Cynthia'S Garden OF Knowledge

10A NCAC 09 .0604 · Violation

Name of Operation: CYNTHIA'S GARDEN OF KNOWLEDGE Facility ID: 98000092 Consultant: TINA JONES Operation Type: Center Case Number: Visit Date: 6/16/2026 Number Present: 49 Completed Date: 6/16/2026 Age: From 0 To 10 Total Minutes: 270 Time In: 09:00 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 compliance during an Annual Compliance visit. A checklist was used to note the requirements I monitored today. Staff and training worksheets were completed and monitored during the visit. You, Cynthia Morgan, Administrator, were present when I arrived and you were notified of the purpose of today’s visit and you were available for consultation at the conclusion of the visit. This center currently operates with a three-star license earning five points in staff education, one point in program standards and one quality point for the administrator completing a business training course of at least 30 clock hours. The last annual compliance visit was completed on July 9, 2025. The last sanitation inspection was completed on May 12, 2026, with a “Superior” classification. The last fire inspection was completed on October 8, 2025, and the center was approved for day and nighttime care. CORPORATION STATUS: Cynthia’s Garden of Knowledge, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Cynthia’s Garden of Knowledge Inc. remains current and 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. Forty-nine (49) children were in care today ranging in age from infant to school-age (ten years of age). Children were observed participating in free play in the indoor and outdoor environment with developmentally age-appropriate materials, interacting with caregivers, and having routine care needs met. Infants were observed napping and interacting with caregivers. Prior to today’s visit, the program’s compliance history was 89% over the current 18- month period. A copy of your compliance history report was left with you. Violations documented today may affect your compliance score. The computer-generated visit summary was reviewed with you at the conclusion of the visit and a copy was provided to you. All violations were reviewed with you. The following violations were documented: 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 space 1b, two electrical outlets did not have safety outlets when not being used. 10A NCAC 09 .0604(c) 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. In space 1a, an aerosol can of air freshener was stored in an unlocked drawer, accessible to children. .2820(b) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. In space 1a, sleep checks were not consistently documented for all enrolled infants. One child did not have documented sleep checks for 4 days. .0606(g) 1327 Accurate records were not maintained for all children. Two children did not have documentation of the discussion of the parent participation plan. One child did not have a parent signature on the application. One child did not have medical information on file. Two children did not have a medical exam on file. One child did not have immunization records o file. One child did not have all information required on the application, and four children did not have a signed and dated statement showing the Prevention of Shaken Baby policy was reviewed with them. G.S. 110-91(9) 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. Two staff members did not have documentation showing the required training was completed. J. Blue's training was due by 12/16/25 and S. Manning's training was due by 7/2/2025. .1102(g) CONSULTATION AND TECHNICAL ASSISTANCE: The violations documented above must be corrected immediately. A signed and dated letter of compliance must be mailed to me by June 30, 2026, describing how and when the violations were corrected. This two-week time frame is established to allow you time for submitting your compliance letter and is not intended to be used as a guide for correcting violations, as they should be corrected immediately. The letter of compliance should be mailed or emailed to me, Tina Jones, PO Box 10194, Goldsboro, NC 27532. The compliance letter must be submitted from the email address on file for your program. If you have any questions related to this visit or if I can be of additional assistance, I can be reached at 252-361-3434 or tina.jones@dhhs.nc.gov. You may also contact Susan Fuller, Licensing Supervisor, at 252-373-9809. Please be aware that any written information submitted by you regarding correction of violations documented is legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, Administrative Action, including Revocation of the facility’s license could be issued. Child care licensing requirements are established to ensure a safe and healthy child care environment. Therefore, it is important for you to be knowledgeable of all the licensing requirements that apply to your type of program. It is your responsibility to maintain compliance with the applicable laws and rules; always whether they have been monitored or specifically discussed with you in the past. The best way for you to ensure that you are meeting all requirements is to periodically review the child care laws and rules on the Division of Child Development and Early Education’s website. WATER TESTING: I verified the Lead in Water testing was completed April 1, 2024. You are required to have this test completed every three years; the next testing should be completed by April 1, 2027. QRIS: