Building Blocks FOR Tots

10A NCAC 09 .0601 · Violation

Name of Operation: BUILDING BLOCKS FOR TOTS Facility ID: 98000209 Consultant: KATISHA FARMER Operation Type: Center Case Number: 1125-114A Visit Date: 11/19/2025 Number Present: 88 Completed Date: 11/19/2025 Age: From 0 To 5 Total Minutes: 80 Time In: 09:10 AM Time Out: 10:30 AM 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 childcare facility. Nikki Beaman, Director, was present during the visit. Ms. Beaman accompanied me during a walk through the facility. I discussed the allegations with Ms. Beaman and additional staff members. Limited monitoring of child care requirements occurred during today’s visit. No violations were observed and/or confirmed during today’s visit. Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. A staff member served hot mashed potatoes to a 14-month-old child, burning the inside and outside of the child’s mouth area, resulting in 2nd degree burns. 10A NCAC 09 .0601(a) 830 A First Aid information sheet was not posted in a place for referral and/or the information sheet did not include all the required information. The staff member did not utilize the first aid poster in the classroom when the staff member applied Aquaphor to the burned area of the child’s chin .0802(h) 1810 There was a substantiation of child maltreatment. Pursuant to its investigation, the Division has confirmed sufficient information to determine child maltreatment. GS 110-105.6(a) You may contact me at Katisha Farmer, Investigations Consultant, 252 373-8547, Katisha.farmer@dhhs.nc.gov or Corrie Davenport, Supervisor, corrie.davenport@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

GS 110-105 · Violation

Name of Operation: BUILDING BLOCKS FOR TOTS Facility ID: 98000209 Consultant: KATISHA FARMER Operation Type: Center Case Number: 1125-114A Visit Date: 11/19/2025 Number Present: 88 Completed Date: 11/19/2025 Age: From 0 To 5 Total Minutes: 80 Time In: 09:10 AM Time Out: 10:30 AM 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 childcare facility. Nikki Beaman, Director, was present during the visit. Ms. Beaman accompanied me during a walk through the facility. I discussed the allegations with Ms. Beaman and additional staff members. Limited monitoring of child care requirements occurred during today’s visit. No violations were observed and/or confirmed during today’s visit. Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. A staff member served hot mashed potatoes to a 14-month-old child, burning the inside and outside of the child’s mouth area, resulting in 2nd degree burns. 10A NCAC 09 .0601(a) 830 A First Aid information sheet was not posted in a place for referral and/or the information sheet did not include all the required information. The staff member did not utilize the first aid poster in the classroom when the staff member applied Aquaphor to the burned area of the child’s chin .0802(h) 1810 There was a substantiation of child maltreatment. Pursuant to its investigation, the Division has confirmed sufficient information to determine child maltreatment. GS 110-105.6(a) You may contact me at Katisha Farmer, Investigations Consultant, 252 373-8547, Katisha.farmer@dhhs.nc.gov or Corrie Davenport, Supervisor, corrie.davenport@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

10A NCAC 09 .0604 · Violation

Name of Operation: BUILDING BLOCKS FOR TOTS Facility ID: 98000209 Consultant: VACANT TEAM 13 Operation Type: Center Case Number: Visit Date: 8/14/2025 Number Present: 79 Completed Date: 8/14/2025 Age: From 0 To 5 Total Minutes: 267 Time In: 09:13 AM Time Out: 01:40 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor this program for compliance with applicable child care requirements during an annual compliance visit. B. Lawson, Assistant Administrator, assisted with the visit. S. Elliot, Regional Director was present and assisted with the visit. This center currently operates with a five-star license, earning seven points in the education component, five points in the program standard component and 1 quality point for offering a staff benefit package and infrastructure of parent involvement. This program is required to meet enhanced space and enhanced ratio requirements. The last annual compliance visit was completed on August 20, 2024. The last sanitation inspection was completed on June 17, 2025, earning a “Superior” classification. The last fire inspection was completed on March 17, 2025, and the center was approved for daytime care only. Seventy-nine (79) children ranging from ages zero to five years old were observed in care today. Children were engaged in morning routine/activities, free-choice play, outdoor play, eating lunch, completing hand washing, diapering and toileting routines, interacting with caregivers and napping. Lunch consisted of chicken nuggets, corn, mandarin oranges, bread, and milk. The following violation was documented today: Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In Spaces 1B, 2A, 2B, and 4 electrical outlets were observed not covered with safety plugs while not in use. 10A NCAC 09 .0604(c) TECHNICAL ASSISTANCE AND CONSULTATION: The center’s compliance history score was reviewed with the operator. The program’s compliance history was 97% as of August 14, 2025. CORPORATION STATUS: Premier NC Wilson LLC is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Premier NC Wilson LLC remains current and active. I reminded you the corporation status for your program must always remain Current and Active. Failure to comply may affect your child care license. FACILITY PROFILE INFORMATION: You verified the phone number and mailing address listed on the facility profile are correct. You added the email address has changed and needs to be updated. I asked that you give me written documentation requesting the change. The statement should include the updated email address. If additional changes in your facility’s information occur in the future, contact me at 252-214-8454 or email emily.hargrove@dhhs.nc.gov to discuss the changes and ensure accurate information is updated in our system. PROGRAM RECORDS: Fire Drills/Emergency Drills, Fire inspection, Sanitation report, First Aid/CPR Poster, Playground Outdoor Inspections, EMC Plan and License were reviewed and current. CHILDREN AND STAFF RECORDS: Ten percent (10%) or more of children records were monitored. Children records reviewed, were in compliance. Other children’s files not reviewed should be monitored to ensure compliance for the same information. Ten percent (10%) or more of existent staff files were monitored. Staff records reviewed were in compliance. Other staff records should be monitored for the same information to ensure compliance. ELECTRICAL OUTLETS: In Spaces 1B, 2A, 2B, and 4 electrical outlets were observed not covered with safety plugs while not in use. I discussed with you that it is a requirement to have electrical outlets covered with safety plugs while not in use. I encourage you to have staff, and janitors to double check daily to ensure the outlets are plugged with safety plugs. QRIS MODERNIZATION: I discussed with you and showed you on the DCDEE website how to get to the QRIS Modernization information. I shared with you that you would need to start preparing to choose the pathway you are interested in. Please let me know if you have any questions. Choosing a Pathway to the Stars The Pathways to the Stars transition will begin soon. In August, we’ll provide a rule roll out module in the DCDEE e-learning Moodle platform. We’ll also host informational webinars: Webinars – Choosing a Pathway to the Stars • August 18 at 1:00pm (child care centers and centers located in a residence) Join webinar • August 18 at 6:30pm (family child care homes) Join webinar • August 20 at 1:00pm (family child care homes) Join webinar • August 20 at 6:30pm (child care centers and centers located in a residence) Join webinar In September, child care consultants will host in-person facility operator/administrator meetings within the counties they serve to provide additional guidance on the changes, the transition plan and timeline. Beginning In October, child care consultants will begin discussing the new rules in Section .3200; Standards for Two through Five Star Rated Licenses during licensing visits. Consultants will review the pathway options, identify facility needs, answer questions, and work with the facility operator to establish an individualized timeline for transition to a new rated license within 12 months based on the pathway chosen. PROVIDER DOCUMENTS/FORMS: You should visit the website often to ensure you’re using all updated forms. All requirements must be included if you choose to use your own forms electronically or hard copy. Child care rules updated effective July 1, 2023, and January 1, 2024. RESOURCES: • The most current provider documents/ forms, checklists, resources related to child care, MOODLE trainings, and new child care requirements can be found on the Division of Child Development and Early Education website. https://ncchildcare.ncdhhs.gov/ • NC Child Care Health & Safety Resource Center for posters www.healthychildcare.unc.edu • NCRLAP: NCRLAP.org If you have questions related to this visit or if I can be of additional assistance, I can be reached at 252-214-8454 or emily.hargrove@dhhs.nc.gov. You may also contact Susan Fuller, Licensing Supervisor at 252-373-9809 or susan.fuller@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0601 · Violation

