on a fixed dose of insulin). Some children are unable to tolerate certain foods because of their allergy to the food or their inability to digest it. The 8 most common foods to cause anaphylaxis in children are cow’s milk, eggs, soy, wheat, fish, shellfish, peanuts, and tree nuts (3). Staff members must know ahead of time what procedures to follow, as well as their designated roles, during an emergency. As a safety and health precaution, staff should know in advance whether a child has food allergies, inborn errors of metabolism, diabetes, celiac disease, tongue thrust, or special health care needs related to feeding, such as requiring special feeding utensils or equipment, nasogastric or gastric tube feedings, or special positioning. These situations require individual planning prior to the child’s entry into an early care and education program and on an ongoing basis (2). In some cases, dietary modifications are based on religious or cultural beliefs. Detailed information on each child’s special needs, whether stemming from dietary, feeding equipment, or cultural needs, is invaluable to the facility staff in meeting the nutritional needs of all the children in their care. COMMENTS Guidance on Completing a Written Allergy and Anaphylaxis Emergency Plan TYPE OF FACILITY RELATED STANDARDS 3.5.0.1 4.2.0.1 4.2.0.2 4.2.0.12 4.3.1.2 4.5.0.10 REFERENCES 1. Samour PQ, King K. Pediatric Nutrition. 4th ed. Sunbury, MA: Jones and Bartlett Learning; 2010 2. Kleinman RE, Greer FR, eds. Pediatric Nutrition. 7th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2014 3. Kaczkowski CH, Caffrey C. Pediatric nutrition. In: Blanchfield DS, ed. : . Vol 3. 3rd ed. Farmington Hills, MI: Gale; 2016:2063–2066 The Gale Encyclopedia of Children's Health Infancy Through Adolescence 4. Wang J, Sicherer SH; American Academy of Pediatrics Section on Allergy and Immunology. Guidance on completing a written allergy and anaphylaxis emergency plan. Pediatrics. 2017;139(3):e20164005 NOTES Content in the STANDARD was modified on 11/9/2017. 4.2.0.8: Feeding Plans and Dietary Modifications 02/24/2025 2 Standards from Caring for Our Children Online Database Additional Information/Consultation: • You must notify your consultant 30 days prior to changing the ownership status of your facility. • We discussed having a staff meeting with everyone to address the nutritional requirements and opt out requirements. • Remind staff to keep administration aware of any questionable situation so they are always aware of what is going on. • Visit NCRLAP website and read the information on Connecting with the Three’s! ECERS-3 and ITERS 3 will be used beginning 2/1/25. • The QRIS is in the process of being implemented and is now open for public comment. Go to the Division’s website, under What’s New and scroll down to QRIS Modernization, then read about QRIS Modernization Rulemaking Update. The Public comment is open 2/3/25 through 4/4/25. This is your opportunity to comment. • 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) 814-6401 and someone will assist you. • Public schools and licensed child care facilities in North Carolina are eligible to participate in the funding mechanisms to cover the costs of testing for lead in water and inspecting for asbestos and lead-based paint hazards beyond the May 1, 2024 deadline listed in 10A NCAC 41C .1002(a). Due to the recent impacts of Hurricane Helene and other natural disasters, this deadline has been revised statewide, and facilities that have not yet enrolled should complete the online process by May 31, 2025. The Clean Classrooms for Carolina Kids Program is providing free facility-wide testing and inspections without any out-of-pocket costs. Due to the volume of testing and inspections, completion of the online enrollment process in the program is considered temporary compliance with the testing and inspection requirement and will allow facilities to participate in the funding mechanisms. Required water testing for child care centers under rule 15A NCAC 18A .2816 is not affected by the new May 31, 2025 deadline. Enroll today at https://www.cleanwaterforcarolinakids.org/enroll. If you have enrolled for only one or two of the program sections, log back in to complete surveys for the remaining section(s) to comply with the rule requirements. Thank you for your participation in ensuring healthy learning environments for children across North Carolina. Please contact me at ed.norman@dhhs.nc.gov or 919-218-6511 if you have questions regarding this guidance. * Moodle Helpful Hints 1. When on the Moodle homepage, scroll down past the three-square boxes to find directions to self-register for various training opportunities. 2. If you do not access a training opportunity for 150 days, the training will be suspended. To regain access, email a request to set status to “active” including the name of the training course to dcdee_moodle_support@dhhs.nc.gov. 3. Send any questions about DCDEE Moodle trainings to dcdee_moodle_support@dhhs.nc.gov. Tips for MY NCID Users Did you know that if you do not login on any DCDEE platforms (e.g., Moodle, WORKS, CBC) for a period of 12 months, your account will be archived? An archived account cannot be reinstated. You will need to create a new one and then email all platforms (e.g., Moodle, WORKS, CBC) to merge accounts. Pro Tip: Set your calendar to remind you every 6 months to login and out at https://myncid.nc.gov to keep your account activated and it will NOT be archived. At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Karen Young, Child Care Consultant (336) 207-2151 Karen.young@dhhs.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ Violation Number Comment Rule 1885 When a parent had opted out, but did not provide a snack or meal, the program did not replace the missing meal or snack. A child whose parents opt-out, was not provided a nutritious meal by the program on February 14, 2025. .0901(d)(4) 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 .1722 · Violation
Name of Operation: LEARNING THRU PLAY TOO CHILD DEVELOPMENT CENTER Facility ID: 05000067 Consultant: KAREN YOUNG Operation Type: Center Case Number: 0225-200L Visit Date: 2/24/2025 Number Present: 15 Completed Date: 2/24/2025 Age: From 4 To 5 Total Minutes: 300 Time In: 11:15 AM Time Out: 04:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to obtain information regarding alleged violations of childcare requirements. This visit was conducted by Karen Young, childcare consultant with Donna Wilkinson, Director. The allegations are as follows: There is a concern related to nutrition. 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. During today’s visit, the allegations were discussed with you. You had the opportunity to respond. Information shared during this visit are documented in this visit summary. There are eighty-one (81) total children present in the program today. Your program currently operates with a Five (5) Star license effective 10/22/18. Restrictions include 1st shift day time care; meets enhanced ratios; meets enhanced space; children under 2.5 years in rooms with direct exits only. The owner is listed as Debbie L. Williams who is the sole proprietor of Learning Thru Play Too Child Development Center. The program’s compliance history was 95% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • Adequate / Approved Space • License Posted • Permit Restrictions Allegation #1: There is a concern related to nutrition. Observation #1: During today’s visit, I observed the NC pre-k classroom. I asked if there were any nutrition opt-out forms for any of the children in this classroom and I reviewed one opt -out form for the child in the Pre-K classroom during the visit today. I asked if parents were contacted if the child opts-out, but parents fail to send lunch, what happens next. Director Donna Wilkinson and assistant Director Tisha Thomas stated that they always order an extra plate from the school system in case they ever need an extra plate and they also have food that is prepared for the infant/toddler wing of the school. So, they always have two (2) extra plates available for children. Currently, they have two (2) children in the entire school who opt-out. Parents are not usually contacted to have an opportunity to bring lunch for their child, if they have forgotten lunch since two (2) plates are always extra. The child did have breakfast bread on February 14, 2025. Mom had brought in blueberries and blackberries for the afternoon Valentine party snack. When mom brought the child into the 3-year-old classroom for early arrival on the 14th of February, mom stated to the floater, A Price and to the cook M. Bare, who was in the room giving breakfast that she had not packed breakfast or lunch for that day thinking since it was a party day that food was provided for the party. M. Bare, cook, stated to the mother, per A. Price, floater, that she could not provide food for the child since she opts-out and was not in the food program. It was reported that mom looked surprised but went on to work. The child did have breakfast bread for breakfast, but the child refused the bread and pushed it away. The lead teacher and teacher in this classroom were not present on February 14, 2025 since it was an optional teacher work day for the NC Pre-K and Ashe County Public School. The staff in the room on this day was Mackenzie Price, floater. I interviewed M. Price over the phone today. She stated that the child did not have any lunch, so M. Price called the 3 year old classroom and A. Price, floater, made the child a plate of snack party food for the child’s lunch which consisted of chips and dip, cheese puffs, applesauce, a juice box, and the floater’s own oats and honey bar. A Price brought the snack plate over to the 4 year old classroom. A. Price stated she knew that child had no allergies and wanted the child to have food to eat. I observed the children having lunch today in the pre-k space today regarding the events that allegedly took place on February 14, 2025. I also interviewed the cook of the center to ask if she was asked to prepare a plate for the child in the pre-k classroom. The cook stated that she did not tell the mom she could not have a plate. I asked to view and then viewed the camera footage for February 14, 2025 in the pre-k classroom during lunch time on the date of February 14, 2025. Camera footage began at 11:19 am when cook, M. Bare starts serving food. In the film footage, at 11:25 am I was able to view an empty plate at the child’s space and the child go over to the space and sit down. At 11:26 I saw M. Price go over to the phone to make a call. At 11:28 I saw A. Price come into the room with a plate of items that I could not make out in the video. A. Price sated the items were chips and dip, cheese puffs, applesauce, juice box and an oats and honey bar. The child begins to eat the food and continues to eat until 12:01 when the child gets up from the table. I also reviewed the center’s operational policies related to nutrition. I also asked to see the menu from the week of February 14, 2025. I observed the camera footage for breakfast on February 14th, 2025. The child was offered breakfast bread for breakfast but pushed the plate away and refused. Donna Wilkinson and Tisha Thomas were not made aware that the child did not have lunch that day, or they would have provided a nutritious lunch for the child with the extra plates. The optout form for this child began 1/14/25. Prior to this date, the child was being provided a plate from the school but not eating anything. The child drinks only water. Conclusion #1: Based on the above information, observation, video footage viewed and interviews during today’s visit, the allegation was confirmed and substantiated. Allegation #2: 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. Observation #2: The child was viewed on the camera footage eating the plate of snack food provided to her by staff. The child was not crying or seemingly upset at anything. She was eating her food and sitting beside the other children. The child was not seen being mistreated in any manner. Conclusion #2: Based on the above information, observations, and video footage during today’s visit, the allegation regarding nurture care of children could not be confirmed. This allegation was unsubstantiated. The following violations were cited during today’s visit: Comments Section – Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violation cited during today's visit immediately and send me documentation verifying compliance on or before Monday, March 10, 2025. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation You may email the letter to karen.young@dhhs.nc.gov or mail two copies of the letter to: Karen Young P.O. Box 1012 Lewisville, NC 27023 If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action being taken by the DCDEE. Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action being taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit: Nutrition is vital for a child's healthy growth and development. It helps children build strong bones and muscles, develop their brains, and maintain a healthy weight. Nutrition is important for physical health and brain development. • 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS Meals and snacks served to children in a child care center shall comply with the Meal Patterns for Children in Child Care Programs from the United States Department of Agriculture (USDA) which are based on the recommended nutrient intake judged by the National Research Council to be adequate for maintaining good nutrition. The types of food, number and size of servings shall be appropriate for the ages and developmental levels of the children in care. The Meal Patterns for Children in Child Care Programs are incorporated by reference and include subsequent amendments. A copy of the Meal Patterns for Children in Child Care Programs is available online at https://www.fns.usda.gov/cacfp/meals-and-snacks. When food is prepared by or provided by the center, menus for nutritious meals and snacks shall be planned at least one week in advance. At least one dated copy of the current week's menu shall be posted where it can be seen by parents and food preparation staff when food is prepared or provided by the center. A variety of food shall be included in meals and snacks. Any substitution shall be of comparable food value and shall be recorded on the menu prior to the meal or snack being served. When children bring their own food for meals or snacks to the center, if the food does not meet the nutritional requirements specified in Paragraph (a) of this Rule, the center must provide additional food necessary to meet those requirements. A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. Drinking water shall be freely available to children of all ages. Drinking fountains or individual drinking utensils shall be provided. When a private water supply is used, it must be tested by and meet the requirements of the Commission for Public Health as set forth in 15A NCAC 18A .2800. The child care provider shall serve only the following beverages: (1) breast milk, as specified in Paragraph (k) of this Rule; (2) formula; (3) water; (4) unflavored whole milk, for children ages 12-23 months; (5) unflavored skim or lowfat milk for children 24 months through five years; (6) unflavored skim milk, unflavored low-fat milk, or flavored skim milk for children six years and older; or (7) 100 percent fruit juice, limited to 6 ounces per day, for all ages. Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. The food required by special diets for medical, religious, or cultural reasons, or parental preferences, may be provided by the center or may be brought to the center by the parents. If the diet is prescribed by a health care professional, a statement signed by the health care professional shall be on file at the center and written instructions shall be provided by the child's parent, health care professional, or a licensed dietitian/nutritionist. If the diet is not prescribed by a health care professional, written instructions shall be provided by the child's parent and shall be on file at the center. Food that does not meet the nutritional requirements specified in Paragraph (a) of this Rule, such as cupcakes, cakes, and donuts shall only be offered for special occasions such as holidays and birthdays. Staff shall role model appropriate eating behaviors by consuming only food or beverages that meet the nutritional requirements specified in Paragraph (a) of this Rule in the presence of children in care. • 10A NCAC 09 .2411 NUTRITION REQUIREMENTS Meals and snacks shall be provided in accordance with Section .0900 of this Chapter unless a child's individualized plan of care specifies otherwise. • 10A NCAC 09 .1722 PROHIBITED DISCIPLINE No child shall be subjected to any form of corporal punishment by the family child care home operator, additional caregiver, substitute provider, or any other person in the home, whether or not these persons reside in the home as follows: (1) No child shall be handled roughly in any way, including shaking, pushing, shoving, pinching, slapping, biting, kicking, or spanking; (2) No child shall ever be placed in a locked room, closet, or box, or be left alone in a room separated from staff; (3) No discipline shall ever be delegated to another child; (4) No food shall be withheld or given as a means of punishment or reward; (5) No child shall ever be disciplined for toileting accidents; (6) No child shall ever be disciplined for not sleeping during rest period; (7) No child shall be disciplined by assigning chores that require contact with or use (8) Physical activity, such as running laps and doing push-ups, shall not be withheld or required as punishment; (9) No child shall ever be yelled at, shamed, humiliated, frightened, threatened, or bullied; and (10) No child shall be restrained as a form of discipline unless the child's safety or the safety of others is at risk. For purposes of this Rule, "restraining" shall mean that a caregiver physically holds a child in a manner that restricts the child's movement, for a minimum amount of time necessary to ensure a safe environment. Children shall not be restrained through the use of heavy objects, including a caregiver's body, or any device such as straps, blankets, car seats, or cribs. of hazardous materials, such as cleaning bathrooms or floors, or emptying diaper pails; Discipline practices shall be age and developmentally appropriate. * § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (10) Each operator or staff member shall attend to any child in a nurturing and appropriate manner, and in keeping with the child's developmental needs. Each child care facility shall have a written policy on discipline, describing the methods and practices used to discipline children enrolled in that facility. This written policy shall be discussed with, and a copy given to, each child's parent prior to the first time the child attends the facility. Subsequently, any change in discipline methods or practices shall be communicated in writing to the parents prior to the effective date of the change. * Chapter 4: Nutrition and Food Service 4.2 General Requirements 4.2.0 4.2.0.8: Feeding Plans and Dietary Modifications Before a child enters an early care and education facility, the facility should obtain a written history that contains any special nutrition or feeding needs for the child, including use of human milk or any special feeding utensils. The staff should review this history with the child’s parents/guardians, clarifying and discussing how the parents’/guardians’ home feeding routines may differ from the facility’s planned routine. The child’s primary health care provider should provide written information to the parent/guardian about any dietary modifications or special feeding techniques that are required at the early care and education program so they can be shared with and implemented by the program. If dietary modifications are indicated, based on a child’s medical or special dietary needs, caregivers/teachers should modify or supplement the child’s diet to meet the individual child’s specific needs. Dietary modifications should be made in consultation with the parents/guardians and the child’s primary health care provider. Caregivers/teachers can consult with a nutritionist/registered dietitian. A child’s diet may be modified because of food sensitivity, a food allergy, or many other reasons. includes a range of conditions in which a child exhibits an adverse reaction to a food that, in some instances, can be life-threatening. Modification of a child’s diet may also be related to a food allergy, an inability to digest or to tolerate certain foods, a need for extra calories, a need for special positioning while eating, diabetes and the need to match food with insulin, food idiosyncrasies, and other identified feeding issues, including celiac disease, phenylketonuria, diabetes, and severe food allergy (anaphylaxis). In some cases, a child may become ill if he/she is unable to eat, so missing a meal could have a negative consequence, especially for children with diabetes. For a child with special health care needs who requires dietary modifications or special feeding techniques, written instructions from the child’s parent/guardian and the child’s primary health care provider should be provided in the child’s record and carried out accordingly. Dietary modifications should be recorded. These written instructions must identify a. The child’s full name and date of instructions b. The child’s special health care needs c. Any dietary restrictions based on those special needs d. Any special feeding or eating utensils e. Any foods to be omitted from the diet and any foods to be substituted f. Any other pertinent information about the child’s special health care needs g. What, if anything, needs to be done if the child is exposed to restricted foods The written history of special nutrition or feeding needs should be used to develop individual feeding plans and, collectively, to develop facility menus. Health care providers with experience in disciplines related to special nutrition needs, including nutrition, nursing, speech therapy, occupational therapy, and physical therapy, should participate when needed and/or when they are available to the facility. If available, the nutritionist/registered dietitian should approve menus that accommodate needed dietary modifications. The feeding plan should include steps to take when a situation arises that requires rapid response by the staff, such as a child choking during mealtime or a child with a known history of food allergies demonstrating signs and symptoms of anaphylaxis (severe allergic reaction), such as difficulty breathing and severe redness and swelling of the face or mouth. The completed plan should be on file and accessible to staff and available to parents/guardians on request. Food sensitivity RATIONALE Children with special health care needs may have individual requirements related to diet and swallowing, involving special feeding 4.2.0.8: Feeding Plans and Dietary Modifications 02/24/2025 1 Standards from Caring for Our Children Online Database Close collaboration between families and the facility is necessary for children on special diets. Parents/guardians may have to provide food on a temporary, or even permanent, basis, if the facility, after exploring all community resources, is unable to provide the special diet. Programs may consider using the American Academy of Pediatrics (AAP) Allergy and Anaphylaxis Emergency Plan, which is included in the AAP clinical report, (4). Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home Care Plan for Children with Special Health Care Needs Written Nutrition Plan Assessment and Planning of Nutrition for Individual Children Vegetarian/Vegan Diets Responsive Feeding of Infants by a Consistent Caregiver/Teacher Foods that Are Choking Hazards utensils and feeding needs that will necessitate the development of an individual plan prior to their entry into the facility (1). Many children with special health care needs have difficulty with feeding, including delayed attainment of basic chewing, swallowing, and independent feeding skills. Food, eating style, food utensils, and equipment, including furniture, may have to be adapted to meet the developmental and physical needs of individual children (2,3,). Some children have difficulty with slow weight gain and need their caloric intake monitored and supplemented. Others, such as those with diabetes, may need to have their diet matched to their medication (e.g., insulin, if they are on a fixed dose of insulin). Some children are unable to tolerate certain foods because of their allergy to the food or their inability to digest it. The 8 most common foods to cause anaphylaxis in children are cow’s milk, eggs, soy, wheat, fish, shellfish, peanuts, and tree nuts (3). Staff members must know ahead of time what procedures to follow, as well as their designated roles, during an emergency. As a safety and health precaution, staff should know in advance whether a child has food allergies, inborn errors of metabolism, diabetes, celiac disease, tongue thrust, or special health care needs related to feeding, such as requiring special feeding utensils or equipment, nasogastric or gastric tube feedings, or special positioning. These situations require individual planning prior to the child’s entry into an early care and education program and on an ongoing basis (2). In some cases, dietary modifications are based on religious or cultural beliefs. Detailed information on each child’s special needs, whether stemming from dietary, feeding equipment, or cultural needs, is invaluable to the facility staff in meeting the nutritional needs of all the children in their care. COMMENTS Guidance on Completing a Written Allergy and Anaphylaxis Emergency Plan TYPE OF FACILITY RELATED STANDARDS 3.5.0.1 4.2.0.1 4.2.0.2 4.2.0.12 4.3.1.2 4.5.0.10 REFERENCES 1. Samour PQ, King K. Pediatric Nutrition. 4th ed. Sunbury, MA: Jones and Bartlett Learning; 2010 2. Kleinman RE, Greer FR, eds. Pediatric Nutrition. 7th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2014 3. Kaczkowski CH, Caffrey C. Pediatric nutrition. In: Blanchfield DS, ed. : . Vol 3. 3rd ed. Farmington Hills, MI: Gale; 2016:2063–2066 The Gale Encyclopedia of Children's Health Infancy Through Adolescence 4. Wang J, Sicherer SH; American Academy of Pediatrics Section on Allergy and Immunology. Guidance on completing a written allergy and anaphylaxis emergency plan. Pediatrics. 2017;139(3):e20164005 NOTES Content in the STANDARD was modified on 11/9/2017. 4.2.0.8: Feeding Plans and Dietary Modifications 02/24/2025 2 Standards from Caring for Our Children Online Database Additional Information/Consultation: • You must notify your consultant 30 days prior to changing the ownership status of your facility. • We discussed having a staff meeting with everyone to address the nutritional requirements and opt out requirements. • Remind staff to keep administration aware of any questionable situation so they are always aware of what is going on. • Visit NCRLAP website and read the information on Connecting with the Three’s! ECERS-3 and ITERS 3 will be used beginning 2/1/25. • The QRIS is in the process of being implemented and is now open for public comment. Go to the Division’s website, under What’s New and scroll down to QRIS Modernization, then read about QRIS Modernization Rulemaking Update. The Public comment is open 2/3/25 through 4/4/25. This is your opportunity to comment. • 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) 814-6401 and someone will assist you. • Public schools and licensed child care facilities in North Carolina are eligible to participate in the funding mechanisms to cover the costs of testing for lead in water and inspecting for asbestos and lead-based paint hazards beyond the May 1, 2024 deadline listed in 10A NCAC 41C .1002(a). Due to the recent impacts of Hurricane Helene and other natural disasters, this deadline has been revised statewide, and facilities that have not yet enrolled should complete the online process by May 31, 2025. The Clean Classrooms for Carolina Kids Program is providing free facility-wide testing and inspections without any out-of-pocket costs. Due to the volume of testing and inspections, completion of the online enrollment process in the program is considered temporary compliance with the testing and inspection requirement and will allow facilities to participate in the funding mechanisms. Required water testing for child care centers under rule 15A NCAC 18A .2816 is not affected by the new May 31, 2025 deadline. Enroll today at https://www.cleanwaterforcarolinakids.org/enroll. If you have enrolled for only one or two of the program sections, log back in to complete surveys for the remaining section(s) to comply with the rule requirements. Thank you for your participation in ensuring healthy learning environments for children across North Carolina. Please contact me at ed.norman@dhhs.nc.gov or 919-218-6511 if you have questions regarding this guidance. * Moodle Helpful Hints 1. When on the Moodle homepage, scroll down past the three-square boxes to find directions to self-register for various training opportunities. 2. If you do not access a training opportunity for 150 days, the training will be suspended. To regain access, email a request to set status to “active” including the name of the training course to dcdee_moodle_support@dhhs.nc.gov. 3. Send any questions about DCDEE Moodle trainings to dcdee_moodle_support@dhhs.nc.gov. Tips for MY NCID Users Did you know that if you do not login on any DCDEE platforms (e.g., Moodle, WORKS, CBC) for a period of 12 months, your account will be archived? An archived account cannot be reinstated. You will need to create a new one and then email all platforms (e.g., Moodle, WORKS, CBC) to merge accounts. Pro Tip: Set your calendar to remind you every 6 months to login and out at https://myncid.nc.gov to keep your account activated and it will NOT be archived. At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Karen Young, Child Care Consultant (336) 207-2151 Karen.young@dhhs.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ Violation Number Comment Rule 1885 When a parent had opted out, but did not provide a snack or meal, the program did not replace the missing meal or snack. A child whose parents opt-out, was not provided a nutritious meal by the program on February 14, 2025. .0901(d)(4) 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 .2411 · Violation