We reviewed the required documents and requirements for the new QRIS. We reviewed staff’s education and what will be required for your facility to meet the four-star education standard. We discussed you contacting me when you are ready to complete a reassessment of your license. The Application for Assessment for a Rated License for Centers was reviewed with you today. RESOURCES: CHALLENGING BEHAVIORS HOTLINE: The Healthy Social Behaviors Project offers coaching for child care providers who would like support managing challenging classroom behaviors. The goal is to empower teachers to create learning environments that promote pro-social skills, like self-control and problem solving. Support is available by phone (888-600-1685, Option 1), email, or through an online form PROFESSIONAL DEVELOPMENT: Ready to strengthen relationships with the adults you work with? This free, self-paced online training is made for teachers, directors, family child care home professionals, and others working in North Carolina child care programs. DCDEE credit hours are available. Register at https://www.dcdee.moodle.nc.gov/. Winter 2026 Edition of Healthy Child Care NC Newsletter. The NC Child Care Health and Safety Resource Center's Newsletter—Ready, Set, Action!—includes in-depth information about health and safety concerns in early care and education settings as well as information for child care programs to share with families. This edition is filled with information on the role of medical action plans in child care, responding to emergencies, and more! To view the newsletter click on : https://sway.cloud.microsoft/zNeLZz5RRmxCuvGT?ref=Link&loc=play. 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, 2025. 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/. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-91 · Violation

Name of Operation: CYNTHIA'S GARDEN OF KNOWLEDGE Facility ID: 98000092 Consultant: TINA JONES Operation Type: Center Case Number: Visit Date: 6/16/2026 Number Present: 49 Completed Date: 6/16/2026 Age: From 0 To 10 Total Minutes: 270 Time In: 09:00 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 compliance during an Annual Compliance visit. A checklist was used to note the requirements I monitored today. Staff and training worksheets were completed and monitored during the visit. You, Cynthia Morgan, Administrator, were present when I arrived and you were notified of the purpose of today’s visit and you were available for consultation at the conclusion of the visit. This center currently operates with a three-star license earning five points in staff education, one point in program standards and one quality point for the administrator completing a business training course of at least 30 clock hours. The last annual compliance visit was completed on July 9, 2025. The last sanitation inspection was completed on May 12, 2026, with a “Superior” classification. The last fire inspection was completed on October 8, 2025, and the center was approved for day and nighttime care. CORPORATION STATUS: Cynthia’s Garden of Knowledge, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Cynthia’s Garden of Knowledge Inc. remains current and 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. Forty-nine (49) children were in care today ranging in age from infant to school-age (ten years of age). Children were observed participating in free play in the indoor and outdoor environment with developmentally age-appropriate materials, interacting with caregivers, and having routine care needs met. Infants were observed napping and interacting with caregivers. Prior to today’s visit, the program’s compliance history was 89% over the current 18- month period. A copy of your compliance history report was left with you. Violations documented today may affect your compliance score. The computer-generated visit summary was reviewed with you at the conclusion of the visit and a copy was provided to you. All violations were reviewed with you. The following violations were documented: 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 space 1b, two electrical outlets did not have safety outlets when not being used. 10A NCAC 09 .0604(c) 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. In space 1a, an aerosol can of air freshener was stored in an unlocked drawer, accessible to children. .2820(b) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. In space 1a, sleep checks were not consistently documented for all enrolled infants. One child did not have documented sleep checks for 4 days. .0606(g) 1327 Accurate records were not maintained for all children. Two children did not have documentation of the discussion of the parent participation plan. One child did not have a parent signature on the application. One child did not have medical information on file. Two children did not have a medical exam on file. One child did not have immunization records o file. One child did not have all information required on the application, and four children did not have a signed and dated statement showing the Prevention of Shaken Baby policy was reviewed with them. G.S. 110-91(9) 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. Two staff members did not have documentation showing the required training was completed. J. Blue's training was due by 12/16/25 and S. Manning's training was due by 7/2/2025. .1102(g) CONSULTATION AND TECHNICAL ASSISTANCE: The violations documented above must be corrected immediately. A signed and dated letter of