Name of Operation: BUILDING BLOCKS FOR TOTS Facility ID: 98000209 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 2/25/2025 Number Present: 96 Completed Date: 2/25/2025 Age: From 0 To 5 Total Minutes: 155 Time In: 08:20 AM Time Out: 10:55 AM 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 this program for compliance with applicable child care requirements during a routine unannounced visit. B. Lawson, Assistant Director, assisted with the visit. This center currently operates with a five-star license, earning seven points in education standards, five points in program standards, and 1 quality point for the center offering a staff benefits package and an infrastructure of parent involvement. The last annual compliance visit was conducted on August 20, 2024. The last sanitation inspection was completed on December 19, 2024, earning a “Superior” classification. The last fire inspection was completed on March 1326, 2024, and the center was approved for daytime care only. Ninety (96) children ranging from ages zero (30) to five (5) years old were observed in care today. Children were engaged in morning routines/activities, free-choice play, eating breakfast, completing hand washing, diapering and toileting routines, and interacting with caregivers. Breakfast consisted of cereal, peaches, and milk. The following violations were documented today. Violation Number Comment Rule 405 A child's hands were not washed after each diaper change. A child's hands were not washed after diaper changing in Space #3. 15A NCAC 18A .2803(c)(2) 807 A safe indoor and outdoor environment was not provided for the children. The base of the basketball goal was cracked exposing sharp edges, two white laundry baskets attached to the fence and accessible to children were cracked exposing sharp edges and nail were protruding from the wooden fence on the playground. 10A NCAC 09 .0601(a) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. Written authorization was not on file a container of Vani cream kept onsite for one preschool child enrolled. 10A NCAC 09 .0803(1)(a & b) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Documentation verifying completion or renewal of First Aid training was not on file for four employees. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. .1102(d) 1756 Enhanced staff/child ratios and group sizes were not met. Enhanced staff/child ratio and group sizes were not met when two teachers were providing care for sixteen children ranging from ages one (1) to two (2) years old in Space #3. 10A NCAC 09 .2818 The violations documented must be corrected immediately. Please send a compliance verification letter to me describing how the violations were corrected. You can submit the compliance verification letter by postal mail to Keshia Hayward, PO Box 1504 Greenville NC 27834, or email keshia.hayward@dhhs.nc.gov. The compliance verification letter must be received on or before March 4, 2025. The two-week time frame is established to allow you time for submitting your compliance verification letter. This timeframe is not intended to be used as a guide for correcting violations, as they should be corrected immediately. Please be aware that any written information submitted by you regarding correction of violations documented during the visit is legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined the information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility's Star Rated License could be issued. If sufficient information is not received by the due date, a follow-up visit will be conducted. COMPLIANCE HISTORY SCORE: The center’s compliance history score was reviewed with the operator. The program’s compliance history was 81% as of February 24, 2025. CORPORATION STATUS: Premier NC Wilson LLC is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Premier NC Wilson LLC is listed as current but not active. You should contact the NC secretary of State to find out what the status has changed. Based on what information is provided, steps should be made to bring the status back to active. Prior to making any changes in the ownership status contact me to discuss the change of ownership procedures. Failure to comply could impact the program license status. STAFF/CHILD INTERACTIONS: Upon arrival, children in all spaces were either engaged in free choice play or eating breakfast. Staff communicated with children as they transitioned from one activity to another. Diapering and bottle feeding were observed. Infants were held for bottle feeding. During the diapering process staff talked to children. Children utilized a variety of materials while playing. Activities observed were listed on the lesson plans posted. Children were also taken outside this morning to play. They were allowed to roam the outdoor play area freely. Positive redirection and guidance were implemented. STAFF/CHILD RATIO: During my walk-through, children were transferred from one space to another. When attendance was taken in Space #3, sixteen children ranging from ages one (1) to two years old were being cared for by two (2) caregivers. I informed staff their classroom was out of compliance with staff/child ratio based on the age of the youngest child. A caregiver stated the one (1) year old child would be turning two (2) tomorrow. I explained compliance must be maintained based on his age at the time of the visit. I further shared the number of children present exceed the group size as well. You stated according to your understanding children could transition to the next class prior to becoming that age. I explained the transition was fine; however, staff/child ratio must be met for the age of the youngest child and the group size cannot be exceeded at any time. I recommend you develop a transition plan that includes the ages of children in each space and how many staff are required. The staff/child ratio posters can be used to determine groups sizes. Maintaining staff/child ratios help ensure children are cared for in a healthy and safe environment. It also gives caregiver time and opportunity to provide individualized care to the children they serve. Caring for more children than allowed increases the chance for unwarranted behaviors and injuries. An unannounced follow-up visit will be conducted to monitor staff/child ratio requirements. CPR/FIRST AID: Documentation was not on file to verify the completion or renewal of first aid/CPR for four employees. One employee did not meet the 90-day timeframe from the date of employment for completing CPR/first aid as required. A certificate on file for one employee was from an agency that offers CPR first aid online only. I explained this type of training does not satisfy the requirements according to the child care rules. I further shared that the agency was not an approved agencies listed by the Division. I recommended talking with staff about checking the Division website to ensure agency where they receive first aid/CPR training meets the Division’s guidelines for approval. You stated staff were supposed to take the training two weeks ago; however, it was cancelled so another training has been scheduled. Professional development as an early educator and child care provider is important. Meeting North Carolina state requirements for First Aid and CPR training is one part of your professional development. While distance learning (pre-recorded training) is not permitted for CPR or First Aid, a blended learning course (including face-to-face and virtual instruction) is permitted; so long as the course received is from an approved training organization and the student’s competency has been evaluated by the instructor. First aid and CPR instructors must be certified by an approved agency. If you have questions about a trainer, please contact the First Aid and/or CPR agency to express your concerns and confirm the trainer’s status. SAFE INDOOR/OUTDOOR ENVIRONMENT: I informed you the two white laundry baskets attached to the fence on the playground at the back of the building and the base of the basketball was cracked. I explained the hard plastic could puncture a child’s skin if encountered the wrong way. The laundry baskets should be removed or replaced to eliminate children from sustaining unwarranted injuries. You should also find a way to remove the hazard from the basketball base whether it be covering the sharp points or taking it from the playground. It is recommended checking for broken toys and cracked plastic during outdoor play inspections and correcting the issues immediately. Be reminded a safe environment must always be provided for children in care. EDUCATION EQUIVALENCY EXAM: The Division of Child Development and Early Education (DCDEE) prioritizes increasing career pathways for future ECE teachers. However, after lengthy careful consideration DCDEE has reluctantly decided it will not bring back the Early Childhood Equivalency Exam due to concerns about academic integrity. We make this decision to ensure fair and equitable opportunity for all aspiring early childhood teachers, uphold minimum educational standards, and keep staff and children in licensed child care environments safe. Note, other Pathways to the Profession of Early Childhood Teacher still include: •EDU 119 – Introduction to Early Childhood Education •Test-Out Option for EDU 119 •EDU 3119 – Intro to Early Childhood Education •Child Development Associate® Credential (CDA) Refer to the Raising North Carolina newsletter for additional information about each pathways and how to access them. DCDEE RESOURCES: I recommended you periodically visit the DCDEE website at https://ncchildcare.ncdhhs.gov/ under the "What's New" tab to stay abreast of updated information provided. At the conclusion of this visit, the visit summary report was completed, reviewed, and left with you. Be reminded you are responsible for maintaining compliance with all applicable child care requirements whether they have been discussed or reviewed with you in the past. CONTACT INFORMATION: If you have questions regarding today’s visit, my contact information is listed above. You may also contact Licensing Supervisor, Susan Fuller at 252-373-9809 or email susan.fuller@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0803 · Violation

Name of Operation: BUILDING BLOCKS FOR TOTS Facility ID: 98000209 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 2/25/2025 Number Present: 96 Completed Date: 2/25/2025 Age: From 0 To 5 Total Minutes: 155 Time In: 08:20 AM Time Out: 10:55 AM 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 this program for compliance with applicable child care requirements during a routine unannounced visit. B. Lawson, Assistant Director, assisted with the visit. This center currently operates with a five-star license, earning seven points in education standards, five points in program standards, and 1 quality point for the center offering a staff benefits package and an infrastructure of parent involvement. The last annual compliance visit was conducted on August 20, 2024. The last sanitation inspection was completed on December 19, 2024, earning a “Superior” classification. The last fire inspection was completed on March 1326, 2024, and the center was approved for daytime care only. Ninety (96) children ranging from ages zero (30) to five (5) years old were observed in care today. Children were engaged in morning routines/activities, free-choice play, eating breakfast, completing hand washing, diapering and toileting routines, and interacting with caregivers. Breakfast consisted of cereal, peaches, and milk. The following violations were documented today. Violation Number Comment Rule 405 A child's hands were not washed after each diaper change. A child's hands were not washed after diaper changing in Space #3. 15A NCAC 18A .2803(c)(2) 807 A safe indoor and outdoor environment was not provided for the children. The base of the basketball goal was cracked exposing sharp edges, two white laundry baskets attached to the fence and accessible to children were cracked exposing sharp edges and nail were protruding from the wooden fence on the playground. 10A NCAC 09 .0601(a) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. Written authorization was not on file a container of Vani cream kept onsite for one preschool child enrolled. 10A NCAC 09 .0803(1)(a & b) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Documentation verifying completion or renewal of First Aid training was not on file for four employees. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. .1102(d) 1756 Enhanced staff/child ratios and group sizes were not met. Enhanced staff/child ratio and group sizes were not met when two teachers were providing care for sixteen children ranging from ages one (1) to two (2) years old in Space #3. 10A NCAC 09 .2818 The violations documented must be corrected immediately. Please send a compliance verification letter to me describing how the violations were corrected. You can submit the compliance verification letter by postal mail to Keshia Hayward, PO Box 1504 Greenville NC 27834, or email keshia.hayward@dhhs.nc.gov. The compliance verification letter must be received on or before March 4, 2025. The two-week time frame is established to allow you time for submitting your compliance verification letter. This timeframe is not intended to be used as a guide for correcting violations, as they should be corrected immediately. Please be aware that any written information submitted by you regarding correction of violations documented during the visit is legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined the information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility's Star Rated License could be issued. If sufficient information is not received by the due date, a follow-up visit will be conducted. COMPLIANCE HISTORY SCORE: The center’s compliance history score was reviewed with the operator. The program’s compliance history was 81% as of February 24, 2025. CORPORATION STATUS: Premier NC Wilson LLC is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Premier NC Wilson LLC is listed as current but not active. You should contact the NC secretary of State to find out what the status has changed. Based on what information is provided, steps should be made to bring the status back to active. Prior to making any changes in the ownership status contact me to discuss the change of ownership procedures. Failure to comply could impact the program license status. STAFF/CHILD INTERACTIONS: Upon arrival, children in all spaces were either engaged in free choice play or eating breakfast. Staff communicated with children as they transitioned from one activity to another. Diapering and bottle feeding were observed. Infants were held for bottle feeding. During the diapering process staff talked to children. Children utilized a variety of materials while playing. Activities observed were listed on the lesson plans posted. Children were also taken outside this morning to play. They were allowed to roam the outdoor play area freely. Positive redirection and guidance were implemented. STAFF/CHILD RATIO: During my walk-through, children were transferred from one space to another. When attendance was taken in Space #3, sixteen children ranging from ages one (1) to two years old were being cared for by two (2) caregivers. I informed staff their classroom was out of compliance with staff/child ratio based on the age of the youngest child. A caregiver stated the one (1) year old child would be turning two (2) tomorrow. I explained compliance must be maintained based on his age at the time of the visit. I further shared the number of children present exceed the group size as well. You stated according to your understanding children could transition to the next class prior to becoming that age. I explained the transition was fine; however, staff/child ratio must be met for the age of the youngest child and the group size cannot be exceeded at any time. I recommend you develop a transition plan that includes the ages of children in each space and how many staff are required. The staff/child ratio posters can be used to determine groups sizes. Maintaining staff/child ratios help ensure children are cared for in a healthy and safe environment. It also gives caregiver time and opportunity to provide individualized care to the children they serve. Caring for more children than allowed increases the chance for unwarranted behaviors and injuries. An unannounced follow-up visit will be conducted to monitor staff/child ratio requirements. CPR/FIRST AID: Documentation was not on file to verify the completion or renewal of first aid/CPR for four employees. One employee did not meet the 90-day timeframe from the date of employment for completing CPR/first aid as required. A certificate on file for one employee was from an agency that offers CPR first aid online only. I explained this type of training does not satisfy the requirements according to the child care rules. I further shared that the agency was not an approved agencies listed by the Division. I recommended talking with staff about checking the Division website to ensure agency where they receive first aid/CPR training meets the Division’s guidelines for approval. You stated staff were supposed to take the training two weeks ago; however, it was cancelled so another training has been scheduled. Professional development as an early educator and child care provider is important. Meeting North Carolina state requirements for First Aid and CPR training is one part of your professional development. While distance learning (pre-recorded training) is not permitted for CPR or First Aid, a blended learning course (including face-to-face and virtual instruction) is permitted; so long as the course received is from an approved training organization and the student’s competency has been evaluated by the instructor. First aid and CPR instructors must be certified by an approved agency. If you have questions about a trainer, please contact the First Aid and/or CPR agency to express your concerns and confirm the trainer’s status. SAFE INDOOR/OUTDOOR ENVIRONMENT: I informed you the two white laundry baskets attached to the fence on the playground at the back of the building and the base of the basketball was cracked. I explained the hard plastic could puncture a child’s skin if encountered the wrong way. The laundry baskets should be removed or replaced to eliminate children from sustaining unwarranted injuries. You should also find a way to remove the hazard from the basketball base whether it be covering the sharp points or taking it from the playground. It is recommended checking for broken toys and cracked plastic during outdoor play inspections and correcting the issues immediately. Be reminded a safe environment must always be provided for children in care. EDUCATION EQUIVALENCY EXAM: The Division of Child Development and Early Education (DCDEE) prioritizes increasing career pathways for future ECE teachers. However, after lengthy careful consideration DCDEE has reluctantly decided it will not bring back the Early Childhood Equivalency Exam due to concerns about academic integrity. We make this decision to ensure fair and equitable opportunity for all aspiring early childhood teachers, uphold minimum educational standards, and keep staff and children in licensed child care environments safe. Note, other Pathways to the Profession of Early Childhood Teacher still include: •EDU 119 – Introduction to Early Childhood Education •Test-Out Option for EDU 119 •EDU 3119 – Intro to Early Childhood Education •Child Development Associate® Credential (CDA) Refer to the Raising North Carolina newsletter for additional information about each pathways and how to access them. DCDEE RESOURCES: I recommended you periodically visit the DCDEE website at https://ncchildcare.ncdhhs.gov/ under the "What's New" tab to stay abreast of updated information provided. At the conclusion of this visit, the visit summary report was completed, reviewed, and left with you. Be reminded you are responsible for maintaining compliance with all applicable child care requirements whether they have been discussed or reviewed with you in the past. CONTACT INFORMATION: If you have questions regarding today’s visit, my contact information is listed above. You may also contact Licensing Supervisor, Susan Fuller at 252-373-9809 or email susan.fuller@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2818 · Violation