Name of Operation: LEARNING THRU PLAY TOO CHILD DEVELOPMENT CENTER Facility ID: 05000067 Consultant: KAREN YOUNG Operation Type: Center Case Number: 0225-200L Visit Date: 2/24/2025 Number Present: 15 Completed Date: 2/24/2025 Age: From 4 To 5 Total Minutes: 300 Time In: 11:15 AM Time Out: 04:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to obtain information regarding alleged violations of childcare requirements. This visit was conducted by Karen Young, childcare consultant with Donna Wilkinson, Director. The allegations are as follows: There is a concern related to nutrition. 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. During today’s visit, the allegations were discussed with you. You had the opportunity to respond. Information shared during this visit are documented in this visit summary. There are eighty-one (81) total children present in the program today. Your program currently operates with a Five (5) Star license effective 10/22/18. Restrictions include 1st shift day time care; meets enhanced ratios; meets enhanced space; children under 2.5 years in rooms with direct exits only. The owner is listed as Debbie L. Williams who is the sole proprietor of Learning Thru Play Too Child Development Center. The program’s compliance history was 95% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • Adequate / Approved Space • License Posted • Permit Restrictions Allegation #1: There is a concern related to nutrition. Observation #1: During today’s visit, I observed the NC pre-k classroom. I asked if there were any nutrition opt-out forms for any of the children in this classroom and I reviewed one opt -out form for the child in the Pre-K classroom during the visit today. I asked if parents were contacted if the child opts-out, but parents fail to send lunch, what happens next. Director Donna Wilkinson and assistant Director Tisha Thomas stated that they always order an extra plate from the school system in case they ever need an extra plate and they also have food that is prepared for the infant/toddler wing of the school. So, they always have two (2) extra plates available for children. Currently, they have two (2) children in the entire school who opt-out. Parents are not usually contacted to have an opportunity to bring lunch for their child, if they have forgotten lunch since two (2) plates are always extra. The child did have breakfast bread on February 14, 2025. Mom had brought in blueberries and blackberries for the afternoon Valentine party snack. When mom brought the child into the 3-year-old classroom for early arrival on the 14th of February, mom stated to the floater, A Price and to the cook M. Bare, who was in the room giving breakfast that she had not packed breakfast or lunch for that day thinking since it was a party day that food was provided for the party. M. Bare, cook, stated to the mother, per A. Price, floater, that she could not provide food for the child since she opts-out and was not in the food program. It was reported that mom looked surprised but went on to work. The child did have breakfast bread for breakfast, but the child refused the bread and pushed it away. The lead teacher and teacher in this classroom were not present on February 14, 2025 since it was an optional teacher work day for the NC Pre-K and Ashe County Public School. The staff in the room on this day was Mackenzie Price, floater. I interviewed M. Price over the phone today. She stated that the child did not have any lunch, so M. Price called the 3 year old classroom and A. Price, floater, made the child a plate of snack party food for the child’s lunch which consisted of chips and dip, cheese puffs, applesauce, a juice box, and the floater’s own oats and honey bar. A Price brought the snack plate over to the 4 year old classroom. A. Price stated she knew that child had no allergies and wanted the child to have food to eat. I observed the children having lunch today in the pre-k space today regarding the events that allegedly took place on February 14, 2025. I also interviewed the cook of the center to ask if she was asked to prepare a plate for the child in the pre-k classroom. The cook stated that she did not tell the mom she could not have a plate. I asked to view and then viewed the camera footage for February 14, 2025 in the pre-k classroom during lunch time on the date of February 14, 2025. Camera footage began at 11:19 am when cook, M. Bare starts serving food. In the film footage, at 11:25 am I was able to view an empty plate at the child’s space and the child go over to the space and sit down. At 11:26 I saw M. Price go over to the phone to make a call. At 11:28 I saw A. Price come into the room with a plate of items that I could not make out in the video. A. Price sated the items were chips and dip, cheese puffs, applesauce, juice box and an oats and honey bar. The child begins to eat the food and continues to eat until 12:01 when the child gets up from the table. I also reviewed the center’s operational policies related to nutrition. I also asked to see the menu from the week of February 14, 2025. I observed the camera footage for breakfast on February 14th, 2025. The child was offered breakfast bread for breakfast but pushed the plate away and refused. Donna Wilkinson and Tisha Thomas were not made aware that the child did not have lunch that day, or they would have provided a nutritious lunch for the child with the extra plates. The optout form for this child began 1/14/25. Prior to this date, the child was being provided a plate from the school but not eating anything. The child drinks only water. Conclusion #1: Based on the above information, observation, video footage viewed and interviews during today’s visit, the allegation was confirmed and substantiated. Allegation #2: 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. Observation #2: The child was viewed on the camera footage eating the plate of snack food provided to her by staff. The child was not crying or seemingly upset at anything. She was eating her food and sitting beside the other children. The child was not seen being mistreated in any manner. Conclusion #2: Based on the above information, observations, and video footage during today’s visit, the allegation regarding nurture care of children could not be confirmed. This allegation was unsubstantiated. The following violations were cited during today’s visit: Comments Section – Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violation cited during today's visit immediately and send me documentation verifying compliance on or before Monday, March 10, 2025. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation You may email the letter to karen.young@dhhs.nc.gov or mail two copies of the letter to: Karen Young P.O. Box 1012 Lewisville, NC 27023 If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action being taken by the DCDEE. Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action being taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit: Nutrition is vital for a child's healthy growth and development. It helps children build strong bones and muscles, develop their brains, and maintain a healthy weight. Nutrition is important for physical health and brain development. • 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS Meals and snacks served to children in a child care center shall comply with the Meal Patterns for Children in Child Care Programs from the United States Department of Agriculture (USDA) which are based on the recommended nutrient intake judged by the National Research Council to be adequate for maintaining good nutrition. The types of food, number and size of servings shall be appropriate for the ages and developmental levels of the children in care. The Meal Patterns for Children in Child Care Programs are incorporated by reference and include subsequent amendments. A copy of the Meal Patterns for Children in Child Care Programs is available online at https://www.fns.usda.gov/cacfp/meals-and-snacks. When food is prepared by or provided by the center, menus for nutritious meals and snacks shall be planned at least one week in advance. At least one dated copy of the current week's menu shall be posted where it can be seen by parents and food preparation staff when food is prepared or provided by the center. A variety of food shall be included in meals and snacks. Any substitution shall be of comparable food value and shall be recorded on the menu prior to the meal or snack being served. When children bring their own food for meals or snacks to the center, if the food does not meet the nutritional requirements specified in Paragraph (a) of this Rule, the center must provide additional food necessary to meet those requirements. A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. Drinking water shall be freely available to children of all ages. Drinking fountains or individual drinking utensils shall be provided. When a private water supply is used, it must be tested by and meet the requirements of the Commission for Public Health as set forth in 15A NCAC 18A .2800. The child care provider shall serve only the following beverages: (1) breast milk, as specified in Paragraph (k) of this Rule; (2) formula; (3) water; (4) unflavored whole milk, for children ages 12-23 months; (5) unflavored skim or lowfat milk for children 24 months through five years; (6) unflavored skim milk, unflavored low-fat milk, or flavored skim milk for children six years and older; or (7) 100 percent fruit juice, limited to 6 ounces per day, for all ages. Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. The food required by special diets for medical, religious, or cultural reasons, or parental preferences, may be provided by the center or may be brought to the center by the parents. If the diet is prescribed by a health care professional, a statement signed by the health care professional shall be on file at the center and written instructions shall be provided by the child's parent, health care professional, or a licensed dietitian/nutritionist. If the diet is not prescribed by a health care professional, written instructions shall be provided by the child's parent and shall be on file at the center. Food that does not meet the nutritional requirements specified in Paragraph (a) of this Rule, such as cupcakes, cakes, and donuts shall only be offered for special occasions such as holidays and birthdays. Staff shall role model appropriate eating behaviors by consuming only food or beverages that meet the nutritional requirements specified in Paragraph (a) of this Rule in the presence of children in care. • 10A NCAC 09 .2411 NUTRITION REQUIREMENTS Meals and snacks shall be provided in accordance with Section .0900 of this Chapter unless a child's individualized plan of care specifies otherwise. • 10A NCAC 09 .1722 PROHIBITED DISCIPLINE No child shall be subjected to any form of corporal punishment by the family child care home operator, additional caregiver, substitute provider, or any other person in the home, whether or not these persons reside in the home as follows: (1) No child shall be handled roughly in any way, including shaking, pushing, shoving, pinching, slapping, biting, kicking, or spanking; (2) No child shall ever be placed in a locked room, closet, or box, or be left alone in a room separated from staff; (3) No discipline shall ever be delegated to another child; (4) No food shall be withheld or given as a means of punishment or reward; (5) No child shall ever be disciplined for toileting accidents; (6) No child shall ever be disciplined for not sleeping during rest period; (7) No child shall be disciplined by assigning chores that require contact with or use (8) Physical activity, such as running laps and doing push-ups, shall not be withheld or required as punishment; (9) No child shall ever be yelled at, shamed, humiliated, frightened, threatened, or bullied; and (10) No child shall be restrained as a form of discipline unless the child's safety or the safety of others is at risk. For purposes of this Rule, "restraining" shall mean that a caregiver physically holds a child in a manner that restricts the child's movement, for a minimum amount of time necessary to ensure a safe environment. Children shall not be restrained through the use of heavy objects, including a caregiver's body, or any device such as straps, blankets, car seats, or cribs. of hazardous materials, such as cleaning bathrooms or floors, or emptying diaper pails; Discipline practices shall be age and developmentally appropriate. * § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (10) Each operator or staff member shall attend to any child in a nurturing and appropriate manner, and in keeping with the child's developmental needs. Each child care facility shall have a written policy on discipline, describing the methods and practices used to discipline children enrolled in that facility. This written policy shall be discussed with, and a copy given to, each child's parent prior to the first time the child attends the facility. Subsequently, any change in discipline methods or practices shall be communicated in writing to the parents prior to the effective date of the change. * Chapter 4: Nutrition and Food Service 4.2 General Requirements 4.2.0 4.2.0.8: Feeding Plans and Dietary Modifications Before a child enters an early care and education facility, the facility should obtain a written history that contains any special nutrition or feeding needs for the child, including use of human milk or any special feeding utensils. The staff should review this history with the child’s parents/guardians, clarifying and discussing how the parents’/guardians’ home feeding routines may differ from the facility’s planned routine. The