compliance must be mailed to me by June 30, 2026, describing how and when the violations were corrected. This two-week time frame is established to allow you time for submitting your compliance letter and is not intended to be used as a guide for correcting violations, as they should be corrected immediately. The letter of compliance should be mailed or emailed to me, Tina Jones, PO Box 10194, Goldsboro, NC 27532. The compliance letter must be submitted from the email address on file for your program. If you have any questions related to this visit or if I can be of additional assistance, I can be reached at 252-361-3434 or tina.jones@dhhs.nc.gov. You may also contact Susan Fuller, Licensing Supervisor, at 252-373-9809. Please be aware that any written information submitted by you regarding correction of violations documented is legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, Administrative Action, including Revocation of the facility’s license could be issued. Child care licensing requirements are established to ensure a safe and healthy child care environment. Therefore, it is important for you to be knowledgeable of all the licensing requirements that apply to your type of program. It is your responsibility to maintain compliance with the applicable laws and rules; always whether they have been monitored or specifically discussed with you in the past. The best way for you to ensure that you are meeting all requirements is to periodically review the child care laws and rules on the Division of Child Development and Early Education’s website. WATER TESTING: I verified the Lead in Water testing was completed April 1, 2024. You are required to have this test completed every three years; the next testing should be completed by April 1, 2027. QRIS: We reviewed the required documents and requirements for the new QRIS. We reviewed staff’s education and what will be required for your facility to meet the four-star education standard. We discussed you contacting me when you are ready to complete a reassessment of your license. The Application for Assessment for a Rated License for Centers was reviewed with you today. RESOURCES: CHALLENGING BEHAVIORS HOTLINE: The Healthy Social Behaviors Project offers coaching for child care providers who would like support managing challenging classroom behaviors. The goal is to empower teachers to create learning environments that promote pro-social skills, like self-control and problem solving. Support is available by phone (888-600-1685, Option 1), email, or through an online form PROFESSIONAL DEVELOPMENT: Ready to strengthen relationships with the adults you work with? This free, self-paced online training is made for teachers, directors, family child care home professionals, and others working in North Carolina child care programs. DCDEE credit hours are available. Register at https://www.dcdee.moodle.nc.gov/. Winter 2026 Edition of Healthy Child Care NC Newsletter. The NC Child Care Health and Safety Resource Center's Newsletter—Ready, Set, Action!—includes in-depth information about health and safety concerns in early care and education settings as well as information for child care programs to share with families. This edition is filled with information on the role of medical action plans in child care, responding to emergencies, and more! To view the newsletter click on : https://sway.cloud.microsoft/zNeLZz5RRmxCuvGT?ref=Link&loc=play. 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, 2025. 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/. 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: CYNTHIA'S GARDEN OF KNOWLEDGE Facility ID: 98000092 Consultant: TINA JONES Operation Type: Center Case Number: Visit Date: 1/14/2026 Number Present: 28 Completed Date: 1/14/2026 Age: From 1 To 4 Total Minutes: 240 Time In: 09:30 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor this program for compliance with applicable child are requirements for a Routine Unannounced visit. Today’s visit was completed with you, C. Morgan, Administrator. You were present when I arrived, and you were notified of the purpose of the visit. You stated no new staff members have been hired since the last Annual Compliance visit completed on July 9, 2025. This center currently operates with a three-star license earning five points in staff education, one point in program standards and one quality point for the administrator completing a business training course of at least 30 clock hours. Twenty-eight (28) children were in care today ranging in age from one (1) to four (4) years old. Children were observed participating in free play in the indoor and outdoor environment with developmentally age-appropriate materials, interacting with caregivers, and having routine care needs met. Prior to today’s visit, the program’s compliance history was 89% over the current 18- month period. A copy of your compliance history report was left with you. Violations documented today may affect your compliance score. The computer-generated visit summary was reviewed with you at the conclusion of the visit and a copy was provided to you. All violations were reviewed with you. I used the Child Care Center Item Number Listing (DCD 0357) as a basic monitoring tool to assess compliance with all applicable child care requirements. The following violations of child care requirements was documented. Violation Number Comment Rule 532 All children were not held or placed in feeding chairs or other appropriate apparatus to be fed. One child in space 1b was drinking from a bottle while walking around the room. The teacher stated that a bouncy seat and a play saucer was used as feeding chairs. These chairs are not easily cleaned; therefore, are not approved feeding apparatus. 