Name of Operation: BUILDING BLOCKS FOR TOTS Facility ID: 98000209 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 2/25/2025 Number Present: 96 Completed Date: 2/25/2025 Age: From 0 To 5 Total Minutes: 155 Time In: 08:20 AM Time Out: 10:55 AM 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 this program for compliance with applicable child care requirements during a routine unannounced visit. B. Lawson, Assistant Director, assisted with the visit. This center currently operates with a five-star license, earning seven points in education standards, five points in program standards, and 1 quality point for the center offering a staff benefits package and an infrastructure of parent involvement. The last annual compliance visit was conducted on August 20, 2024. The last sanitation inspection was completed on December 19, 2024, earning a “Superior” classification. The last fire inspection was completed on March 1326, 2024, and the center was approved for daytime care only. Ninety (96) children ranging from ages zero (30) to five (5) years old were observed in care today. Children were engaged in morning routines/activities, free-choice play, eating breakfast, completing hand washing, diapering and toileting routines, and interacting with caregivers. Breakfast consisted of cereal, peaches, and milk. The following violations were documented today. Violation Number Comment Rule 405 A child's hands were not washed after each diaper change. A child's hands were not washed after diaper changing in Space #3. 15A NCAC 18A .2803(c)(2) 807 A safe indoor and outdoor environment was not provided for the children. The base of the basketball goal was cracked exposing sharp edges, two white laundry baskets attached to the fence and accessible to children were cracked exposing sharp edges and nail were protruding from the wooden fence on the playground. 10A NCAC 09 .0601(a) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. Written authorization was not on file a container of Vani cream kept onsite for one preschool child enrolled. 10A NCAC 09 .0803(1)(a & b) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Documentation verifying completion or renewal of First Aid training was not on file for four employees. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. .1102(d) 1756 Enhanced staff/child ratios and group sizes were not met. Enhanced staff/child ratio and group sizes were not met when two teachers were providing care for sixteen children ranging from ages one (1) to two (2) years old in Space #3. 10A NCAC 09 .2818 The violations documented must be corrected immediately. Please send a compliance verification letter to me describing how the violations were corrected. You can submit the compliance verification letter by postal mail to Keshia Hayward, PO Box 1504 Greenville NC 27834, or email keshia.hayward@dhhs.nc.gov. The compliance verification letter must be received on or before March 4, 2025. The two-week time frame is established to allow you time for submitting your compliance verification letter. This timeframe is not intended to be used as a guide for correcting violations, as they should be corrected immediately. Please be aware that any written information submitted by you regarding correction of violations documented during the visit is legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined the information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility's Star Rated License could be issued. If sufficient information is not received by the due date, a follow-up visit will be conducted. COMPLIANCE HISTORY SCORE: The center’s compliance history score was reviewed with the operator. The program’s compliance history was 81% as of February 24, 2025. CORPORATION STATUS: Premier NC Wilson LLC is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Premier NC Wilson LLC is listed as current but not active. You should contact the NC secretary of State to find out what the status has changed. Based on what information is provided, steps should be made to bring the status back to active. Prior to making any changes in the ownership status contact me to discuss the change of ownership procedures. Failure to comply could impact the program license status. STAFF/CHILD INTERACTIONS: Upon arrival, children in all spaces were either engaged in free choice play or eating breakfast. Staff communicated with children as they transitioned from one activity to another. Diapering and bottle feeding were observed. Infants were held for bottle feeding. During the diapering process staff talked to children. Children utilized a variety of materials while playing. Activities observed were listed on the lesson plans posted. Children were also taken outside this morning to play. They were allowed to roam the outdoor play area freely. Positive redirection and guidance were implemented. STAFF/CHILD RATIO: During my walk-through, children were transferred from one space to another. When attendance was taken in Space #3, sixteen children ranging from ages one (1) to two years old were being cared for by two (2) caregivers. I informed staff their classroom was out of compliance with staff/child ratio based on the age of the youngest child. A caregiver stated the one (1) year old child would be turning two (2) tomorrow. I explained compliance must be maintained based on his age at the time of the visit. I further shared the number of children present exceed the group size as well. You stated according to your understanding children could transition to the next class prior to becoming that age. I explained the transition was fine; however, staff/child ratio must be met for the age of the youngest child and the group size cannot be exceeded at any time. I recommend you develop a transition plan that includes the ages of children in each space and how many staff are required. The staff/child ratio posters can be used to determine groups sizes. Maintaining staff/child ratios help ensure children are cared for in a healthy and safe environment. It also gives caregiver time and opportunity to provide individualized care to the children they serve. Caring for more children than allowed increases the chance for unwarranted behaviors and injuries. An unannounced follow-up visit will be conducted to monitor staff/child ratio requirements. CPR/FIRST AID: Documentation was not on file to verify the completion or renewal of first aid/CPR for four employees. One employee did not meet the 90-day timeframe from the date of employment for completing CPR/first aid as required. A certificate on file for one employee was from an agency that offers CPR first aid online only. I explained this type of training does not satisfy the requirements according to the child care rules. I further shared that the agency was not an approved agencies listed by the Division. I recommended talking with staff about checking the Division website to ensure agency where they receive first aid/CPR training meets the Division’s guidelines for approval. You stated staff were supposed to take the training two weeks ago; however, it was cancelled so another training has been scheduled. Professional development as an early educator and child care provider is important. Meeting North Carolina state requirements for First Aid and CPR training is one part of your professional development. While distance learning (pre-recorded training) is not permitted for CPR or First Aid, a blended learning course (including face-to-face and virtual instruction) is permitted; so long as the course received is from an approved training organization and the student’s competency has been evaluated by the instructor. First aid and CPR instructors must be certified by an approved agency. If you have questions about a trainer, please contact the First Aid and/or CPR agency to express your concerns and confirm the trainer’s status. SAFE INDOOR/OUTDOOR ENVIRONMENT: I informed you the two white laundry baskets attached to the fence on the playground at the back of the building and the base of the basketball was cracked. I explained the hard plastic could puncture a child’s skin if encountered the wrong way. The laundry baskets should be removed or replaced to eliminate children from sustaining unwarranted injuries. You should also find a way to remove the hazard from the basketball base whether it be covering the sharp points or taking it from the playground. It is recommended checking for broken toys and cracked plastic during outdoor play inspections and correcting the issues immediately. Be reminded a safe environment must always be provided for children in care. EDUCATION EQUIVALENCY EXAM: The Division of Child Development and Early Education (DCDEE) prioritizes increasing career pathways for future ECE teachers. However, after lengthy careful consideration DCDEE has reluctantly decided it will not bring back the Early Childhood Equivalency Exam due to concerns about academic integrity. We make this decision to ensure fair and equitable opportunity for all aspiring early childhood teachers, uphold minimum educational standards, and keep staff and children in licensed child care environments safe. Note, other Pathways to the Profession of Early Childhood Teacher still include: •EDU 119 – Introduction to Early Childhood Education •Test-Out Option for EDU 119 •EDU 3119 – Intro to Early Childhood Education •Child Development Associate® Credential (CDA) Refer to the Raising North Carolina newsletter for additional information about each pathways and how to access them. DCDEE RESOURCES: I recommended you periodically visit the DCDEE website at https://ncchildcare.ncdhhs.gov/ under the "What's New" tab to stay abreast of updated information provided. At the conclusion of this visit, the visit summary report was completed, reviewed, and left with you. Be reminded you are responsible for maintaining compliance with all applicable child care requirements whether they have been discussed or reviewed with you in the past. CONTACT INFORMATION: If you have questions regarding today’s visit, my contact information is listed above. You may also contact Licensing Supervisor, Susan Fuller at 252-373-9809 or email susan.fuller@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0514 · Violation