child’s primary health care provider should provide written information to the parent/guardian about any dietary modifications or special feeding techniques that are required at the early care and education program so they can be shared with and implemented by the program. If dietary modifications are indicated, based on a child’s medical or special dietary needs, caregivers/teachers should modify or supplement the child’s diet to meet the individual child’s specific needs. Dietary modifications should be made in consultation with the parents/guardians and the child’s primary health care provider. Caregivers/teachers can consult with a nutritionist/registered dietitian. A child’s diet may be modified because of food sensitivity, a food allergy, or many other reasons. includes a range of conditions in which a child exhibits an adverse reaction to a food that, in some instances, can be life-threatening. Modification of a child’s diet may also be related to a food allergy, an inability to digest or to tolerate certain foods, a need for extra calories, a need for special positioning while eating, diabetes and the need to match food with insulin, food idiosyncrasies, and other identified feeding issues, including celiac disease, phenylketonuria, diabetes, and severe food allergy (anaphylaxis). In some cases, a child may become ill if he/she is unable to eat, so missing a meal could have a negative consequence, especially for children with diabetes. For a child with special health care needs who requires dietary modifications or special feeding techniques, written instructions from the child’s parent/guardian and the child’s primary health care provider should be provided in the child’s record and carried out accordingly. Dietary modifications should be recorded. These written instructions must identify a. The child’s full name and date of instructions b. The child’s special health care needs c. Any dietary restrictions based on those special needs d. Any special feeding or eating utensils e. Any foods to be omitted from the diet and any foods to be substituted f. Any other pertinent information about the child’s special health care needs g. What, if anything, needs to be done if the child is exposed to restricted foods The written history of special nutrition or feeding needs should be used to develop individual feeding plans and, collectively, to develop facility menus. Health care providers with experience in disciplines related to special nutrition needs, including nutrition, nursing, speech therapy, occupational therapy, and physical therapy, should participate when needed and/or when they are available to the facility. If available, the nutritionist/registered dietitian should approve menus that accommodate needed dietary modifications. The feeding plan should include steps to take when a situation arises that requires rapid response by the staff, such as a child choking during mealtime or a child with a known history of food allergies demonstrating signs and symptoms of anaphylaxis (severe allergic reaction), such as difficulty breathing and severe redness and swelling of the face or mouth. The completed plan should be on file and accessible to staff and available to parents/guardians on request. Food sensitivity RATIONALE Children with special health care needs may have individual requirements related to diet and swallowing, involving special feeding 4.2.0.8: Feeding Plans and Dietary Modifications 02/24/2025 1 Standards from Caring for Our Children Online Database Close collaboration between families and the facility is necessary for children on special diets. Parents/guardians may have to provide food on a temporary, or even permanent, basis, if the facility, after exploring all community resources, is unable to provide the special diet. Programs may consider using the American Academy of Pediatrics (AAP) Allergy and Anaphylaxis Emergency Plan, which is included in the AAP clinical report, (4). Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home Care Plan for Children with Special Health Care Needs Written Nutrition Plan Assessment and Planning of Nutrition for Individual Children Vegetarian/Vegan Diets Responsive Feeding of Infants by a Consistent Caregiver/Teacher Foods that Are Choking Hazards utensils and feeding needs that will necessitate the development of an individual plan prior to their entry into the facility (1). Many children with special health care needs have difficulty with feeding, including delayed attainment of basic chewing, swallowing, and independent feeding skills. Food, eating style, food utensils, and equipment, including furniture, may have to be adapted to meet the developmental and physical needs of individual children (2,3,). Some children have difficulty with slow weight gain and need their caloric intake monitored and supplemented. Others, such as those with diabetes, may need to have their diet matched to their medication (e.g., insulin, if they are on a fixed dose of insulin). Some children are unable to tolerate certain foods because of their allergy to the food or their inability to digest it. The 8 most common foods to cause anaphylaxis in children are cow’s milk, eggs, soy, wheat, fish, shellfish, peanuts, and tree nuts (3). Staff members must know ahead of time what procedures to follow, as well as their designated roles, during an emergency. As a safety and health precaution, staff should know in advance whether a child has food allergies, inborn errors of metabolism, diabetes, celiac disease, tongue thrust, or special health care needs related to feeding, such as requiring special feeding utensils or equipment, nasogastric or gastric tube feedings, or special positioning. These situations require individual planning prior to the child’s entry into an early care and education program and on an ongoing basis (2). In some cases, dietary modifications are based on religious or cultural beliefs. Detailed information on each child’s special needs, whether stemming from dietary, feeding equipment, or cultural needs, is invaluable to the facility staff in meeting the nutritional needs of all the children in their care. COMMENTS Guidance on Completing a Written Allergy and Anaphylaxis Emergency Plan TYPE OF FACILITY RELATED STANDARDS 3.5.0.1 4.2.0.1 4.2.0.2 4.2.0.12 4.3.1.2 4.5.0.10 REFERENCES 1. Samour PQ, King K. Pediatric Nutrition. 4th ed. Sunbury, MA: Jones and Bartlett Learning; 2010 2. Kleinman RE, Greer FR, eds. Pediatric Nutrition. 7th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2014 3. Kaczkowski CH, Caffrey C. Pediatric nutrition. In: Blanchfield DS, ed. : . Vol 3. 3rd ed. Farmington Hills, MI: Gale; 2016:2063–2066 The Gale Encyclopedia of Children's Health Infancy Through Adolescence 4. Wang J, Sicherer SH; American Academy of Pediatrics Section on Allergy and Immunology. Guidance on completing a written allergy and anaphylaxis emergency plan. Pediatrics. 2017;139(3):e20164005 NOTES Content in the STANDARD was modified on 11/9/2017. 4.2.0.8: Feeding Plans and Dietary Modifications 02/24/2025 2 Standards from Caring for Our Children Online Database Additional Information/Consultation: • You must notify your consultant 30 days prior to changing the ownership status of your facility. • We discussed having a staff meeting with everyone to address the nutritional requirements and opt out requirements. • Remind staff to keep administration aware of any questionable situation so they are always aware of what is going on. • Visit NCRLAP website and read the information on Connecting with the Three’s! ECERS-3 and ITERS 3 will be used beginning 2/1/25. • The QRIS is in the process of being implemented and is now open for public comment. Go to the Division’s website, under What’s New and scroll down to QRIS Modernization, then read about QRIS Modernization Rulemaking Update. The Public comment is open 2/3/25 through 4/4/25. This is your opportunity to comment. • 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) 814-6401 and someone will assist you. • Public schools and licensed child care facilities in North Carolina are eligible to participate in the funding mechanisms to cover the costs of testing for lead in water and inspecting for asbestos and lead-based paint hazards beyond the May 1, 2024 deadline listed in 10A NCAC 41C .1002(a). Due to the recent impacts of Hurricane Helene and other natural disasters, this deadline has been revised statewide, and facilities that have not yet enrolled should complete the online process by May 31, 2025. The Clean Classrooms for Carolina Kids Program is providing free facility-wide testing and inspections without any out-of-pocket costs. Due to the volume of testing and inspections, completion of the online enrollment process in the program is considered temporary compliance with the testing and inspection requirement and will allow facilities to participate in the funding mechanisms. Required water testing for child care centers under rule 15A NCAC 18A .2816 is not affected by the new May 31, 2025 deadline. Enroll today at https://www.cleanwaterforcarolinakids.org/enroll. If you have enrolled for only one or two of the program sections, log back in to complete surveys for the remaining section(s) to comply with the rule requirements. Thank you for your participation in ensuring healthy learning environments for children across North Carolina. Please contact me at ed.norman@dhhs.nc.gov or 919-218-6511 if you have questions regarding this guidance. * Moodle Helpful Hints 1. When on the Moodle homepage, scroll down past the three-square boxes to find directions to self-register for various training opportunities. 2. If you do not access a training opportunity for 150 days, the training will be suspended. To regain access, email a request to set status to “active” including the name of the training course to dcdee_moodle_support@dhhs.nc.gov. 3. Send any questions about DCDEE Moodle trainings to dcdee_moodle_support@dhhs.nc.gov. Tips for MY NCID Users Did you know that if you do not login on any DCDEE platforms (e.g., Moodle, WORKS, CBC) for a period of 12 months, your account will be archived? An archived account cannot be reinstated. You will need to create a new one and then email all platforms (e.g., Moodle, WORKS, CBC) to merge accounts. Pro Tip: Set your calendar to remind you every 6 months to login and out at https://myncid.nc.gov to keep your account activated and it will NOT be archived. At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Karen Young, Child Care Consultant (336) 207-2151 Karen.young@dhhs.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ Violation Number Comment Rule 1885 When a parent had opted out, but did not provide a snack or meal, the program did not replace the missing meal or snack. A child whose parents opt-out, was not provided a nutritious meal by the program on February 14, 2025. .0901(d)(4) 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: LEARNING THRU PLAY TOO CHILD DEVELOPMENT CENTER Facility ID: 05000067 Consultant: KAREN YOUNG Operation Type: Center Case Number: 0225-200L Visit Date: 2/24/2025 Number Present: 15 Completed Date: 2/24/2025 Age: From 4 To 5 Total Minutes: 300 Time In: 11:15 AM Time Out: 04:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to obtain information regarding alleged violations of childcare requirements. This visit was conducted by Karen Young, childcare consultant with Donna Wilkinson, Director. The allegations are as follows: There is a concern related to nutrition. 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. During today’s visit, the allegations were discussed with you. You had the opportunity to respond. Information shared during this visit are documented in this visit summary. There are eighty-one (81) total children present in the program today. Your program currently operates with a Five (5) Star license effective 10/22/18. Restrictions include 1st shift day time care; meets enhanced ratios; meets enhanced space; children under 2.5 years in rooms with direct exits only. The owner is listed as Debbie L. Williams who is the sole proprietor of Learning Thru Play Too Child Development Center. The program’s compliance history was 95% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • Adequate / Approved Space • License Posted • Permit Restrictions Allegation #1: There is a concern related to nutrition. Observation #1: During today’s visit, I observed the NC pre-k classroom. I asked if there were any nutrition opt-out forms for any of the children in this classroom and I reviewed one opt -out form for the child in the Pre-K classroom during the visit today. I asked if parents were contacted if the child opts-out, but parents fail to send lunch, what happens next. Director Donna Wilkinson and assistant Director Tisha Thomas stated that they always order an extra plate from the school system in case they ever need an extra plate and they also have food that is prepared for the infant/toddler wing of the school. So, they always have two (2) extra plates available for children. Currently, they have two (2) children in the entire school who opt-out. Parents are not usually contacted to have an opportunity to bring lunch for their child, if they have forgotten lunch since two (2) plates are always extra. The child did have breakfast bread on February 14, 2025. Mom had brought in blueberries and blackberries for the afternoon Valentine party snack. When mom brought the child into the 3-year-old classroom for early arrival on the 14th of February, mom stated to the floater, A Price and to the cook M. Bare, who was in the room giving breakfast that she had not packed breakfast or lunch for that day thinking since it was a party day that food was provided for the party. M. Bare, cook, stated to the mother, per A. Price, floater, that she could not provide food for the child since she opts-out and was not in the food program. It was reported that mom looked surprised but went on to work. The child did have breakfast bread for breakfast, but the child refused the bread and pushed it away. The lead teacher and teacher in this classroom were not present on February 14, 2025 since it was an optional teacher work day for the NC Pre-K and Ashe County Public School. The staff in the room on this day was Mackenzie Price, floater. I interviewed M. Price over the phone today. She stated that the child did not have any lunch, so M. Price called the 3 year old classroom and A. Price, floater, made the child a plate of snack party food for the child’s lunch which consisted of chips and dip, cheese puffs, applesauce, a juice box, and the floater’s own oats and honey bar. A Price brought the snack plate over to the 4 year old classroom. A. Price stated she knew that child had no allergies and wanted the child to have food to eat. I observed the