10A NCAC 09 .0902(b) 538 Baby bottles were not stored to protect from contamination. Baby bottles were being stored in the refrigerator in the kitchen. Five bottles did not have lids to avoid contamination. 15A NCAC 18A .2804(d) 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. (omit posting for centers located in a residence) Two children under that age of 15 months did not have an individual written feeding plan available for review or posted. 10A NCAC 09 .0902(a) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. The walls and doors throughout the facility were not in good repair. The doors need painting and some of the walls need painting. 15A NCAC 18A .2825(a) 807 A safe indoor and outdoor environment was not provided for the children. There was a staff member's purse in an unlocked closet in space 1a. On the playground, nails were protruding from the wood in a small playhouse and broken plastic toys were accessible to children. In space 1b, adult scissors and push pins were not stored out of the reach of children. 10A NCAC 09 .0601(a) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In space 1a, plastic bags were stored under the sink. Children in this space are one and two years of age. .0604(q) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The last date of the posted EMC Plan was dated August 2022. The plan has not been revised to reflect changes in staffing. 10A NCAC 09 .0802(a) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. Eleven children did not have a photograph used for identifying information in the vehicle used for transporting children. 10A NCAC 09 .1003(d) 1322 A written statement from each child's parent giving standing permission which may be valid for up to twelve months for participation in off premise activities that occur on a regular basis was not available. On the permission statements for transporting children, there were not dates provided to verify the timeframe of the standing permission to transport. .1005(b)(4) 1898 Staff did not complete the health and safety training within one year of employment. A. Mercer's hire date was 8/2024. The Health and Safety trainings were not completed within one year of hire date. The trainings were required to be completed by 8/2025. .1102(a) CONSULTATION AND TECHNICAL ASSISTANCE: The violations documented above must be corrected immediately. A signed and dated letter of compliance must be mailed to me by January 28, 2026, describing how and when the violations were corrected. This two-week time frame is established to allow you time for submitting your compliance letter and is not intended to be used as a guide for correcting violations, as they should be corrected immediately. The letter of compliance should be mailed or emailed to me, Tina Jones, PO Box 10194, Goldsboro, NC 27532. The compliance letter must be submitted from the email address on file for your program. If you have any questions related to this visit or if I can be of additional assistance, I can be reached at 252-361-3434 or tina.jones@dhhs.nc.gov. You may also contact Susan Fuller, Licensing Supervisor, at 252-373-9809. Please be aware that any written information submitted by you regarding correction of violations documented is legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, Administrative Action, including Revocation of the facility’s license could be issued. Child care licensing requirements are established to ensure a safe and healthy child care environment. Therefore, it is important for you to be knowledgeable of all the licensing requirements that apply to your type of program. It is your responsibility to maintain compliance with the applicable laws and rules; always whether they have been monitored or specifically discussed with you in the past. The best way for you to ensure that you are meeting all requirements is to periodically review the child care laws and rules on the Division of Child Development and Early Education’s website. Rated License: The “hold harmless” state of rated license reassessments had ended, and the new Quality Rating Improvement System standards are here. We discussed in detail the next steps that need to be taken to ensure success. I have provided you with the following documents: CONTINUOUS QUALITY IMPROVEMENT (CQI) PLAN AND PROFESSIONAL DEVELOPMENT PLAN: This plan is meant to be an intentional process that you will use to identify areas of growth and determine a path toward enhanced teaching, learning and practices that achieve better outcomes for children, staff, and programs. This process will build over time, using established goals to support both you in achieving and maintaining long term quality care within your program. All plans should identify a goal, what is needed to accomplish the goal, why the goal is needed, and an annual review of progress toward the goal. It is possible that a goal is achieved, and a new goal is set during your annual review. It is also possible that there were challenges in completing a goal that are documented during the annual review. Revising and changing goals is expected to be part of this process. FAMILY AND COMMUNITY ENGAGEMENT STANDARDS: These new rules require that a program offers engagement opportunities through foundational practices