Name of Operation: BUILDING BLOCKS FOR TOTS Facility ID: 98000209 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 8/20/2024 Number Present: 80 Completed Date: 8/20/2024 Age: From 0 To 4 Total Minutes: 285 Time In: 08:45 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor this program for compliance with applicable child care requirements during an annual compliance visit. H. Beamon, Administrator, assisted with the visit. This center currently operates with a five-star license, earning seven points in the education component, five points in the program standard component and 1 quality point for offering a staff benefit package and infrastructure of parent involvement. This program is required to meet enhanced space and enhanced ratio requirements. The last annual compliance visit was completed on August 26, 2023. The last sanitation inspection was completed on June 24, 2024, earning a “Superior” classification. The last fire inspection was completed on March 26, 2024, and the center was approved for daytime care only. Seventy (70) children ranging from ages zero to four years old were observed in care today. Children were engaged in morning routine/activities, free-choice play, outdoor play, eating lunch, completing hand washing, diapering and toileting routines, interacting with caregivers and napping. Lunch consisted of macaroni cheese, mixed fruit, green beans, and milk. The following violations were documented. Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. Documentation was not on file to verify the NC Child Care Law was given to parents of eight children enrolled in the center. GS 110-102 807 A safe indoor and outdoor environment was not provided for the children. Tree roots were protruding above ground posing tripping hazards on preschool and toddler playgrounds. A watering container and clear storage container was cracked exposing sharp edges on the preschool playground. A bamboo pole lying on the ground on the far back side of the preschool playground was cracked exposing sharp edges. 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. A container of pepper spray attached to keys was observed on the counter next to the hand washing sink in Space #2A. .2820(b) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. Written authorization and/or instructions from a child's parent was not on file for Sun Bum baby eczema cream, Butt paste, and mosquito repellent for one preschool child enrolled in Space #3. 10A NCAC 09 .0803(1)(a & b) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. Documentation was not on file to verify outdoor play inspections was not on file for May 2024 to June 2024. .0605(q) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. An annual evaluation was not on file for one staff member. The last evaluation was dated for October 2022. 10A NCAC 09 .0514(f) 1245 For each child, there was not at least 30 sq. ft. inside space per the total licensed capacity and 100 sq. ft. outside space for each child using the outdoor learning environment at any one time. Thirteen children were cared for in Space #1A which exceeded the licensing space capacity for eleven children at 30 sq. ft. per child. 10A NCAC 09 .2809(a) 1756 Enhanced staff/child ratios and group sizes were not met. Enhanced staff child ratios were not met when two caregivers were observed providing care to thirteen infants under twelve months old from 8:55am to 9:02am in Space #1A. The group size for children under twelve months was also exceeded in Space #1A. 10A NCAC 09 .2818 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Documentation was not no file verifying recognizing and responding to suspicions of child maltreatment was completed by three employees hired on October 9, 2023, March 27, 2024, and May 16, 2024. .1102(g) The violations documented must be corrected immediately. Please send a compliance verification letter to me describing how the violations were corrected. You can submit the compliance verification letter by postal mail to Keshia Hayward, PO Box 1504 Greenville NC 27834, or email keshia.hayward@dhhs.nc.gov. The compliance verification letter must be received on or before September 3, 2024. The two-week time frame is established to allow you time for submitting your compliance verification letter. This timeframe is not intended to be used as a guide for correcting violations, as they should be corrected immediately. Please be aware that any written information submitted by you regarding correction of violations documented during the visit is legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined the information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility's Star Rated License could be issued. If sufficient information is not received by the due date, a follow-up visit will be conducted. The center’s compliance history score was reviewed with the operator. The program’s compliance history was 89% as of August 19, 2024. CORPORATION STATUS: Premier NC Wilson LLC is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Premier NC Wilson LLC remains current and active. I reminded you the corporation status for your program must always remain Current and Active. Failure to comply may affect your child care license. FACILITY PROFILE INFORMATION: You verified the phone number and mailing address listed on the facility profile are correct. You added the email address has changed and needs to be updated. I asked that you give me written documentation requesting the change. The statement should include the updated email address. If additional changes in your facility’s information occur in the future, contact me at 252-214-2709 or email keshia.hayward@dhhs.nc.gov to discuss the changes and ensure accurate information is updated in our system. STAFF/CHILD RATIO: Two caregivers were observed providing care for thirteen infants under the age of twelve months in Space 1A. You were notified immediately the space was out of compliance with staff/child ratio. You stated you were aware of the noncompliance with staff/child ratio. You added the third employee who was supposed to transition the overflow for that group was running late for work. You and another employee transitioned five of the children into Space #2A with one caregiver for continued care leaving Space #1A with eight children and two caregivers. Also, when thirteen children were cared for in Space #1A the licensed space capacity for that classroom was exceeded. Your program is licensed to meeting enhanced space capacity; therefore, the requirements of 30 sq. ft. per child as listed on the floor plan must always be met. You and staff should monitor the number of children cared for in each space to ensure capacity is not exceeded at any time. Research indicates that staff/child ratio and group sizes are strong indicators of quality of child care. Sufficient staff should be available to maintain staff/child ratio requirements for each group of children. A staffing patterns with schedules could assist with ensuring there are enough staff members present and available for staff/child ratio. A plan of action should be put into place to implement when staff need to be absent for emergency reason or just to step outside the classroom for to attend to personal care. Smaller groups and lower staff/child ratios are r elated to positive outcomes for children, including increased adult interaction, less aggression, and more cooperation amongst children. UNANNOUNCED FOLLOW-UP VISIT: An unannounced follow-up visit will be conducted to monitor staff/child ratio requirements. MEDICATION ADMINISTRATION: Written authorization to administer medication should be on file for all prescription and over the counter medication provided for children in child care. When discussing the option to administer medication with parents a copy of the medication permission form should be given and requested when the medication is received. The parent completed the medication permission form during the visit. Documentation was provided for review during consultation. It is important to have authorization with instructions for administering the medication from the parents/health care physician at the time the medication is left at the facility. Administering medication to children without written authorization places a liability on your program in the event an incident occurs because of the medication given. RECOGNIZING AND RESPONDING TO SUSPICIONS OF CHILD MALTREATMENT TRAINING: Two new staff hired had copies of recognizing and responding to suspicions of child maltreatment trainings in their files; however, the training was more than twelve months old. I informed you because the training was over twelve months it was not valid although it was still within the five-year timeframe. We also discussed ensuring staff complete the recognizing and responding to suspicions of child maltreatment within 90 days of employment as required. Planning for staff to complete training early will help avoid missing timelines and renewals dates. You could develop a system for tracking required trainings and due dates. The staff file checklist is also a good tool to use to help determine and track training dates and requirements. QUALITY RATING IMPROVEMENT SYSTEM: The Governor signed Senate Bill 425 (now Session Law 2024-34), Health and Human Services Omnibus Bill, which includes the Quality Rating Improvement System (QRIS) Modifications recommended to the Legislature by the NC Child Care Commission to update QRIS and create additional pathways for licensed child care facilities to earn star rated licenses. Hold Harmless provisions have been extended and star rated license assessments for licensed child care providers will be conducted by provider request only, until the QRIS rulemaking process has been completed. Star rated license assessments are still required for new child care programs; however, current license programs are not required to complete the process until further notice unless it is requested voluntarily. This legislation also provides a pathway for child care programs currently accredited through the approved accrediting bodies to move to a 3 or 5 star license if they are not already at this star level. Providers will need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. MENTAL HEALTH BEGINS BY BIRTH: A free 6-hour training on the foundations of infant and early childhood mental health, offered by the ARCh Project at the Center for Child & Family Health. The six hours are divided over two half-days of content: The training dates will be on Friday, August 30th and Friday, September 6th, from 9:30am to 12:30pm each of those days. I will send you registration information via email. Available to anyone in NC whose professional work supports the relational, emotional, and mental health of babies and young children. DCDEE RESOURCES: I recommended you periodically visit the DCDEE website at https://ncchildcare.ncdhhs.gov/ under the "What's New" tab to stay abreast of updated information provided. Be reminded you are responsible for maintaining compliance with all applicable child care requirements whether they have been discussed or reviewed with you in the past. CONTACT INFORMATION: If you have questions regarding today’s visit, my contact information is listed above. You may also contact Licensing Supervisor, Susan Fuller at 252-373-9809 or email susan.fuller@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0803 · Violation

Name of Operation: BUILDING BLOCKS FOR TOTS Facility ID: 98000209 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 8/20/2024 Number Present: 80 Completed Date: 8/20/2024 Age: From 0 To 4 Total Minutes: 285 Time In: 08:45 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor this program for compliance with applicable child care requirements during an annual compliance visit. H. Beamon, Administrator, assisted with the visit. This center currently operates with a five-star license, earning seven points in the education component, five points in the program standard component and 1 quality point for offering a staff benefit package and infrastructure of parent involvement. This program is required to meet enhanced space and enhanced ratio requirements. The last annual compliance visit was completed on August 26, 2023. The last sanitation inspection was completed on June 24, 2024, earning a “Superior” classification. The last fire inspection was completed on March 26, 2024, and the center was approved for daytime care only. Seventy (70) children ranging from ages zero to four years old were observed in care today. Children were engaged in morning routine/activities, free-choice play, outdoor play, eating lunch, completing hand washing, diapering and toileting routines, interacting with caregivers and napping. Lunch consisted of macaroni cheese, mixed fruit, green beans, and milk. The following violations were documented. Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. Documentation was not on file to verify the NC Child Care Law was given to parents of eight children enrolled in the center. GS 110-102 807 A safe indoor and outdoor environment was not provided for the children. Tree roots were protruding above ground posing tripping hazards on preschool and toddler playgrounds. A watering container and clear storage container was cracked exposing sharp edges on the preschool playground. A bamboo pole lying on the ground on the far back side of the preschool playground was cracked exposing sharp edges. 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. A container of pepper spray attached to keys was observed on the counter next to the hand washing sink in Space #2A. .2820(b) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. Written authorization and/or instructions from a child's parent was not on file for Sun Bum baby eczema cream, Butt paste, and mosquito repellent for one preschool child enrolled in Space #3. 10A NCAC 09 .0803(1)(a & b) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. Documentation was not on file to verify outdoor play inspections was not on file for May 2024 to June 2024. .0605(q) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. An annual evaluation was not on file for one staff member. The last evaluation was dated for October 2022. 10A NCAC 09 .0514(f) 1245 For each child, there was not at least 30 sq. ft. inside space per the total licensed capacity and 100 sq. ft. outside space for each child using the outdoor learning environment at any one time. Thirteen children were cared for in Space #1A which exceeded the licensing space capacity for eleven children at 30 sq. ft. per child. 10A NCAC 09 .2809(a) 1756 Enhanced staff/child ratios and group sizes were not met. Enhanced staff child ratios were not met when two caregivers were observed providing care to thirteen infants under twelve months old from 8:55am to 9:02am in Space #1A. The group size for children under twelve months was also exceeded in Space #1A. 10A NCAC 09 .2818 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Documentation was not no file verifying recognizing and responding to suspicions of child maltreatment was completed by three employees hired on October 9, 2023, March 27, 2024, and May 16, 2024. .1102(g) The violations documented must be corrected immediately. Please send a compliance verification letter to me describing how the violations were corrected. You can submit the compliance verification letter by postal mail to Keshia Hayward, PO Box 1504 Greenville NC 27834, or email keshia.hayward@dhhs.nc.gov. The compliance verification letter must be received on or before September 3, 2024. The two-week time frame is established to allow you time for submitting your compliance verification letter. This timeframe is not intended to be used as a guide for correcting violations, as they should be corrected immediately. Please be aware that any written information submitted by you regarding correction of violations documented during the visit is legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined the information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility's Star Rated License could be issued. If sufficient information is not received by the due date, a follow-up visit will be conducted. The center’s compliance history score was reviewed with the operator. The program’s compliance history was 89% as of August 19, 2024. CORPORATION STATUS: Premier NC Wilson LLC is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Premier NC Wilson LLC remains current and active. I reminded you the corporation status for your program must always remain Current and Active. Failure to comply may affect your child care license. FACILITY PROFILE INFORMATION: You verified the phone number and mailing address listed on the facility profile are correct. You added the email address has changed and needs to be updated. I asked that you give me written documentation requesting the change. The statement should include the updated email address. If additional changes in your facility’s information occur in the future, contact me at 252-214-2709 or email keshia.hayward@dhhs.nc.gov to discuss the changes and ensure accurate information is updated in our system. STAFF/CHILD RATIO: Two caregivers were observed providing care for thirteen infants under the age of twelve months in Space 1A. You were notified immediately the space was out of compliance with staff/child ratio. You stated you were aware of the noncompliance with staff/child ratio. You added the third employee who was supposed to transition the overflow for that group was running late for work. You and another employee transitioned five of the children into Space #2A with one caregiver for continued care leaving Space #1A with eight children and two caregivers. Also, when thirteen children were cared for in Space #1A the licensed space capacity for that classroom was exceeded. Your program is licensed to meeting enhanced space capacity; therefore, the requirements of 30 sq. ft. per child as listed on the floor plan must always be met. You and staff should monitor the number of children cared for in each space to ensure capacity is not exceeded at any time. Research indicates that staff/child ratio and group sizes are strong indicators of quality of child care. Sufficient staff should be available to maintain staff/child ratio requirements for each group of children. A staffing patterns with schedules could assist with ensuring there are enough staff members present and available for staff/child ratio. A plan of action should be put into place to implement when staff need to be absent for emergency reason or just to step outside the classroom for to attend to personal care. Smaller groups and lower staff/child ratios are r elated to positive outcomes for children, including increased adult interaction, less aggression, and more cooperation amongst children. UNANNOUNCED FOLLOW-UP VISIT: An unannounced follow-up visit will be conducted to monitor staff/child ratio requirements. MEDICATION ADMINISTRATION: Written authorization to administer medication should be on file for all prescription and over the counter medication provided for children in child care. When discussing the option to administer medication with parents a copy of the medication permission form should be given and requested when the medication is received. The parent completed the medication permission form during the visit. Documentation was provided for review during consultation. It is important to have authorization with instructions for administering the medication from the parents/health care physician at the time the medication is left at the facility. Administering medication to children without written authorization places a liability on your program in the event an incident occurs because of the medication given. RECOGNIZING AND RESPONDING TO SUSPICIONS OF CHILD MALTREATMENT TRAINING: Two new staff hired had copies of recognizing and responding to suspicions of child maltreatment trainings in their files; however, the training was more than twelve months old. I informed you because the training was over twelve months it was not valid although it was still within the five-year timeframe. We also discussed ensuring staff complete the recognizing and responding to suspicions of child maltreatment within 90 days of employment as required. Planning for staff to complete training early will help avoid missing timelines and renewals dates. You could develop a system for tracking required trainings and due dates. The staff file checklist is also a good tool to use to help determine and track training dates and requirements. QUALITY RATING IMPROVEMENT SYSTEM: The Governor signed Senate Bill 425 (now Session Law 2024-34), Health and Human Services Omnibus Bill, which includes the Quality Rating Improvement System (QRIS) Modifications recommended to the Legislature by the NC Child Care Commission to update QRIS and create additional pathways for licensed child care facilities to earn star rated licenses. Hold Harmless provisions have been extended and star rated license assessments for licensed child care providers will be conducted by provider request only, until the QRIS rulemaking process has been completed. Star rated license assessments are still required for new child care programs; however, current license programs are not required to complete the process until further notice unless it is requested voluntarily. This legislation also provides a pathway for child care programs currently accredited through the approved accrediting bodies to move to a 3 or 5 star license if they are not already at this star level. Providers will need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. MENTAL HEALTH BEGINS BY BIRTH: A free 6-hour training on the foundations of infant and early childhood mental health, offered by the ARCh Project at the Center for Child & Family Health. The six hours are divided over two half-days of content: The training dates will be on Friday, August 30th and Friday, September 6th, from 9:30am to 12:30pm each of those days. I will send you registration information via email. Available to anyone in NC whose professional work supports the relational, emotional, and mental health of babies and young children. DCDEE RESOURCES: I recommended you periodically visit the DCDEE website at https://ncchildcare.ncdhhs.gov/ under the "What's New" tab to stay abreast of updated information provided. Be reminded you are responsible for maintaining compliance with all applicable child care requirements whether they have been discussed or reviewed with you in the past. CONTACT INFORMATION: If you have questions regarding today’s visit, my contact information is listed above. You may also contact Licensing Supervisor, Susan Fuller at 252-373-9809 or email susan.fuller@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2809 · Violation