children having lunch today in the pre-k space today regarding the events that allegedly took place on February 14, 2025. I also interviewed the cook of the center to ask if she was asked to prepare a plate for the child in the pre-k classroom. The cook stated that she did not tell the mom she could not have a plate. I asked to view and then viewed the camera footage for February 14, 2025 in the pre-k classroom during lunch time on the date of February 14, 2025. Camera footage began at 11:19 am when cook, M. Bare starts serving food. In the film footage, at 11:25 am I was able to view an empty plate at the child’s space and the child go over to the space and sit down. At 11:26 I saw M. Price go over to the phone to make a call. At 11:28 I saw A. Price come into the room with a plate of items that I could not make out in the video. A. Price sated the items were chips and dip, cheese puffs, applesauce, juice box and an oats and honey bar. The child begins to eat the food and continues to eat until 12:01 when the child gets up from the table. I also reviewed the center’s operational policies related to nutrition. I also asked to see the menu from the week of February 14, 2025. I observed the camera footage for breakfast on February 14th, 2025. The child was offered breakfast bread for breakfast but pushed the plate away and refused. Donna Wilkinson and Tisha Thomas were not made aware that the child did not have lunch that day, or they would have provided a nutritious lunch for the child with the extra plates. The optout form for this child began 1/14/25. Prior to this date, the child was being provided a plate from the school but not eating anything. The child drinks only water. Conclusion #1: Based on the above information, observation, video footage viewed and interviews during today’s visit, the allegation was confirmed and substantiated. Allegation #2: 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. Observation #2: The child was viewed on the camera footage eating the plate of snack food provided to her by staff. The child was not crying or seemingly upset at anything. She was eating her food and sitting beside the other children. The child was not seen being mistreated in any manner. Conclusion #2: Based on the above information, observations, and video footage during today’s visit, the allegation regarding nurture care of children could not be confirmed. This allegation was unsubstantiated. The following violations were cited during today’s visit: Comments Section – Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violation cited during today's visit immediately and send me documentation verifying compliance on or before Monday, March 10, 2025. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation You may email the letter to karen.young@dhhs.nc.gov or mail two copies of the letter to: Karen Young P.O. Box 1012 Lewisville, NC 27023 If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action being taken by the DCDEE. Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action being taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit: Nutrition is vital for a child's healthy growth and development. It helps children build strong bones and muscles, develop their brains, and maintain a healthy weight. Nutrition is important for physical health and brain development. • 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS Meals and snacks served to children in a child care center shall comply with the Meal Patterns for Children in Child Care Programs from the United States Department of Agriculture (USDA) which are based on the recommended nutrient intake judged by the National Research Council to be adequate for maintaining good nutrition. The types of food, number and size of servings shall be appropriate for the ages and developmental levels of the children in care. The Meal Patterns for Children in Child Care Programs are incorporated by reference and include subsequent amendments. A copy of the Meal Patterns for Children in Child Care Programs is available online at https://www.fns.usda.gov/cacfp/meals-and-snacks. When food is prepared by or provided by the center, menus for nutritious meals and snacks shall be planned at least one week in advance. At least one dated copy of the current week's menu shall be posted where it can be seen by parents and food preparation staff when food is prepared or provided by the center. A variety of food shall be included in meals and snacks. Any substitution shall be of comparable food value and shall be recorded on the menu prior to the meal or snack being served. When children bring their own food for meals or snacks to the center, if the food does not meet the nutritional requirements specified in Paragraph (a) of this Rule, the center must provide additional food necessary to meet those requirements. A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. Drinking water shall be freely available to children of all ages. Drinking fountains or individual drinking utensils shall be provided. When a private water supply is used, it must be tested by and meet the requirements of the Commission for Public Health as set forth in 15A NCAC 18A .2800. The child care provider shall serve only the following beverages: (1) breast milk, as specified in Paragraph (k) of this Rule; (2) formula; (3) water; (4) unflavored whole milk, for children ages 12-23 months; (5) unflavored skim or lowfat milk for children 24 months through five years; (6) unflavored skim milk, unflavored low-fat milk, or flavored skim milk for children six years and older; or (7) 100 percent fruit juice, limited to 6 ounces per day, for all ages. Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. The food required by special diets for medical, religious, or cultural reasons, or parental preferences, may be provided by the center or may be brought to the center by the parents. If the diet is prescribed by a health care professional, a statement signed by the health care professional shall be on file at the center and written instructions shall be provided by the child's parent, health care professional, or a licensed dietitian/nutritionist. If the diet is not prescribed by a health care professional, written instructions shall be provided by the child's parent and shall be on file at the center. Food that does not meet the nutritional requirements specified in Paragraph (a) of this Rule, such as cupcakes, cakes, and donuts shall only be offered for special occasions such as holidays and birthdays. Staff shall role model appropriate eating behaviors by consuming only food or beverages that meet the nutritional requirements specified in Paragraph (a) of this Rule in the presence of children in care. • 10A NCAC 09 .2411 NUTRITION REQUIREMENTS Meals and snacks shall be provided in accordance with Section .0900 of this Chapter unless a child's individualized plan of care specifies otherwise. • 10A NCAC 09 .1722 PROHIBITED DISCIPLINE No child shall be subjected to any form of corporal punishment by the family child care home operator, additional caregiver, substitute provider, or any other person in the home, whether or not these persons reside in the home as follows: (1) No child shall be handled roughly in any way, including shaking, pushing, shoving, pinching, slapping, biting, kicking, or spanking; (2) No child shall ever be placed in a locked room, closet, or box, or be left alone in a room separated from staff; (3) No discipline shall ever be delegated to another child; (4) No food shall be withheld or given as a means of punishment or reward; (5) No child shall ever be disciplined for toileting accidents; (6) No child shall ever be disciplined for not sleeping during rest period; (7) No child shall be disciplined by assigning chores that require contact with or use (8) Physical activity, such as running laps and doing push-ups, shall not be withheld or required as punishment; (9) No child shall ever be yelled at, shamed, humiliated, frightened, threatened, or bullied; and (10) No child shall be restrained as a form of discipline unless the child's safety or the safety of others is at risk. For purposes of this Rule, "restraining" shall mean that a caregiver physically holds a child in a manner that restricts the child's movement, for a minimum amount of time necessary to ensure a safe environment. Children shall not be restrained through the use of heavy objects, including a caregiver's body, or any device such as straps, blankets, car seats, or cribs. of hazardous materials, such as cleaning bathrooms or floors, or emptying diaper pails; Discipline practices shall be age and developmentally appropriate. * § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (10) Each operator or staff member shall attend to any child in a nurturing and appropriate manner, and in keeping with the child's developmental needs. Each child care facility shall have a written policy on discipline, describing the methods and practices used to discipline children enrolled in that facility. This written policy shall be discussed with, and a copy given to, each child's parent prior to the first time the child attends the facility. Subsequently, any change in discipline methods or practices shall be communicated in writing to the parents prior to the effective date of the change. * Chapter 4: Nutrition and Food Service 4.2 General Requirements 4.2.0 4.2.0.8: Feeding Plans and Dietary Modifications Before a child enters an early care and education facility, the facility should obtain a written history that contains any special nutrition or feeding needs for the child, including use of human milk or any special feeding utensils. The staff should review this history with the child’s parents/guardians, clarifying and discussing how the parents’/guardians’ home feeding routines may differ from the facility’s planned routine. The child’s primary health care provider should provide written information to the parent/guardian about any dietary modifications or special feeding techniques that are required at the early care and education program so they can be shared with and implemented by the program. If dietary modifications are indicated, based on a child’s medical or special dietary needs, caregivers/teachers should modify or supplement the child’s diet to meet the individual child’s specific needs. Dietary modifications should be made in consultation with the parents/guardians and the child’s primary health care provider. Caregivers/teachers can consult with a nutritionist/registered dietitian. A child’s diet may be modified because of food sensitivity, a food allergy, or many other reasons. includes a range of conditions in which a child exhibits an adverse reaction to a food that, in some instances, can be life-threatening. Modification of a child’s diet may also be related to a food allergy, an inability to digest or to tolerate certain foods, a need for extra calories, a need for special positioning while eating, diabetes and the need to match food with insulin, food idiosyncrasies, and other identified feeding issues, including celiac disease, phenylketonuria, diabetes, and severe food allergy (anaphylaxis). In some cases, a child may become ill if he/she is unable to eat, so missing a meal could have a negative consequence, especially for children with diabetes. For a child with special health care needs who requires dietary modifications or special feeding techniques, written instructions from the child’s parent/guardian and the child’s primary health care provider should be provided in the child’s record and carried out accordingly. Dietary modifications should be recorded. These written instructions must identify a. The child’s full name and date of instructions b. The child’s special health care needs c. Any dietary restrictions based on those special needs d. Any special feeding or eating utensils e. Any foods to be omitted from the diet and any foods to be substituted f. Any other pertinent information about the child’s special health care needs g. What, if anything, needs to be done if the child is exposed to restricted foods The written history of special nutrition or feeding needs should be used to develop individual feeding plans and, collectively, to develop facility menus. Health care providers with experience in disciplines related to special nutrition needs, including nutrition, nursing, speech therapy, occupational therapy, and physical therapy, should participate when needed and/or when they are available to the facility. If available, the nutritionist/registered dietitian should approve menus that accommodate needed dietary modifications. The feeding plan should include steps to take when a situation arises that requires rapid response by the staff, such as a child choking during mealtime or a child with a known history of food allergies demonstrating signs and symptoms of anaphylaxis (severe allergic reaction), such as difficulty breathing and severe redness and swelling of the face or mouth. The completed plan should be on file and accessible to staff and available to parents/guardians on request. Food sensitivity RATIONALE Children with special health care needs may have individual requirements related to diet and swallowing, involving special feeding 4.2.0.8: Feeding Plans and Dietary Modifications 02/24/2025 1 Standards from Caring for Our Children Online Database Close collaboration between families and the facility is necessary for children on special diets. Parents/guardians may have to provide food on a temporary, or even permanent, basis, if the facility, after exploring all community resources, is unable to provide the special diet. Programs may consider using the American Academy of Pediatrics (AAP) Allergy and Anaphylaxis Emergency Plan, which is included in the AAP clinical report, (4). Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home Care Plan for Children with Special Health Care Needs Written Nutrition Plan Assessment and Planning of Nutrition for Individual Children Vegetarian/Vegan Diets Responsive Feeding of Infants by a Consistent Caregiver/Teacher Foods that Are Choking Hazards utensils and feeding needs that will necessitate the development of an individual plan prior to their entry into the facility (1). Many children with special health care needs have difficulty with feeding, including delayed attainment of basic chewing, swallowing, and independent feeding skills. Food, eating style, food utensils, and equipment, including furniture, may have to be adapted to meet the developmental and physical needs of individual children (2,3,). Some children have difficulty with slow weight gain and need their caloric intake monitored and supplemented. Others, such as those with diabetes, may need to have their diet matched to their medication (e.g., insulin, if they are on a fixed dose of insulin). Some children are unable to tolerate certain foods because of their allergy to the food or their inability to digest it. The 8 most common foods to cause anaphylaxis in children are cow’s milk, eggs, soy, wheat, fish, shellfish, peanuts, and tree nuts (3). Staff members must know ahead of time what procedures to follow, as well as their designated roles, during an emergency. As a safety and health precaution, staff should know in advance whether a child has food allergies, inborn errors of metabolism, diabetes, celiac disease, tongue thrust, or special health care needs related to feeding, such as requiring special feeding utensils or equipment, nasogastric or gastric tube feedings, or special positioning. These situations require individual planning prior to the child’s entry into an early care and education program and on an ongoing basis (2). In some cases, dietary modifications are based on religious or cultural beliefs. Detailed information on each child’s special needs, whether stemming from dietary, feeding equipment, or cultural needs, is invaluable to the facility staff in meeting the nutritional needs of all the children in their care. COMMENTS Guidance on Completing a Written Allergy and Anaphylaxis Emergency Plan TYPE OF FACILITY RELATED STANDARDS 3.5.0.1 4.2.0.1 4.2.0.2 4.2.0.12 4.3.1.2 4.5.0.10 REFERENCES 1. Samour PQ, King K. Pediatric Nutrition. 4th ed. Sunbury, MA: Jones and Bartlett Learning; 2010 2. Kleinman RE, Greer FR, eds. Pediatric Nutrition. 7th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2014 3. Kaczkowski CH, Caffrey C. Pediatric nutrition. In: Blanchfield DS, ed. : . Vol 3. 3rd ed. Farmington Hills, MI: Gale; 2016:2063–2066 The Gale Encyclopedia of Children's Health Infancy Through Adolescence 4. Wang J, Sicherer SH; American Academy of Pediatrics Section on Allergy and Immunology. Guidance on completing a written allergy and anaphylaxis emergency plan. Pediatrics. 2017;139(3):e20164005 NOTES Content in the STANDARD was modified on 11/9/2017. 4.2.0.8: Feeding Plans and Dietary Modifications 02/24/2025 2 Standards from Caring for Our Children Online Database Additional Information/Consultation: • You must notify your consultant 30 days prior to changing the ownership status of your facility. • We discussed having a staff meeting with everyone to address the nutritional requirements and opt out requirements. • Remind staff to keep administration aware of any questionable situation so they are always aware of what is going on. • Visit NCRLAP website and read the information on Connecting with the Three’s! ECERS-3 and ITERS 3 will be used beginning 2/1/25. • The QRIS is in the process of being implemented and is now open for public comment. Go to the Division’s website, under What’s New and scroll down to QRIS Modernization, then read about QRIS Modernization Rulemaking Update. The Public comment is open 2/3/25 through 4/4/25. This is your opportunity to comment. • 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) 814-6401 and someone will assist you. • Public schools and licensed child care facilities in North Carolina are eligible to participate in the funding mechanisms to cover the costs of testing for lead in water and inspecting for asbestos and lead-based paint hazards beyond the May 1, 2024 deadline listed in 10A NCAC 41C .1002(a). Due to the recent impacts of Hurricane Helene and other natural disasters, this deadline has been revised statewide, and facilities that have not yet enrolled should complete the online process by May 31, 2025. The Clean Classrooms for Carolina Kids Program is providing free facility-wide testing and inspections without any out-of-pocket costs. Due to the volume of testing and inspections, completion of the online enrollment process in the program is considered temporary compliance with the testing and inspection requirement and will allow facilities to participate in the funding mechanisms. Required water testing for child care centers under rule 15A NCAC 18A .2816 is not affected by the new May 31, 2025 deadline. Enroll today at https://www.cleanwaterforcarolinakids.org/enroll. If you have enrolled for only one or two of the program sections, log back in to complete surveys for the remaining section(s) to comply with the rule requirements. Thank you for your participation in ensuring healthy learning environments for children across North Carolina. Please contact me at ed.norman@dhhs.nc.gov or 919-218-6511 if you have questions regarding this guidance. * Moodle Helpful Hints 1. When on the Moodle homepage, scroll down past the three-square boxes to find directions to self-register for various training opportunities. 2. If you do not access a training opportunity for 150 days, the training will be suspended. To regain access, email a request to set status to “active” including the name of the training course to dcdee_moodle_support@dhhs.nc.gov. 3. Send any questions about DCDEE Moodle trainings to dcdee_moodle_support@dhhs.nc.gov. Tips for MY NCID Users Did you know that if you do not login on any DCDEE platforms (e.g., Moodle, WORKS, CBC) for a period of 12 months, your account will be archived? An archived account cannot be reinstated. You will need to create a new one and then email all platforms (e.g., Moodle, WORKS, CBC) to merge accounts. Pro Tip: Set your calendar to remind you every 6 months to login and out at https://myncid.nc.gov to keep your account activated and it will NOT be archived. At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Karen Young, Child Care Consultant (336) 207-2151 Karen.young@dhhs.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ Violation Number Comment Rule 1885 When a parent had opted out, but did not provide a snack or meal, the program did not replace the missing meal or snack. A child whose parents opt-out, was not provided a nutritious meal by the program on February 14, 2025. .0901(d)(4) If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
NC GS 110-90 · Violation
Name of Operation: LEARNING THRU PLAY TOO CHILD DEVELOPMENT CENTER Facility ID: 05000067 Consultant: KAREN YOUNG Operation Type: Center Case Number: 0225-200L Visit Date: 2/24/2025 Number Present: 15 Completed Date: 2/24/2025 Age: From 4 To 5 Total Minutes: 300 Time In: 11:15 AM Time Out: 04:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to obtain information regarding alleged violations of childcare requirements. This visit was conducted by Karen Young, childcare consultant with Donna Wilkinson, Director. The allegations are as follows: There is a concern related to nutrition. 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. During today’s visit, the allegations were discussed with you. You had the opportunity to respond. Information shared during this visit are documented in this visit summary. There are eighty-one (81) total children present in the program today. Your program currently operates with a Five (5) Star license effective 10/22/18. Restrictions include 1st shift day time care; meets enhanced ratios; meets enhanced space; children under 2.5 years in rooms with direct exits only. The owner is listed as Debbie L. Williams who is the sole proprietor of Learning Thru Play Too Child Development Center. The program’s compliance history was 95% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • Adequate / Approved Space • License Posted • Permit Restrictions Allegation #1: There is a concern related to nutrition. Observation #1: During today’s visit, I observed the NC pre-k classroom. I asked if there were any nutrition opt-out forms for any of the children in this classroom and I reviewed one opt -out form for the child in the Pre-K classroom during the visit today. I asked if parents were contacted if the child opts-out, but parents fail to send lunch, what happens next. Director Donna Wilkinson and assistant Director Tisha Thomas stated that they always order an extra plate from the school system in case they ever need an extra plate and they also have food that is prepared for the infant/toddler wing of the school. So, they always have two (2) extra plates available for children. Currently, they have two (2) children in the entire school who opt-out. Parents are not usually contacted to have an opportunity to bring lunch for their child, if they have forgotten lunch since two (2) plates are always extra. The child did have breakfast bread on February 14, 2025. Mom had brought in blueberries and blackberries for the afternoon Valentine party snack. When mom brought the child into the 3-year-old classroom for early arrival on the 14th of February, mom stated to the floater, A Price and to the cook M. Bare, who was in the room giving breakfast that she had not packed breakfast or lunch for that day thinking since it was a party day that food was provided for the party. M. Bare, cook, stated to the mother, per A. Price, floater, that she could not provide food for the child since she opts-out and was not in the food program. It was reported that mom looked surprised but went on to work. The child did have breakfast bread for breakfast, but the child refused the bread and pushed it away. The lead teacher and teacher in this classroom were not present on February 14, 2025 since it was an optional teacher work day for the NC Pre-K and Ashe County Public School. The staff in the room on this day was Mackenzie Price, floater. I interviewed M. Price over the phone today. She stated that the child did not have any lunch, so M. Price called the 3 year old classroom and A. Price, floater, made the child a plate of snack party food for the child’s lunch which consisted of chips and dip, cheese puffs, applesauce, a juice box, and the floater’s own oats and honey bar. A Price brought the snack plate over to the 4 year old classroom. A. Price stated she knew that child had no allergies and wanted the child to have food to eat. I observed the children having lunch today in the pre-k space today regarding the events that allegedly took place on February 14, 2025. I also interviewed the cook of the center to ask if she was asked to prepare a plate for the child in the pre-k classroom. The cook stated that she did not tell the mom she could not have a plate. I asked to view and then viewed the camera footage for February 14, 2025 in the pre-k classroom during lunch time on the date of February 14, 2025. Camera footage began at 11:19 am when cook, M. Bare starts serving food. In the film footage, at 11:25 am I was able to view an empty plate at the child’s space and the child go over to the space and sit down. At 11:26 I saw M. Price go over to the phone to make a call. At 11:28 I saw A. Price come into the room with a plate of items that I could not make out in the video. A. Price sated the items were chips and dip, cheese puffs, applesauce, juice box and an oats and honey bar. The child begins to eat the food and continues to eat until 12:01 when the child gets up from the table. I also reviewed the center’s operational policies related to nutrition. I also asked to see the menu from the week of February 14, 2025. I observed the camera footage for breakfast on February 14th, 2025. The child was offered breakfast bread for breakfast but pushed the plate away and refused. Donna Wilkinson and Tisha Thomas were not made aware that the child did not have lunch that day, or they would have provided a nutritious lunch for the child with the extra plates. The optout form for this child began 1/14/25. Prior to this date, the child was being provided a plate from the school but not eating anything. The child drinks only water. Conclusion #1: Based on the above information, observation, video footage viewed and interviews during today’s visit, the allegation was confirmed and substantiated. Allegation #2: 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. Observation #2: The child was viewed on the camera footage eating the plate of snack food provided to her by staff. The child was not crying or seemingly upset at anything. She was eating her food and sitting beside the other children. The child was not seen being mistreated in any manner. Conclusion #2: Based on the above information, observations, and video footage during today’s visit, the allegation regarding nurture care of children could not be confirmed. This allegation was unsubstantiated. The following violations were cited during today’s visit: Comments Section – Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violation cited during today's visit immediately and send me documentation verifying compliance on or before Monday, March 10, 2025. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation You may email the letter to karen.young@dhhs.nc.gov or mail two copies of the letter to: Karen Young P.O. Box 1012 Lewisville, NC 27023 If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action being taken by the DCDEE. Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action being taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit: Nutrition is vital for a child's healthy growth and development. It helps children build strong bones and muscles, develop their brains, and maintain a healthy weight. Nutrition is important for physical health and brain development. • 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS Meals and snacks served to children in a child care center shall comply with the Meal Patterns for Children in Child Care Programs from the United States Department of Agriculture (USDA) which are based on the recommended nutrient intake judged by the National Research Council to be adequate for maintaining good nutrition. The types of food, number and size of servings shall be appropriate for the ages and developmental levels of the children in care. The Meal Patterns for Children in Child Care Programs are incorporated by reference and include subsequent amendments. A copy of the Meal Patterns for Children in Child Care Programs is available online at https://www.fns.usda.gov/cacfp/meals-and-snacks. When food is prepared by or provided by the center, menus for nutritious meals and snacks shall be planned at least one week in advance. At least one dated copy of the current week's menu shall be posted where it can be seen by parents and food preparation staff when food is prepared or provided by the center. A variety of food shall be included in meals and snacks. Any substitution shall be of comparable food value and shall be recorded on the menu prior to the meal or snack being served. When children bring their own food for meals or snacks to the center, if the food does not meet the nutritional requirements specified in Paragraph (a) of this Rule, the center must provide additional food necessary to meet those requirements. A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. Drinking water shall be freely available to children of all ages. Drinking fountains or individual drinking utensils shall be provided. When a private water supply is used, it must be tested by and meet the requirements of the Commission for Public Health as set forth in 15A NCAC 18A .2800. The child care provider shall serve only the following beverages: (1) breast milk, as specified in Paragraph (k) of this Rule; (2) formula; (3) water; (4) unflavored whole milk, for children ages 12-23 months; (5) unflavored skim or lowfat milk for children 24 months through five years; (6) unflavored skim milk, unflavored low-fat milk, or flavored skim milk for children six years and older; or (7) 100 percent fruit juice, limited to 6 ounces per day, for all ages. Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. The food required by special diets for medical, religious, or cultural reasons, or parental preferences, may be provided by the center or may be brought to the center by the parents. If the diet is prescribed by a health care professional, a statement signed by the health care professional shall be on file at the center and written instructions shall be provided by the child's parent, health care professional, or a licensed dietitian/nutritionist. If the diet is not prescribed by a health care professional, written instructions shall be provided by the child's parent and shall be on file at the center. Food that does not meet the nutritional requirements specified in Paragraph (a) of this Rule, such as cupcakes, cakes, and donuts shall only be offered for special occasions such as holidays and birthdays. Staff shall role model appropriate eating behaviors by consuming only food or beverages that meet the nutritional requirements specified in Paragraph (a) of this Rule in the presence of children in care. • 10A NCAC 09 .2411 NUTRITION REQUIREMENTS Meals and snacks shall be provided in accordance with Section .0900 of this Chapter unless a child's individualized plan of care specifies otherwise. • 10A NCAC 09 .1722 PROHIBITED DISCIPLINE No child shall be subjected to any form of corporal punishment by the family child care home operator, additional caregiver, substitute provider, or any other person in the home, whether or not these persons reside in the home as follows: (1) No child shall be handled roughly in any way, including shaking, pushing, shoving, pinching, slapping, biting, kicking, or spanking; (2) No child shall ever be placed in a locked room, closet, or box, or be left alone in a room separated from staff; (3) No discipline shall ever be delegated to another child; (4) No food shall be withheld or given as a means of punishment or reward; (5) No child shall ever be disciplined for toileting accidents; (6) No child shall ever be disciplined for not sleeping during rest period; (7) No child shall be disciplined by assigning chores that require contact with or use (8) Physical activity, such as running laps and doing push-ups, shall not be withheld or required as punishment; (9) No child shall ever be yelled at, shamed, humiliated, frightened, threatened, or bullied; and (10) No child shall be restrained as a form of discipline unless the child's safety or the safety of others is at risk. For purposes of this Rule, "restraining" shall mean that a caregiver physically holds a child in a manner that restricts the child's movement, for a minimum amount of time necessary to ensure a safe environment. Children shall not be restrained through the use of heavy objects, including a caregiver's body, or any device such as straps, blankets, car seats, or cribs. of hazardous materials, such as cleaning bathrooms or floors, or emptying diaper pails; Discipline practices shall be age and developmentally appropriate. * § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (10) Each operator or staff member shall attend to any child in a nurturing and appropriate manner, and in keeping with the child's developmental needs. Each child care facility shall have a written policy on discipline, describing the methods and practices used to discipline children enrolled in that facility. This written policy shall be discussed with, and a copy given to, each child's parent prior to the first time the child attends the facility. Subsequently, any change in discipline methods or practices shall be communicated in writing to the parents prior to the effective date of the change. * Chapter 4: Nutrition and Food Service 4.2 General Requirements 4.2.0 4.2.0.8: Feeding Plans and Dietary Modifications Before a child enters an early care and education facility, the facility should obtain a written history that contains any special nutrition or feeding needs for the child, including use of human milk or any special feeding utensils. The staff should review this history with the child’s parents/guardians, clarifying and discussing how the parents’/guardians’ home feeding routines may differ from the facility’s planned routine. The child’s primary health care provider should provide written information to the parent/guardian about any dietary modifications or special feeding techniques that are required at the early care and education program so they can be shared with and implemented by the program. If dietary modifications are indicated, based on a child’s medical or special dietary needs, caregivers/teachers should modify or supplement the child’s diet to meet the individual child’s specific needs. Dietary modifications should be made in consultation with the parents/guardians and the child’s primary health care provider. Caregivers/teachers can consult with a nutritionist/registered dietitian. A child’s diet may be modified because of food sensitivity, a food allergy, or many other reasons. includes a range of conditions in which a child exhibits an adverse reaction to a food that, in some instances, can be life-threatening. Modification of a child’s diet may also be related to a food allergy, an inability to digest or to tolerate certain foods, a need for extra calories, a need for special positioning while eating, diabetes and the need to match food with insulin, food idiosyncrasies, and other identified feeding issues, including celiac disease, phenylketonuria, diabetes, and severe food allergy (anaphylaxis). In some cases, a child may become ill if he/she is unable to eat, so missing a meal could have a negative consequence, especially for children with diabetes. For a child with special health care needs who requires dietary modifications or special feeding techniques, written instructions from the child’s parent/guardian and the child’s primary health care provider should be provided in the child’s record and carried out accordingly. Dietary modifications should be recorded. These written instructions must identify a. The child’s full name and date of instructions b. The child’s special health care needs c. Any dietary restrictions based on those special needs d. Any special feeding or eating utensils e. Any foods to be omitted from the diet and any foods to be substituted f. Any other pertinent information about the child’s special health care needs g. What, if anything, needs to be done if the child is exposed to restricted foods The written history of special nutrition or feeding needs should be used to develop individual feeding plans and, collectively, to develop facility menus. Health care providers with experience in disciplines related to special nutrition needs, including nutrition, nursing, speech therapy, occupational therapy, and physical therapy, should participate when needed and/or when they are available to the facility. If available, the nutritionist/registered dietitian should approve menus that accommodate needed dietary modifications. The feeding plan should include steps to take when a situation arises that requires rapid response by the staff, such as a child choking during mealtime or a child with a known history of food allergies demonstrating signs and symptoms of anaphylaxis (severe allergic reaction), such as difficulty breathing and severe redness and swelling of the face or mouth. The completed plan should be on file and accessible to staff and available to parents/guardians on request. Food sensitivity RATIONALE Children with special health care needs may have individual requirements related to diet and swallowing, involving special feeding 4.2.0.8: Feeding Plans and Dietary Modifications 02/24/2025 1 Standards from Caring for Our Children Online Database Close collaboration between families and the facility is necessary for children on special diets. Parents/guardians may have to provide food on a temporary, or even permanent, basis, if the facility, after exploring all community resources, is unable to provide the special diet. Programs may consider using the American Academy of Pediatrics (AAP) Allergy and Anaphylaxis Emergency Plan, which is included in the AAP clinical report, (4). Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home Care Plan for Children with Special Health Care Needs Written Nutrition Plan Assessment and Planning of Nutrition for Individual Children Vegetarian/Vegan Diets Responsive Feeding of Infants by a Consistent Caregiver/Teacher Foods that Are Choking Hazards utensils and feeding needs that will necessitate the development of an individual plan prior to their entry into the facility (1). Many children with special health care needs have difficulty with feeding, including delayed attainment of basic chewing, swallowing, and independent feeding skills. Food, eating style, food utensils, and equipment, including furniture, may have to be adapted to meet the developmental and physical needs of individual children (2,3,). Some children have difficulty with slow weight gain and need their caloric intake monitored and supplemented. Others, such as those with diabetes, may need to have their diet matched to their medication (e.g., insulin, if they are on a fixed dose of insulin). Some children are unable to tolerate certain foods because of their allergy to the food or their inability to digest it. The 8 most common foods to cause anaphylaxis in children are cow’s milk, eggs, soy, wheat, fish, shellfish, peanuts, and tree nuts (3). Staff members must know ahead of time what procedures to follow, as well as their designated roles, during an emergency. As a safety and health precaution, staff should know in advance whether a child has food allergies, inborn errors of metabolism, diabetes, celiac disease, tongue thrust, or special health care needs related to feeding, such as requiring special feeding utensils or equipment, nasogastric or gastric tube feedings, or special positioning. These situations require individual planning prior to the child’s entry into an early care and education program and on an ongoing basis (2). In some cases, dietary modifications are based on religious or cultural beliefs. Detailed information on each child’s special needs, whether stemming from dietary, feeding equipment, or cultural needs, is invaluable to the facility staff in meeting the nutritional needs of all the children in their care. COMMENTS Guidance on Completing a Written Allergy and Anaphylaxis Emergency Plan TYPE OF FACILITY RELATED STANDARDS 3.5.0.1 4.2.0.1 4.2.0.2 4.2.0.12 4.3.1.2 4.5.0.10 REFERENCES 1. Samour PQ, King K. Pediatric Nutrition. 4th ed. Sunbury, MA: Jones and Bartlett Learning; 2010 2. Kleinman RE, Greer FR, eds. Pediatric Nutrition. 7th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2014 3. Kaczkowski CH, Caffrey C. Pediatric nutrition. In: Blanchfield DS, ed. : . Vol 3. 3rd ed. Farmington Hills, MI: Gale; 2016:2063–2066 The Gale Encyclopedia of Children's Health Infancy Through Adolescence 4. Wang J, Sicherer SH; American Academy of Pediatrics Section on Allergy and Immunology. Guidance on completing a written allergy and anaphylaxis emergency plan. Pediatrics. 2017;139(3):e20164005 NOTES Content in the STANDARD was modified on 11/9/2017. 4.2.0.8: Feeding Plans and Dietary Modifications 02/24/2025 2 Standards from Caring for Our Children Online Database Additional Information/Consultation: • You must notify your consultant 30 days prior to changing the ownership status of your facility. • We discussed having a staff meeting with everyone to address the nutritional requirements and opt out requirements. • Remind staff to keep administration aware of any questionable situation so they are always aware of what is going on. • Visit NCRLAP website and read the information on Connecting with the Three’s! ECERS-3 and ITERS 3 will be used beginning 2/1/25. • The QRIS is in the process of being implemented and is now open for public comment. Go to the Division’s website, under What’s New and scroll down to QRIS Modernization, then read about QRIS Modernization Rulemaking Update. The Public comment is open 2/3/25 through 4/4/25. This is your opportunity to comment. • 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) 814-6401 and someone will assist you. • Public schools and licensed child care facilities in North Carolina are eligible to participate in the funding mechanisms to cover the costs of testing for lead in water and inspecting for asbestos and lead-based paint hazards beyond the May 1, 2024 deadline listed in 10A NCAC 41C .1002(a). Due to the recent impacts of Hurricane Helene and other natural disasters, this deadline has been revised statewide, and facilities that have not yet enrolled should complete the online process by May 31, 2025. The Clean Classrooms for Carolina Kids Program is providing free facility-wide testing and inspections without any out-of-pocket costs. Due to the volume of testing and inspections, completion of the online enrollment process in the program is considered temporary compliance with the testing and inspection requirement and will allow facilities to participate in the funding mechanisms. Required water testing for child care centers under rule 15A NCAC 18A .2816 is not affected by the new May 31, 2025 deadline. Enroll today at https://www.cleanwaterforcarolinakids.org/enroll. If you have enrolled for only one or two of the program sections, log back in to complete surveys for the remaining section(s) to comply with the rule requirements. Thank you for your participation in ensuring healthy learning environments for children across North Carolina. Please contact me at ed.norman@dhhs.nc.gov or 919-218-6511 if you have questions regarding this guidance. * Moodle Helpful Hints 1. When on the Moodle homepage, scroll down past the three-square boxes to find directions to self-register for various training opportunities. 