and engagement opportunities. It is up to each individual family to determine if and how they would like to participate in offered activities. At the 3-, 4- and 5-star levels, foundational practices continue but you will choose additional options that best fit the needs of your families. The number of choices increases as the star rating increases. We reviewed and discussed many of the options that you are already providing for your families. We discussed ways that you can document these options. CURRICULUM: This pathway requires curriculum to be implemented for all ages served by the program, ensuring quality practices that are developmentally appropriate for each age group. Child-focused planning through observation of individual growth and development is included in this pathway. We reviewed that at the 3-Star level, a curriculum is required. We reviewed that there is a free curriculum, Early Learning Matters. The link for this is https://elmcurriculum.org/. EDUCATION STANDARDS: We reviewed the requirements in the education standard for you and your staff. We discussed you ensuring everyone is in the WORKS system. In WORKS, we are able to verify all education received by each staff member and seeing where everyone is in the education standards. CONSULTATION: We reviewed that all programs will be required to transition to the new QRIS utilizing the pathway of your choice. We discussed that you can contact me with any questions you may have about this process. I can assist you by making an additional technical assistance visit. You may also contact your local Partnership for Children to discuss the required coaching and training opportunities. Today we set a goal of submitting your rated license application and transition to a pathway by August of 2026. 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. The NC child care rules were last updated as of July 1, 2025. • 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 www.healthychildcare.unc.edu. 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 .0902 · Violation

Name of Operation: CYNTHIA'S GARDEN OF KNOWLEDGE Facility ID: 98000092 Consultant: TINA JONES Operation Type: Center Case Number: Visit Date: 1/14/2026 Number Present: 28 Completed Date: 1/14/2026 Age: From 1 To 4 Total Minutes: 240 Time In: 09:30 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor this program for compliance with applicable child are requirements for a Routine Unannounced visit. Today’s visit was completed with you, C. Morgan, Administrator. You were present when I arrived, and you were notified of the purpose of the visit. You stated no new staff members have been hired since the last Annual Compliance visit completed on July 9, 2025. This center currently operates with a three-star license earning five points in staff education, one point in program standards and one quality point for the administrator completing a business training course of at least 30 clock hours. Twenty-eight (28) children were in care today ranging in age from one (1) to four (4) years old. Children were observed participating in free play in the indoor and outdoor environment with developmentally age-appropriate materials, interacting with caregivers, and having routine care needs met. Prior to today’s visit, the program’s compliance history was 89% over the current 18- month period. A copy of your compliance history report was left with you. Violations documented today may affect your compliance score. The computer-generated visit summary was reviewed with you at the conclusion of the visit and a copy was provided to you. All violations were reviewed with you. I used the Child Care Center Item Number Listing (DCD 0357) as a basic monitoring tool to assess compliance with all applicable child care requirements. The following violations of child care requirements was documented. Violation Number Comment Rule 532 All children were not held or placed in feeding chairs or other appropriate apparatus to be fed. One child in space 1b was drinking from a bottle while walking around the room. The teacher stated that a bouncy seat and a play saucer was used as feeding chairs. These chairs are not easily cleaned; therefore, are not approved feeding apparatus. 10A NCAC 09 .0902(b) 538 Baby bottles were not stored to protect from contamination. Baby bottles were being stored in the refrigerator in the kitchen. Five bottles did not have lids to avoid contamination. 15A NCAC 18A .2804(d) 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. (omit posting for centers located in a residence) Two children under that age of 15 months did not have an individual written feeding plan available for review or posted. 10A NCAC 09 .0902(a) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. The walls and doors throughout the facility were not in good repair. The doors need painting and some of the walls need painting. 15A NCAC 18A .2825(a) 807 A safe indoor and outdoor environment was not provided for the children. There was a staff member's purse in an unlocked closet in space 1a. On the playground, nails were protruding from the wood in a small playhouse and broken plastic toys were accessible to children. In space 1b, adult scissors and push pins were not stored out of the reach of children. 10A NCAC 09 .0601(a) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In space 1a, plastic bags were stored under the sink. Children in this space are one and two years of age. .0604(q) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The last date of the posted EMC Plan was dated August 2022. The plan has not been revised to reflect changes in staffing. 