Name of Operation: BUILDING BLOCKS FOR TOTS Facility ID: 98000209 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 8/20/2024 Number Present: 80 Completed Date: 8/20/2024 Age: From 0 To 4 Total Minutes: 285 Time In: 08:45 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor this program for compliance with applicable child care requirements during an annual compliance visit. H. Beamon, Administrator, assisted with the visit. This center currently operates with a five-star license, earning seven points in the education component, five points in the program standard component and 1 quality point for offering a staff benefit package and infrastructure of parent involvement. This program is required to meet enhanced space and enhanced ratio requirements. The last annual compliance visit was completed on August 26, 2023. The last sanitation inspection was completed on June 24, 2024, earning a “Superior” classification. The last fire inspection was completed on March 26, 2024, and the center was approved for daytime care only. Seventy (70) children ranging from ages zero to four years old were observed in care today. Children were engaged in morning routine/activities, free-choice play, outdoor play, eating lunch, completing hand washing, diapering and toileting routines, interacting with caregivers and napping. Lunch consisted of macaroni cheese, mixed fruit, green beans, and milk. The following violations were documented. Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. Documentation was not on file to verify the NC Child Care Law was given to parents of eight children enrolled in the center. GS 110-102 807 A safe indoor and outdoor environment was not provided for the children. Tree roots were protruding above ground posing tripping hazards on preschool and toddler playgrounds. A watering container and clear storage container was cracked exposing sharp edges on the preschool playground. A bamboo pole lying on the ground on the far back side of the preschool playground was cracked exposing sharp edges. 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. A container of pepper spray attached to keys was observed on the counter next to the hand washing sink in Space #2A. .2820(b) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. Written authorization and/or instructions from a child's parent was not on file for Sun Bum baby eczema cream, Butt paste, and mosquito repellent for one preschool child enrolled in Space #3. 10A NCAC 09 .0803(1)(a & b) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. Documentation was not on file to verify outdoor play inspections was not on file for May 2024 to June 2024. .0605(q) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. An annual evaluation was not on file for one staff member. The last evaluation was dated for October 2022. 10A NCAC 09 .0514(f) 1245 For each child, there was not at least 30 sq. ft. inside space per the total licensed capacity and 100 sq. ft. outside space for each child using the outdoor learning environment at any one time. Thirteen children were cared for in Space #1A which exceeded the licensing space capacity for eleven children at 30 sq. ft. per child. 10A NCAC 09 .2809(a) 1756 Enhanced staff/child ratios and group sizes were not met. Enhanced staff child ratios were not met when two caregivers were observed providing care to thirteen infants under twelve months old from 8:55am to 9:02am in Space #1A. The group size for children under twelve months was also exceeded in Space #1A. 10A NCAC 09 .2818 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Documentation was not no file verifying recognizing and responding to suspicions of child maltreatment was completed by three employees hired on October 9, 2023, March 27, 2024, and May 16, 2024. .1102(g) The violations documented must be corrected immediately. Please send a compliance verification letter to me describing how the violations were corrected. You can submit the compliance verification letter by postal mail to Keshia Hayward, PO Box 1504 Greenville NC 27834, or email keshia.hayward@dhhs.nc.gov. The compliance verification letter must be received on or before September 3, 2024. The two-week time frame is established to allow you time for submitting your compliance verification letter. This timeframe is not intended to be used as a guide for correcting violations, as they should be corrected immediately. Please be aware that any written information submitted by you regarding correction of violations documented during the visit is legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined the information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility's Star Rated License could be issued. If sufficient information is not received by the due date, a follow-up visit will be conducted. The center’s compliance history score was reviewed with the operator. The program’s compliance history was 89% as of August 19, 2024. CORPORATION STATUS: Premier NC Wilson LLC is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Premier NC Wilson LLC remains current and active. I reminded you the corporation status for your program must always remain Current and Active. Failure to comply may affect your child care license. FACILITY PROFILE INFORMATION: You verified the phone number and mailing address listed on the facility profile are correct. You added the email address has changed and needs to be updated. I asked that you give me written documentation requesting the change. The statement should include the updated email address. If additional changes in your facility’s information occur in the future, contact me at 252-214-2709 or email keshia.hayward@dhhs.nc.gov to discuss the changes and ensure accurate information is updated in our system. STAFF/CHILD RATIO: Two caregivers were observed providing care for thirteen infants under the age of twelve months in Space 1A. You were notified immediately the space was out of compliance with staff/child ratio. You stated you were aware of the noncompliance with staff/child ratio. You added the third employee who was supposed to transition the overflow for that group was running late for work. You and another employee transitioned five of the children into Space #2A with one caregiver for continued care leaving Space #1A with eight children and two caregivers. Also, when thirteen children were cared for in Space #1A the licensed space capacity for that classroom was exceeded. Your program is licensed to meeting enhanced space capacity; therefore, the requirements of 30 sq. ft. per child as listed on the floor plan must always be met. You and staff should monitor the number of children cared for in each space to ensure capacity is not exceeded at any time. Research indicates that staff/child ratio and group sizes are strong indicators of quality of child care. Sufficient staff should be available to maintain staff/child ratio requirements for each group of children. A staffing patterns with schedules could assist with ensuring there are enough staff members present and available for staff/child ratio. A plan of action should be put into place to implement when staff need to be absent for emergency reason or just to step outside the classroom for to attend to personal care. Smaller groups and lower staff/child ratios are r elated to positive outcomes for children, including increased adult interaction, less aggression, and more cooperation amongst children. UNANNOUNCED FOLLOW-UP VISIT: An unannounced follow-up visit will be conducted to monitor staff/child ratio requirements. MEDICATION ADMINISTRATION: Written authorization to administer medication should be on file for all prescription and over the counter medication provided for children in child care. When discussing the option to administer medication with parents a copy of the medication permission form should be given and requested when the medication is received. The parent completed the medication permission form during the visit. Documentation was provided for review during consultation. It is important to have authorization with instructions for administering the medication from the parents/health care physician at the time the medication is left at the facility. Administering medication to children without written authorization places a liability on your program in the event an incident occurs because of the medication given. RECOGNIZING AND RESPONDING TO SUSPICIONS OF CHILD MALTREATMENT TRAINING: Two new staff hired had copies of recognizing and responding to suspicions of child maltreatment trainings in their files; however, the training was more than twelve months old. I informed you because the training was over twelve months it was not valid although it was still within the five-year timeframe. We also discussed ensuring staff complete the recognizing and responding to suspicions of child maltreatment within 90 days of employment as required. Planning for staff to complete training early will help avoid missing timelines and renewals dates. You could develop a system for tracking required trainings and due dates. The staff file checklist is also a good tool to use to help determine and track training dates and requirements. QUALITY RATING IMPROVEMENT SYSTEM: The Governor signed Senate Bill 425 (now Session Law 2024-34), Health and Human Services Omnibus Bill, which includes the Quality Rating Improvement System (QRIS) Modifications recommended to the Legislature by the NC Child Care Commission to update QRIS and create additional pathways for licensed child care facilities to earn star rated licenses. Hold Harmless provisions have been extended and star rated license assessments for licensed child care providers will be conducted by provider request only, until the QRIS rulemaking process has been completed. Star rated license assessments are still required for new child care programs; however, current license programs are not required to complete the process until further notice unless it is requested voluntarily. This legislation also provides a pathway for child care programs currently accredited through the approved accrediting bodies to move to a 3 or 5 star license if they are not already at this star level. Providers will need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. MENTAL HEALTH BEGINS BY BIRTH: A free 6-hour training on the foundations of infant and early childhood mental health, offered by the ARCh Project at the Center for Child & Family Health. The six hours are divided over two half-days of content: The training dates will be on Friday, August 30th and Friday, September 6th, from 9:30am to 12:30pm each of those days. I will send you registration information via email. Available to anyone in NC whose professional work supports the relational, emotional, and mental health of babies and young children. DCDEE RESOURCES: I recommended you periodically visit the DCDEE website at https://ncchildcare.ncdhhs.gov/ under the "What's New" tab to stay abreast of updated information provided. Be reminded you are responsible for maintaining compliance with all applicable child care requirements whether they have been discussed or reviewed with you in the past. CONTACT INFORMATION: If you have questions regarding today’s visit, my contact information is listed above. You may also contact Licensing Supervisor, Susan Fuller at 252-373-9809 or email susan.fuller@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2818 · Violation