2. If you do not access a training opportunity for 150 days, the training will be suspended. To regain access, email a request to set status to “active” including the name of the training course to dcdee_moodle_support@dhhs.nc.gov. 3. Send any questions about DCDEE Moodle trainings to dcdee_moodle_support@dhhs.nc.gov. Tips for MY NCID Users Did you know that if you do not login on any DCDEE platforms (e.g., Moodle, WORKS, CBC) for a period of 12 months, your account will be archived? An archived account cannot be reinstated. You will need to create a new one and then email all platforms (e.g., Moodle, WORKS, CBC) to merge accounts. Pro Tip: Set your calendar to remind you every 6 months to login and out at https://myncid.nc.gov to keep your account activated and it will NOT be archived. At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Karen Young, Child Care Consultant (336) 207-2151 Karen.young@dhhs.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ Violation Number Comment Rule 1885 When a parent had opted out, but did not provide a snack or meal, the program did not replace the missing meal or snack. A child whose parents opt-out, was not provided a nutritious meal by the program on February 14, 2025. .0901(d)(4) 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: LEARNING THRU PLAY TOO CHILD DEVELOPMENT CENTER Facility ID: 05000067 Consultant: JENNIFER HILL Operation Type: Center Case Number: 0724-282A Visit Date: 7/29/2024 Number Present: 85 Completed Date: 7/29/2024 Age: From 0 To 11 Total Minutes: 140 Time In: 01:20 PM Time Out: 03:40 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of this unannounced visit was to investigate allegations of violations of child care requirements at this child care facility. Donna Wilkinson, administrator, accompanied me during a walk-through of the facility. During the visit, I discussed the allegations with Ms. Wilkinson, Tisha Thomas, assistant director, and additional staff members. Limited monitoring of child care requirements occurred during today’s visit. The following violations were observed and/or confirmed during today’s visit. Violation Number Comment Rule 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. On July 22, 2024, a staff member grabbed and pulled on a 7-year-old child's arm. Another staff member who was also present pointed their finger at the same child and abruptly moved the child's chair. G.S. 110-91(10) Violations must be corrected immediately. Within one week (8/5/2024), you must submit documentation of the corrections you made and your plan to maintain compliance with the identified child care requirements to me at Jennifer Hill, Investigations Consultant, 828-358-5387, Jennifer.Hill@dhhs.nc.gov, or faxed to 919-715-1013. You may contact me at Jennifer Hill, Investigations Consultant, 828-358-5387, Jennifer.Hill@dhhs.nc.gov or Natosha Lambeth, Western Investigations Team Supervisor, Natosha.Lambeth@dhhs.nc.gov. Thank you for your time. 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 .0601 · Violation
Name of Operation: LEARNING THRU PLAY TOO CHILD DEVELOPMENT CENTER Facility ID: 05000067 Consultant: KAREN YOUNG Operation Type: Center Case Number: Visit Date: 6/11/2024 Number Present: 88 Completed Date: 6/11/2024 Age: From 0 To 12 Total Minutes: 300 Time In: 10:30 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements. This visit was conducted by Karen Young, Childcare Consultant, with Donna Wilkinson, Director. Your program currently operates with a Five (5) Star license effective 10/22/18. Restrictions include 1st shift day time care; meets enhanced ratios; meets enhanced space; children under 2.5 years in rooms with direct exits only. The license was observed, and the restrictions were found in compliance. The NC Secretary of State website was reviewed on 6/11/24 and Learning Thru Play, Inc. was listed as current and active. The program’s compliance history was 95% prior to today’s visit. All programs are required to maintain at least 75% compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. I observed positive interactions today. I observed children having free choice play, eating lunch, and preparing for nap/rest time. The infants were having individual needs met. I observed developmentally appropriate materials and activities were available to the children in the classrooms. Your program was also monitored for compliance with implementing an approved curriculum as required for all four- and five-star licensed facilities where four-year-old children are enrolled. Your facility uses Creative Curriculum. The last annual compliance visit was conducted on 6/27/23. A sanitation inspection was completed 4/30/24 with an Approved classification with sixteen (16) demerits. The last fire inspection was conducted 7/6/23. I asked the director to scan to a copy of the fire inspection, since your copier was broken today. Program records and required postings were monitored. A fire drill was conducted on 5/30/24 at 7:15 am with six (6) minutes to evacuate fifteen (15) children and six (6) adults by Donna Wilkinson. A lockdown drill was documented on 5/23/24 at 10:15 am with seven (7) minutes to lockdown by Donna Wilkinson . An outdoor inspection was documented on 5/21/24 at 9:15 am. Staff files and children’s records were monitored per DCDEE procedures. I monitored five (5) new staff and seven regular staff today. Nutrition requirements were monitored per DCDEE procedures. Storage of hazardous items was monitored today. Storage and administration of medication were monitored. Medication authorization was monitored. Diaper creams and ointments were monitored today. The program does not provide transportation. The following violations were cited during today’s visit: Violation Number Comment Rule 601 Refrigerator(s) did not maintain a temperature of 45 degrees F. or below. I observed the thermometer in Space 4 read 20 degrees and no items were frozen. This thermometer was replaced during the visit today. This item was corrected during the visit. 15A NCAC 18A .2806(j)(2) 612 Each child's bed, cot, or 2" mat was not individually assigned and identified. I observed three (3) cribs in the infant room that were not labeled with individual names. Three (3) new infants have started within the last few days per/the assistant director. 15A NCAC 18A .2821(b) & (c) 807 A safe indoor and outdoor environment was not provided for the children. I observed a hole dug out on the toddler playground that is a tripping and fall hazard. The ground cover was showing through at the hole as well. I observed a portion of the fence on the large playground that measured only three (3) feet in height. Mulch has washed up to the bottom of the fence. I observed mulch measured three (3) inches at the bottom of the green scalloped slide on the large playground. 10A NCAC 09 .0601(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. I observed the closet in Space 6 was unlocked and contained hazardous cleaning materials. .2820(b) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violations cited during today's visit immediately and send me documentation verifying compliance on or before Tuesday, June 25, 2024. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation You may email the letter to karen.young@dhhs.nc.gov or mail two copies of the letter to: Karen Young P.O. Box 1012 Lewisville, NC 27023 If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance provided during today’s visit: • Infant cribs are to be labeled with child’s name on the first day of attendance. • Thermometers should read above 32 degrees and below 40 degrees. • Hazardous materials are to be locked away to keep out of reach of children. • Outside areas are to remain safe at all times. Consultation today included: • You must notify your consultant 30 days prior to changing the ownership status of your facility. • Your prep year for license reassessment is 7/1/23-6/30/24 and is coming to an end. • Your actual license reassessment year will be 7/1/24-6/30/25. • I sent you tasks and activities to complete during your prep year to be ready for the reassessment year. Those included getting ALL staff education sent to DCDEE/WORKS for evaluation, going over each chapter in the ITERS-R, ECERS-R and SACERS-R books during staff meetings for each group of staff, reviewing all NCRLAP videos during staff meetings as refreshers, and contacting your local Ashe Partnership to conduct mock assessments. This will highlight your strengths and will make you aware of the areas which need attention. • Make sure all staff are up to date on required certifications and training. • Be sure all installed equipment has the proper ground cover depth of at least six (6) inches. • Be sure cots do not touch each other on the top or bottom of the cots. At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Karen Young, Child Care Consultant (336) 207-2151 karen.young@dhh.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.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.
NC GS 110-90 · Violation
Name of Operation: LEARNING THRU PLAY TOO CHILD DEVELOPMENT CENTER Facility ID: 05000067 Consultant: KAREN YOUNG Operation Type: Center Case Number: Visit Date: 6/11/2024 Number Present: 88 Completed Date: 6/11/2024 Age: From 0 To 12 Total Minutes: 300 Time In: 10:30 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements. This visit was conducted by Karen Young, Childcare Consultant, with Donna Wilkinson, Director. Your program currently operates with a Five (5) Star license effective 10/22/18. Restrictions include 1st shift day time care; meets enhanced ratios; meets enhanced space; children under 2.5 years in rooms with direct exits only. The license was observed, and the restrictions were found in compliance. The NC Secretary of State website was reviewed on 6/11/24 and Learning Thru Play, Inc. was listed as current and active. The program’s compliance history was 95% prior to today’s visit. All programs are required to maintain at least 75% compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. I observed positive interactions today. I observed children having free choice play, eating lunch, and preparing for nap/rest time. The infants were having individual needs met. I observed developmentally appropriate materials and activities were available to the children in the classrooms. Your program was also monitored for compliance with implementing an approved curriculum as required for all four- and five-star licensed facilities where four-year-old children are enrolled. Your facility uses Creative Curriculum. The last annual compliance visit was conducted on 6/27/23. A sanitation inspection was completed 4/30/24 with an Approved classification with sixteen (16) demerits. The last fire inspection was conducted 7/6/23. I asked the director to scan to a copy of the fire inspection, since your copier was broken today. Program records and required postings were monitored. A fire drill was conducted on 5/30/24 at 7:15 am with six (6) minutes to evacuate fifteen (15) children and six (6) adults by Donna Wilkinson. A lockdown drill was documented on 5/23/24 at 10:15 am with seven (7) minutes to lockdown by Donna Wilkinson . An outdoor inspection was documented on 5/21/24 at 9:15 am. Staff files and children’s records were monitored per DCDEE procedures. I monitored five (5) new staff and seven regular staff today. Nutrition requirements were monitored per DCDEE procedures. Storage of hazardous items was monitored today. Storage and administration of medication were monitored. Medication authorization was monitored. Diaper creams and ointments were monitored today. The program does not provide transportation. The following violations were cited during today’s visit: Violation Number Comment Rule 601 Refrigerator(s) did not maintain a temperature of 45 degrees F. or below. I observed the thermometer in Space 4 read 20 degrees and no items were frozen. This thermometer was replaced during the visit today. This item was corrected during the visit. 15A NCAC 18A .2806(j)(2) 612 Each child's bed, cot, or 2" mat was not individually assigned and identified. I observed three (3) cribs in the infant room that were not labeled with individual names. Three (3) new infants have started within the last few days per/the assistant director. 15A NCAC 18A .2821(b) & (c) 807 A safe indoor and outdoor environment was not provided for the children. I observed a hole dug out on the toddler playground that is a tripping and fall hazard. The ground cover was showing through at the hole as well. I observed a portion of the fence on the large playground that measured only three (3) feet in height. Mulch has washed up to the bottom of the fence. I observed mulch measured three (3) inches at the bottom of the green scalloped slide on the large playground. 10A NCAC 09 .0601(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. I observed the closet in Space 6 was unlocked and contained hazardous cleaning materials. .2820(b) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violations cited during today's visit immediately and send me documentation verifying compliance on or before Tuesday, June 25, 2024. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation You may email the letter to karen.young@dhhs.nc.gov or mail two copies of the letter to: Karen Young P.O. Box 1012 Lewisville, NC 27023 If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance provided during today’s visit: • Infant cribs are to be labeled with child’s name on the first day of attendance. • Thermometers should read above 32 degrees and below 40 degrees. • Hazardous materials are to be locked away to keep out of reach of children. • Outside areas are to remain safe at all times. Consultation today included: • You must notify your consultant 30 days prior to changing the ownership status of your facility. • Your prep year for license reassessment is 7/1/23-6/30/24 and is coming to an end. • Your actual license reassessment year will be 7/1/24-6/30/25. • I sent you tasks and activities to complete during your prep year to be ready for the reassessment year. Those included getting ALL staff education sent to DCDEE/WORKS for evaluation, going over each chapter in the ITERS-R, ECERS-R and SACERS-R books during staff meetings for each group of staff, reviewing all NCRLAP videos during staff meetings as refreshers, and contacting your local Ashe Partnership to conduct mock assessments. This will highlight your strengths and will make you aware of the areas which need attention. • Make sure all staff are up to date on required certifications and training. • Be sure all installed equipment has the proper ground cover depth of at least six (6) inches. • Be sure cots do not touch each other on the top or bottom of the cots. At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Karen Young, Child Care Consultant (336) 207-2151 karen.young@dhh.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.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.
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.