10A NCAC 09 .0802(a) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. Eleven children did not have a photograph used for identifying information in the vehicle used for transporting children. 10A NCAC 09 .1003(d) 1322 A written statement from each child's parent giving standing permission which may be valid for up to twelve months for participation in off premise activities that occur on a regular basis was not available. On the permission statements for transporting children, there were not dates provided to verify the timeframe of the standing permission to transport. .1005(b)(4) 1898 Staff did not complete the health and safety training within one year of employment. A. Mercer's hire date was 8/2024. The Health and Safety trainings were not completed within one year of hire date. The trainings were required to be completed by 8/2025. .1102(a) CONSULTATION AND TECHNICAL ASSISTANCE: The violations documented above must be corrected immediately. A signed and dated letter of compliance must be mailed to me by January 28, 2026, describing how and when the violations were corrected. This two-week time frame is established to allow you time for submitting your compliance letter and is not intended to be used as a guide for correcting violations, as they should be corrected immediately. The letter of compliance should be mailed or emailed to me, Tina Jones, PO Box 10194, Goldsboro, NC 27532. The compliance letter must be submitted from the email address on file for your program. If you have any questions related to this visit or if I can be of additional assistance, I can be reached at 252-361-3434 or tina.jones@dhhs.nc.gov. You may also contact Susan Fuller, Licensing Supervisor, at 252-373-9809. Please be aware that any written information submitted by you regarding correction of violations documented is legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, Administrative Action, including Revocation of the facility’s license could be issued. Child care licensing requirements are established to ensure a safe and healthy child care environment. Therefore, it is important for you to be knowledgeable of all the licensing requirements that apply to your type of program. It is your responsibility to maintain compliance with the applicable laws and rules; always whether they have been monitored or specifically discussed with you in the past. The best way for you to ensure that you are meeting all requirements is to periodically review the child care laws and rules on the Division of Child Development and Early Education’s website. Rated License: The “hold harmless” state of rated license reassessments had ended, and the new Quality Rating Improvement System standards are here. We discussed in detail the next steps that need to be taken to ensure success. I have provided you with the following documents: CONTINUOUS QUALITY IMPROVEMENT (CQI) PLAN AND PROFESSIONAL DEVELOPMENT PLAN: This plan is meant to be an intentional process that you will use to identify areas of growth and determine a path toward enhanced teaching, learning and practices that achieve better outcomes for children, staff, and programs. This process will build over time, using established goals to support both you in achieving and maintaining long term quality care within your program. All plans should identify a goal, what is needed to accomplish the goal, why the goal is needed, and an annual review of progress toward the goal. It is possible that a goal is achieved, and a new goal is set during your annual review. It is also possible that there were challenges in completing a goal that are documented during the annual review. Revising and changing goals is expected to be part of this process. FAMILY AND COMMUNITY ENGAGEMENT STANDARDS: These new rules require that a program offers engagement opportunities through foundational practices and engagement opportunities. It is up to each individual family to determine if and how they would like to participate in offered activities. At the 3-, 4- and 5-star levels, foundational practices continue but you will choose additional options that best fit the needs of your families. The number of choices increases as the star rating increases. We reviewed and discussed many of the options that you are already providing for your families. We discussed ways that you can document these options. CURRICULUM: This pathway requires curriculum to be implemented for all ages served by the program, ensuring quality practices that are developmentally appropriate for each age group. Child-focused planning through observation of individual growth and development is included in this pathway. We reviewed that at the 3-Star level, a curriculum is required. We reviewed that there is a free curriculum, Early Learning Matters. The link for this is https://elmcurriculum.org/. EDUCATION STANDARDS: We reviewed the requirements in the education standard for you and your staff. We discussed you ensuring everyone is in the WORKS system. In WORKS, we are able to verify all education received by each staff member and seeing where everyone is in the education standards. CONSULTATION: We reviewed that all programs will be required to transition to the new QRIS utilizing the pathway of your choice. We discussed that you can contact me with any questions you may have about this process. I can assist you by making an additional technical assistance visit. You may also contact your local Partnership for Children to discuss the required coaching and training opportunities. Today we set a goal of submitting your rated license application and transition to a pathway by August of 2026. 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. The NC child care rules were last updated as of July 1, 2025. • 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 www.healthychildcare.unc.edu. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0802 · Violation