Name of Operation: BUILDING BLOCKS FOR TOTS Facility ID: 98000209 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 8/20/2024 Number Present: 80 Completed Date: 8/20/2024 Age: From 0 To 4 Total Minutes: 285 Time In: 08:45 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor this program for compliance with applicable child care requirements during an annual compliance visit. H. Beamon, Administrator, assisted with the visit. This center currently operates with a five-star license, earning seven points in the education component, five points in the program standard component and 1 quality point for offering a staff benefit package and infrastructure of parent involvement. This program is required to meet enhanced space and enhanced ratio requirements. The last annual compliance visit was completed on August 26, 2023. The last sanitation inspection was completed on June 24, 2024, earning a “Superior” classification. The last fire inspection was completed on March 26, 2024, and the center was approved for daytime care only. Seventy (70) children ranging from ages zero to four years old were observed in care today. Children were engaged in morning routine/activities, free-choice play, outdoor play, eating lunch, completing hand washing, diapering and toileting routines, interacting with caregivers and napping. Lunch consisted of macaroni cheese, mixed fruit, green beans, and milk. The following violations were documented. Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. Documentation was not on file to verify the NC Child Care Law was given to parents of eight children enrolled in the center. GS 110-102 807 A safe indoor and outdoor environment was not provided for the children. Tree roots were protruding above ground posing tripping hazards on preschool and toddler playgrounds. A watering container and clear storage container was cracked exposing sharp edges on the preschool playground. A bamboo pole lying on the ground on the far back side of the preschool playground was cracked exposing sharp edges. 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. A container of pepper spray attached to keys was observed on the counter next to the hand washing sink in Space #2A. .2820(b) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. Written authorization and/or instructions from a child's parent was not on file for Sun Bum baby eczema cream, Butt paste, and mosquito repellent for one preschool child enrolled in Space #3. 10A NCAC 09 .0803(1)(a & b) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. Documentation was not on file to verify outdoor play inspections was not on file for May 2024 to June 2024. .0605(q) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. An annual evaluation was not on file for one staff member. The last evaluation was dated for October 2022. 10A NCAC 09 .0514(f) 1245 For each child, there was not at least 30 sq. ft. inside space per the total licensed capacity and 100 sq. ft. outside space for each child using the outdoor learning environment at any one time. Thirteen children were cared for in Space #1A which exceeded the licensing space capacity for eleven children at 30 sq. ft. per child. 10A NCAC 09 .2809(a) 1756 Enhanced staff/child ratios and group sizes were not met. Enhanced staff child ratios were not met when two caregivers were observed providing care to thirteen infants under twelve months old from 8:55am to 9:02am in Space #1A. The group size for children under twelve months was also exceeded in Space #1A. 10A NCAC 09 .2818 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Documentation was not no file verifying recognizing and responding to suspicions of child maltreatment was completed by three employees hired on October 9, 2023, March 27, 2024, and May 16, 2024. .1102(g) The violations documented must be corrected immediately. Please send a compliance verification letter to me describing how the violations were corrected. You can submit the compliance verification letter by postal mail to Keshia Hayward, PO Box 1504 Greenville NC 27834, or email keshia.hayward@dhhs.nc.gov. The compliance verification letter must be received on or before September 3, 2024. The two-week time frame is established to allow you time for submitting your compliance verification letter. This timeframe is not intended to be used as a guide for correcting violations, as they should be corrected immediately. Please be aware that any written information submitted by you regarding correction of violations documented during the visit is legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined the information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility's Star Rated License could be issued. If sufficient information is not received by the due date, a follow-up visit will be conducted. The center’s compliance history score was reviewed with the operator. The program’s compliance history was 89% as of August 19, 2024. CORPORATION STATUS: Premier NC Wilson LLC is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Premier NC Wilson LLC remains current and active. I reminded you the corporation status for your program must always remain Current and Active. Failure to comply may affect your child care license. FACILITY PROFILE INFORMATION: You verified the phone number and mailing address listed on the facility profile are correct. You added the email address has changed and needs to be updated. I asked that you give me written documentation requesting the change. The statement should include the updated email address. If additional changes in your facility’s information occur in the future, contact me at 252-214-2709 or email keshia.hayward@dhhs.nc.gov to discuss the changes and ensure accurate information is updated in our system. STAFF/CHILD RATIO: Two caregivers were observed providing care for thirteen infants under the age of twelve months in Space 1A. You were notified immediately the space was out of compliance with staff/child ratio. You stated you were aware of the noncompliance with staff/child ratio. You added the third employee who was supposed to transition the overflow for that group was running late for work. You and another employee transitioned five of the children into Space #2A with one caregiver for continued care leaving Space #1A with eight children and two caregivers. Also, when thirteen children were cared for in Space #1A the licensed space capacity for that classroom was exceeded. Your program is licensed to meeting enhanced space capacity; therefore, the requirements of 30 sq. ft. per child as listed on the floor plan must always be met. You and staff should monitor the number of children cared for in each space to ensure capacity is not exceeded at any time. Research indicates that staff/child ratio and group sizes are strong indicators of quality of child care. Sufficient staff should be available to maintain staff/child ratio requirements for each group of children. A staffing patterns with schedules could assist with ensuring there are enough staff members present and available for staff/child ratio. A plan of action should be put into place to implement when staff need to be absent for emergency reason or just to step outside the classroom for to attend to personal care. Smaller groups and lower staff/child ratios are r elated to positive outcomes for children, including increased adult interaction, less aggression, and more cooperation amongst children. UNANNOUNCED FOLLOW-UP VISIT: An unannounced follow-up visit will be conducted to monitor staff/child ratio requirements. MEDICATION ADMINISTRATION: Written authorization to administer medication should be on file for all prescription and over the counter medication provided for children in child care. When discussing the option to administer medication with parents a copy of the medication permission form should be given and requested when the medication is received. The parent completed the medication permission form during the visit. Documentation was provided for review during consultation. It is important to have authorization with instructions for administering the medication from the parents/health care physician at the time the medication is left at the facility. Administering medication to children without written authorization places a liability on your program in the event an incident occurs because of the medication given. RECOGNIZING AND RESPONDING TO SUSPICIONS OF CHILD MALTREATMENT TRAINING: Two new staff hired had copies of recognizing and responding to suspicions of child maltreatment trainings in their files; however, the training was more than twelve months old. I informed you because the training was over twelve months it was not valid although it was still within the five-year timeframe. We also discussed ensuring staff complete the recognizing and responding to suspicions of child maltreatment within 90 days of employment as required. Planning for staff to complete training early will help avoid missing timelines and renewals dates. You could develop a system for tracking required trainings and due dates. The staff file checklist is also a good tool to use to help determine and track training dates and requirements. QUALITY RATING IMPROVEMENT SYSTEM: The Governor signed Senate Bill 425 (now Session Law 2024-34), Health and Human Services Omnibus Bill, which includes the Quality Rating Improvement System (QRIS) Modifications recommended to the Legislature by the NC Child Care Commission to update QRIS and create additional pathways for licensed child care facilities to earn star rated licenses. Hold Harmless provisions have been extended and star rated license assessments for licensed child care providers will be conducted by provider request only, until the QRIS rulemaking process has been completed. Star rated license assessments are still required for new child care programs; however, current license programs are not required to complete the process until further notice unless it is requested voluntarily. This legislation also provides a pathway for child care programs currently accredited through the approved accrediting bodies to move to a 3 or 5 star license if they are not already at this star level. Providers will need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. MENTAL HEALTH BEGINS BY BIRTH: A free 6-hour training on the foundations of infant and early childhood mental health, offered by the ARCh Project at the Center for Child & Family Health. The six hours are divided over two half-days of content: The training dates will be on Friday, August 30th and Friday, September 6th, from 9:30am to 12:30pm each of those days. I will send you registration information via email. Available to anyone in NC whose professional work supports the relational, emotional, and mental health of babies and young children. DCDEE RESOURCES: I recommended you periodically visit the DCDEE website at https://ncchildcare.ncdhhs.gov/ under the "What's New" tab to stay abreast of updated information provided. Be reminded you are responsible for maintaining compliance with all applicable child care requirements whether they have been discussed or reviewed with you in the past. CONTACT INFORMATION: If you have questions regarding today’s visit, my contact information is listed above. You may also contact Licensing Supervisor, Susan Fuller at 252-373-9809 or email susan.fuller@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-102 · Violation

Name of Operation: BUILDING BLOCKS FOR TOTS Facility ID: 98000209 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 8/20/2024 Number Present: 80 Completed Date: 8/20/2024 Age: From 0 To 4 Total Minutes: 285 Time In: 08:45 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor this program for compliance with applicable child care requirements during an annual compliance visit. H. Beamon, Administrator, assisted with the visit. This center currently operates with a five-star license, earning seven points in the education component, five points in the program standard component and 1 quality point for offering a staff benefit package and infrastructure of parent involvement. This program is required to meet enhanced space and enhanced ratio requirements. The last annual compliance visit was completed on August 26, 2023. The last sanitation inspection was completed on June 24, 2024, earning a “Superior” classification. The last fire inspection was completed on March 26, 2024, and the center was approved for daytime care only. Seventy (70) children ranging from ages zero to four years old were observed in care today. Children were engaged in morning routine/activities, free-choice play, outdoor play, eating lunch, completing hand washing, diapering and toileting routines, interacting with caregivers and napping. Lunch consisted of macaroni cheese, mixed fruit, green beans, and milk. The following violations were documented. Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. Documentation was not on file to verify the NC Child Care Law was given to parents of eight children enrolled in the center. GS 110-102 807 A safe indoor and outdoor environment was not provided for the children. Tree roots were protruding above ground posing tripping hazards on preschool and toddler playgrounds. A watering container and clear storage container was cracked exposing sharp edges on the preschool playground. A bamboo pole lying on the ground on the far back side of the preschool playground was cracked exposing sharp edges. 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. A container of pepper spray attached to keys was observed on the counter next to the hand washing sink in Space #2A. .2820(b) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. Written authorization and/or instructions from a child's parent was not on file for Sun Bum baby eczema cream, Butt paste, and mosquito repellent for one preschool child enrolled in Space #3. 10A NCAC 09 .0803(1)(a & b) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. Documentation was not on file to verify outdoor play inspections was not on file for May 2024 to June 2024. .0605(q) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. An annual evaluation was not on file for one staff member. The last evaluation was dated for October 2022. 10A NCAC 09 .0514(f) 1245 For each child, there was not at least 30 sq. ft. inside space per the total licensed capacity and 100 sq. ft. outside space for each child using the outdoor learning environment at any one time. Thirteen children were cared for in Space #1A which exceeded the licensing space capacity for eleven children at 30 sq. ft. per child. 10A NCAC 09 .2809(a) 1756 Enhanced staff/child ratios and group sizes were not met. Enhanced staff child ratios were not met when two caregivers were observed providing care to thirteen infants under twelve months old from 8:55am to 9:02am in Space #1A. The group size for children under twelve months was also exceeded in Space #1A. 10A NCAC 09 .2818 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Documentation was not no file verifying recognizing and responding to suspicions of child maltreatment was completed by three employees hired on October 9, 2023, March 27, 2024, and May 16, 2024. .1102(g) The violations documented must be corrected immediately. Please send a compliance verification letter to me describing how the violations were corrected. You can submit the compliance verification letter by postal mail to Keshia Hayward, PO Box 1504 Greenville NC 27834, or email keshia.hayward@dhhs.nc.gov. The compliance verification letter must be received on or before September 3, 2024. The two-week time frame is established to allow you time for submitting your compliance verification letter. This timeframe is not intended to be used as a guide for correcting violations, as they should be corrected immediately. Please be aware that any written information submitted by you regarding correction of violations documented during the visit is legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined the information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility's Star Rated License could be issued. If sufficient information is not received by the due date, a follow-up visit will be conducted. The center’s compliance history score was reviewed with the operator. The program’s compliance history was 89% as of August 19, 2024. CORPORATION STATUS: Premier NC Wilson LLC is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Premier NC Wilson LLC remains current and active. I reminded you the corporation status for your program must always remain Current and Active. Failure to comply may affect your child care license. FACILITY PROFILE INFORMATION: You verified the phone number and mailing address listed on the facility profile are correct. You added the email address has changed and needs to be updated. I asked that you give me written documentation requesting the change. The statement should include the updated email address. If additional changes in your facility’s information occur in the future, contact me at 252-214-2709 or email keshia.hayward@dhhs.nc.gov to discuss the changes and ensure accurate information is updated in our system. STAFF/CHILD RATIO: Two caregivers were observed providing care for thirteen infants under the age of twelve months in Space 1A. You were notified immediately the space was out of compliance with staff/child ratio. You stated you were aware of the noncompliance with staff/child ratio. You added the third employee who was supposed to transition the overflow for that group was running late for work. You and another employee transitioned five of the children into Space #2A with one caregiver for continued care leaving Space #1A with eight children and two caregivers. Also, when thirteen children were cared for in Space #1A the licensed space capacity for that classroom was exceeded. Your program is licensed to meeting enhanced space capacity; therefore, the requirements of 30 sq. ft. per child as listed on the floor plan must always be met. You and staff should monitor the number of children cared for in each space to ensure capacity is not exceeded at any time. Research indicates that staff/child ratio and group sizes are strong indicators of quality of child care. Sufficient staff should be available to maintain staff/child ratio requirements for each group of children. A staffing patterns with schedules could assist with ensuring there are enough staff members present and available for staff/child ratio. A plan of action should be put into place to implement when staff need to be absent for emergency reason or just to step outside the classroom for to attend to personal care. Smaller groups and lower staff/child ratios are r elated to positive outcomes for children, including increased adult interaction, less aggression, and more cooperation amongst children. UNANNOUNCED FOLLOW-UP VISIT: An unannounced follow-up visit will be conducted to monitor staff/child ratio requirements. MEDICATION ADMINISTRATION: Written authorization to administer medication should be on file for all prescription and over the counter medication provided for children in child care. When discussing the option to administer medication with parents a copy of the medication permission form should be given and requested when the medication is received. The parent completed the medication permission form during the visit. Documentation was provided for review during consultation. It is important to have authorization with instructions for administering the medication from the parents/health care physician at the time the medication is left at the facility. Administering medication to children without written authorization places a liability on your program in the event an incident occurs because of the medication given. RECOGNIZING AND RESPONDING TO SUSPICIONS OF CHILD MALTREATMENT TRAINING: Two new staff hired had copies of recognizing and responding to suspicions of child maltreatment trainings in their files; however, the training was more than twelve months old. I informed you because the training was over twelve months it was not valid although it was still within the five-year timeframe. We also discussed ensuring staff complete the recognizing and responding to suspicions of child maltreatment within 90 days of employment as required. Planning for staff to complete training early will help avoid missing timelines and renewals dates. You could develop a system for tracking required trainings and due dates. The staff file checklist is also a good tool to use to help determine and track training dates and requirements. QUALITY RATING IMPROVEMENT SYSTEM: The Governor signed Senate Bill 425 (now Session Law 2024-34), Health and Human Services Omnibus Bill, which includes the Quality Rating Improvement System (QRIS) Modifications recommended to the Legislature by the NC Child Care Commission to update QRIS and create additional pathways for licensed child care facilities to earn star rated licenses. Hold Harmless provisions have been extended and star rated license assessments for licensed child care providers will be conducted by provider request only, until the QRIS rulemaking process has been completed. Star rated license assessments are still required for new child care programs; however, current license programs are not required to complete the process until further notice unless it is requested voluntarily. This legislation also provides a pathway for child care programs currently accredited through the approved accrediting bodies to move to a 3 or 5 star license if they are not already at this star level. Providers will need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. MENTAL HEALTH BEGINS BY BIRTH: A free 6-hour training on the foundations of infant and early childhood mental health, offered by the ARCh Project at the Center for Child & Family Health. The six hours are divided over two half-days of content: The training dates will be on Friday, August 30th and Friday, September 6th, from 9:30am to 12:30pm each of those days. I will send you registration information via email. Available to anyone in NC whose professional work supports the relational, emotional, and mental health of babies and young children. DCDEE RESOURCES: I recommended you periodically visit the DCDEE website at https://ncchildcare.ncdhhs.gov/ under the "What's New" tab to stay abreast of updated information provided. Be reminded you are responsible for maintaining compliance with all applicable child care requirements whether they have been discussed or reviewed with you in the past. CONTACT INFORMATION: If you have questions regarding today’s visit, my contact information is listed above. You may also contact Licensing Supervisor, Susan Fuller at 252-373-9809 or email susan.fuller@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0601 · Violation

Name of Operation: BUILDING BLOCKS FOR TOTS Facility ID: 98000209 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 8/20/2024 Number Present: 80 Completed Date: 8/20/2024 Age: From 0 To 4 Total Minutes: 285 Time In: 08:45 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor this program for compliance with applicable child care requirements during an annual compliance visit. H. Beamon, Administrator, assisted with the visit. This center currently operates with a five-star license, earning seven points in the education component, five points in the program standard component and 1 quality point for offering a staff benefit package and infrastructure of parent involvement. This program is required to meet enhanced space and enhanced ratio requirements. The last annual compliance visit was completed on August 26, 2023. The last sanitation inspection was completed on June 24, 2024, earning a “Superior” classification. The last fire inspection was completed on March 26, 2024, and the center was approved for daytime care only. Seventy (70) children ranging from ages zero to four years old were observed in care today. Children were engaged in morning routine/activities, free-choice play, outdoor play, eating lunch, completing hand washing, diapering and toileting routines, interacting with caregivers and napping. Lunch consisted of macaroni cheese, mixed fruit, green beans, and milk. The following violations were documented. Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. Documentation was not on file to verify the NC Child Care Law was given to parents of eight children enrolled in the center. GS 110-102 807 A safe indoor and outdoor environment was not provided for the children. Tree roots were protruding above ground posing tripping hazards on preschool and toddler playgrounds. A watering container and clear storage container was cracked exposing sharp edges on the preschool playground. A bamboo pole lying on the ground on the far back side of the preschool playground was cracked exposing sharp edges. 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. A container of pepper spray attached to keys was observed on the counter next to the hand washing sink in Space #2A. .2820(b) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. Written authorization and/or instructions from a child's parent was not on file for Sun Bum baby eczema cream, Butt paste, and mosquito repellent for one preschool child enrolled in Space #3. 10A NCAC 09 .0803(1)(a & b) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. Documentation was not on file to verify outdoor play inspections was not on file for May 2024 to June 2024. .0605(q) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. An annual evaluation was not on file for one staff member. The last evaluation was dated for October 2022. 10A NCAC 09 .0514(f) 1245 For each child, there was not at least 30 sq. ft. inside space per the total licensed capacity and 100 sq. ft. outside space for each child using the outdoor learning environment at any one time. Thirteen children were cared for in Space #1A which exceeded the licensing space capacity for eleven children at 30 sq. ft. per child. 10A NCAC 09 .2809(a) 1756 Enhanced staff/child ratios and group sizes were not met. Enhanced staff child ratios were not met when two caregivers were observed providing care to thirteen infants under twelve months old from 8:55am to 9:02am in Space #1A. The group size for children under twelve months was also exceeded in Space #1A. 10A NCAC 09 .2818 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Documentation was not no file verifying recognizing and responding to suspicions of child maltreatment was completed by three employees hired on October 9, 2023, March 27, 2024, and May 16, 2024. .1102(g) The violations documented must be corrected immediately. Please send a compliance verification letter to me describing how the violations were corrected. You can submit the compliance verification letter by postal mail to Keshia Hayward, PO Box 1504 Greenville NC 27834, or email keshia.hayward@dhhs.nc.gov. The compliance verification letter must be received on or before September 3, 2024. The two-week time frame is established to allow you time for submitting your compliance verification letter. This timeframe is not intended to be used as a guide for correcting violations, as they should be corrected immediately. Please be aware that any written information submitted by you regarding correction of violations documented during the visit is legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined the information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility's Star Rated License could be issued. If sufficient information is not received by the due date, a follow-up visit will be conducted. The center’s compliance history score was reviewed with the operator. The program’s compliance history was 89% as of August 19, 2024. CORPORATION STATUS: Premier NC Wilson LLC is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Premier NC Wilson LLC remains current and active. I reminded you the corporation status for your program must always remain Current and Active. Failure to comply may affect your child care license. FACILITY PROFILE INFORMATION: You verified the phone number and mailing address listed on the facility profile are correct. You added the email address has changed and needs to be updated. I asked that you give me written documentation requesting the change. The statement should include the updated email address. If additional changes in your facility’s information occur in the future, contact me at 252-214-2709 or email keshia.hayward@dhhs.nc.gov to discuss the changes and ensure accurate information is updated in our system. STAFF/CHILD RATIO: Two caregivers were observed providing care for thirteen infants under the age of twelve months in Space 1A. You were notified immediately the space was out of compliance with staff/child ratio. You stated you were aware of the noncompliance with staff/child ratio. You added the third employee who was supposed to transition the overflow for that group was running late for work. You and another employee transitioned five of the children into Space #2A with one caregiver for continued care leaving Space #1A with eight children and two caregivers. Also, when thirteen children were cared for in Space #1A the licensed space capacity for that classroom was exceeded. Your program is licensed to meeting enhanced space capacity; therefore, the requirements of 30 sq. ft. per child as listed on the floor plan must always be met. You and staff should monitor the number of children cared for in each space to ensure capacity is not exceeded at any time. Research indicates that staff/child ratio and group sizes are strong indicators of quality of child care. Sufficient staff should be available to maintain staff/child ratio requirements for each group of children. A staffing patterns with schedules could assist with ensuring there are enough staff members present and available for staff/child ratio. A plan of action should be put into place to implement when staff need to be absent for emergency reason or just to step outside the classroom for to attend to personal care. Smaller groups and lower staff/child ratios are r elated to positive outcomes for children, including increased adult interaction, less aggression, and more cooperation amongst children. UNANNOUNCED FOLLOW-UP VISIT: An unannounced follow-up visit will be conducted to monitor staff/child ratio requirements. MEDICATION ADMINISTRATION: Written authorization to administer medication should be on file for all prescription and over the counter medication provided for children in child care. When discussing the option to administer medication with parents a copy of the medication permission form should be given and requested when the medication is received. The parent completed the medication permission form during the visit. Documentation was provided for review during consultation. It is important to have authorization with instructions for administering the medication from the parents/health care physician at the time the medication is left at the facility. Administering medication to children without written authorization places a liability on your program in the event an incident occurs because of the medication given. RECOGNIZING AND RESPONDING TO SUSPICIONS OF CHILD MALTREATMENT TRAINING: Two new staff hired had copies of recognizing and responding to suspicions of child maltreatment trainings in their files; however, the training was more than twelve months old. I informed you because the training was over twelve months it was not valid although it was still within the five-year timeframe. We also discussed ensuring staff complete the recognizing and responding to suspicions of child maltreatment within 90 days of employment as required. Planning for staff to complete training early will help avoid missing timelines and renewals dates. You could develop a system for tracking required trainings and due dates. The staff file checklist is also a good tool to use to help determine and track training dates and requirements. QUALITY RATING IMPROVEMENT SYSTEM: The Governor signed Senate Bill 425 (now Session Law 2024-34), Health and Human Services Omnibus Bill, which includes the Quality Rating Improvement System (QRIS) Modifications recommended to the Legislature by the NC Child Care Commission to update QRIS and create additional pathways for licensed child care facilities to earn star rated licenses. Hold Harmless provisions have been extended and star rated license assessments for licensed child care providers will be conducted by provider request only, until the QRIS rulemaking process has been completed. Star rated license assessments are still required for new child care programs; however, current license programs are not required to complete the process until further notice unless it is requested voluntarily. This legislation also provides a pathway for child care programs currently accredited through the approved accrediting bodies to move to a 3 or 5 star license if they are not already at this star level. Providers will need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. MENTAL HEALTH BEGINS BY BIRTH: A free 6-hour training on the foundations of infant and early childhood mental health, offered by the ARCh Project at the Center for Child & Family Health. The six hours are divided over two half-days of content: The training dates will be on Friday, August 30th and Friday, September 6th, from 9:30am to 12:30pm each of those days. I will send you registration information via email. Available to anyone in NC whose professional work supports the relational, emotional, and mental health of babies and young children. DCDEE RESOURCES: I recommended you periodically visit the DCDEE website at https://ncchildcare.ncdhhs.gov/ under the "What's New" tab to stay abreast of updated information provided. Be reminded you are responsible for maintaining compliance with all applicable child care requirements whether they have been discussed or reviewed with you in the past. CONTACT INFORMATION: If you have questions regarding today’s visit, my contact information is listed above. You may also contact Licensing Supervisor, Susan Fuller at 252-373-9809 or email susan.fuller@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0803 · Violation

Name of Operation: BUILDING BLOCKS FOR TOTS Facility ID: 98000209 Consultant: FELICIA FAISON Operation Type: Center Case Number: Visit Date: 9/26/2023 Number Present: 93 Completed Date: 9/26/2023 Age: From 0 To 5 Total Minutes: 435 Time In: 09:15 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of my unannounced visit today was to monitor compliance with child care requirements applicable to a routine unannounced visit. S. Patterson, administrator, was notified of the purpose of my visit and assisted. Due to connectivity issues a handwritten visit summary was left with you today. I will email the computer-generated visit summary to you no later than the close of business tomorrow, September 27th. Currently, this center operates with a Five-star License issued May 2, 2020, earning seven (7) points in the Education Component, five (5) points in the Program Component and one (1) Quality point. The last annual compliance visit was conducted on October 12, 2022. The last sanitation inspection was completed June 9, 2023, earning a Superior rating. The last fire inspection was completed April 3, 2023, and the facility was approved for daytime care only. Children were observed engaging in free choice center play, group time and outdoor play. Infants were observed enjoying tummy time and being held for bottle feedings. Interactions were nurturing in nature between teachers and children. FACILITY PROFILE This facility is owned by PREMIER NC WILSON LLC. The corporation listed as owner of this facility is documented as current and active in the Secretary of State Database and is required to remain so per child care rules. I reviewed contact information for the owner and the facility with you and you verified the current information listed with DCDEE remains correct. The following violations of child care requirements were documented. Violation Number Comment Rule 847 Parent's medication authorization did not include required information. There was no medication authorization form on-site for one child’s desitin cream in space #1B. 10A NCAC 09 .0803(4)(6-9) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. No playground inspection has been documented since 6/28/23. .0605(q) 1739 All records required were not available for review by a representative of the Division. A record for the staff person hired 7/17/23 was not available for review. .2318(1-8) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. No shelter-in-place or lockdown drill has been completed since May 2023. .0604(u);.0302(d)(8) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff hired 12/28/21, 9/27/22, and 1/30/23 have not completed or renewed the Recognizing and Responding to Suspicions of Child Maltreatment training within the required time frame. .1102(g) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. There was no documentation that parents reviewed the center’s SBS/AHT policy for a child enrolled 8/22/23. .0608(b)(1-6) The violations documented above must be corrected immediately. A signed and dated letter of compliance can be mailed or emailed to me and must be received by October 10, 2023. If mailing, you must submit two (2) signed and dated copies. My mailing and email addresses are noted at the bottom. The letter of compliance must detail how the violations were corrected. Please be aware that any written information you submit regarding the correction of the violation is legal documentation. Therefore, it is important that all submitted information is accurate and truthful. If it is determined that submitted information was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. COMPLIANCE HISTORY Prior to today’s visit your compliance history was 90% over an eighteen (18) month period. CHILDREN’S RECORDS I monitored ten (10) percent, or more, of children’s records and one violation was documented. The child enrolled 8/22/23 did not have signed parent documentation that they reviewed or received the Shaken Baby Syndrome/ Abusive Head Trauma (SBS/AHT) policy. Please check the remaining files to be sure that receipt of this required policy is documented with a parent signed and dated form as this is required by the first day of enrollment. STAFF RECORDS I reviewed all new staff records, and ten (10) percent of staff files and two (2) violations were documented. Staff with hire dates 1/30/23 and 9/27/22 did not complete the Recognizing and Responding to Suspicions of Maltreatment (RRSM) training within the first ninety (90) days of hire. The staff person hired 12/28/21 did not renew the RRSM training every five (5) years as required. The staff person hired 7/17/23 did not have a record available to review. Corresponding staff are indicated on the staff and training worksheet. I documented the due dates for the required specialized trainings, CPR and First Aid training and on-going training hours for newer staff on the staff and training worksheet. Please be reminded that staff that do not have current ITS-SIDS training cannot be left alone to care for infants twelve (12) months or younger. MEDICATION The desitin diaper cream on-site for one enrolled child did not have the required Medication Administration Permission form completed. This form is required to be completed and signed by a parent before keeping and/or using any topical ointments on children in care. When informed you removed the desitin cream to your office, so it will not be used, along with the proper form for the parent to fill out this afternoon. PROGRAM RECORDS While reviewing program records, I noted that the last playground inspection was completed 6/28/23. This type of inspection must be completed and documented on the Division form monthly to ensure that there any potential hazards are corrected prior to children playing in the area. There has not been a shelter-in-place or lockdown drill completed since May 2023. Either the shelter-in-place or lockdown drill must be completed and documented quarterly and should have been conducted in August. I encourage you to have at least one other staff person complete the Playground Safety Training so the monthly inspection can be delegated. It may also be helpful to schedule the quarterly drill on your phone or computer calendar to receive reminders. TECHNICAL ASSISTANCE & CONSULTATION Technical assistance discussed continuing to have staff store their purses and personal belongings in approved locked storage. This means it should be a two-step lock such as combination, key or magnetic locks to ensure that if purses hold items that require locked storage it is stored properly. Technical assistance was also given regarding checking outlets that are not the self-closing type and have a cover when not in use. I also recommend that you keep extra tricycle handlebar covers on hand for those that are in disrepair or remove affected tricycles until they can be covered. The NC Commission for Public Health adopted and approved the amended rule regarding lead water testing effective October 1, 2019. The rule requires licensed child care centers test all drinking water faucets and food preparation sinks for lead contamination once every three years. If a child care center finds elevated concentrations of lead in the center’s water, they will be required to take immediate action. If your center was tested in 2020 you are due to re-test this year. I recommend you go to cleanwaterforcarolinakids.org regarding the second round of testing. Child care licensing requirements are established to ensure a safe and healthy child care environment. It is your responsibility to maintain compliance with all applicable laws and rules. The best way to do so is to periodically review the child care laws and rules. The current rule book dated July 1, 2023, is available at the DCDEE website https://ncchildcare.ncdhhs.gov/. There are also modules reviewing the new Child Care Rules available on Moodle, which can be found on the Division website. I recommend you frequently click the “What’s New” tab to stay informed of all updates on the DCDEE website. Please feel free to contact me at (984) 867-7089 or email at Felicia.faison@dhhs.nc.gov for questions and assistance. If needed my mailing address is PO Box 61161, Raleigh NC 27661. You may also contact Susan Fuller, Licensing Supervisor at (252) 373-9809. 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