Name of Operation: CYNTHIA'S GARDEN OF KNOWLEDGE Facility ID: 98000092 Consultant: TINA JONES Operation Type: Center Case Number: Visit Date: 1/14/2026 Number Present: 28 Completed Date: 1/14/2026 Age: From 1 To 4 Total Minutes: 240 Time In: 09:30 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor this program for compliance with applicable child are requirements for a Routine Unannounced visit. Today’s visit was completed with you, C. Morgan, Administrator. You were present when I arrived, and you were notified of the purpose of the visit. You stated no new staff members have been hired since the last Annual Compliance visit completed on July 9, 2025. This center currently operates with a three-star license earning five points in staff education, one point in program standards and one quality point for the administrator completing a business training course of at least 30 clock hours. Twenty-eight (28) children were in care today ranging in age from one (1) to four (4) years old. Children were observed participating in free play in the indoor and outdoor environment with developmentally age-appropriate materials, interacting with caregivers, and having routine care needs met. Prior to today’s visit, the program’s compliance history was 89% over the current 18- month period. A copy of your compliance history report was left with you. Violations documented today may affect your compliance score. The computer-generated visit summary was reviewed with you at the conclusion of the visit and a copy was provided to you. All violations were reviewed with you. I used the Child Care Center Item Number Listing (DCD 0357) as a basic monitoring tool to assess compliance with all applicable child care requirements. The following violations of child care requirements was documented. Violation Number Comment Rule 532 All children were not held or placed in feeding chairs or other appropriate apparatus to be fed. One child in space 1b was drinking from a bottle while walking around the room. The teacher stated that a bouncy seat and a play saucer was used as feeding chairs. These chairs are not easily cleaned; therefore, are not approved feeding apparatus. 10A NCAC 09 .0902(b) 538 Baby bottles were not stored to protect from contamination. Baby bottles were being stored in the refrigerator in the kitchen. Five bottles did not have lids to avoid contamination. 15A NCAC 18A .2804(d) 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. (omit posting for centers located in a residence) Two children under that age of 15 months did not have an individual written feeding plan available for review or posted. 10A NCAC 09 .0902(a) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. The walls and doors throughout the facility were not in good repair. The doors need painting and some of the walls need painting. 15A NCAC 18A .2825(a) 807 A safe indoor and outdoor environment was not provided for the children. There was a staff member's purse in an unlocked closet in space 1a. On the playground, nails were protruding from the wood in a small playhouse and broken plastic toys were accessible to children. In space 1b, adult scissors and push pins were not stored out of the reach of children. 10A NCAC 09 .0601(a) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In space 1a, plastic bags were stored under the sink. Children in this space are one and two years of age. .0604(q) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The last date of the posted EMC Plan was dated August 2022. The plan has not been revised to reflect changes in staffing. 10A NCAC 09 .0802(a) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. Eleven children did not have a photograph used for identifying information in the vehicle used for transporting children. 10A NCAC 09 .1003(d) 1322 A written statement from each child's parent giving standing permission which may be valid for up to twelve months for participation in off premise activities that occur on a regular basis was not available. On the permission statements for transporting children, there were not dates provided to verify the timeframe of the standing permission to transport. .1005(b)(4) 1898 Staff did not complete the health and safety training within one year of employment. A. Mercer's hire date was 8/2024. The Health and Safety trainings were not completed within one year of hire date. The trainings were required to be completed by 8/2025. .1102(a) CONSULTATION AND TECHNICAL ASSISTANCE: The violations documented above must be corrected immediately. A signed and dated letter of compliance must be mailed to me by January 28, 2026, describing how and when the violations were corrected. This two-week time frame is established to allow you time for submitting your compliance letter and is not intended to be used as a guide for correcting violations, as they should be corrected immediately. The letter of compliance should be mailed or emailed to me, Tina Jones, PO Box 10194, Goldsboro, NC 27532. The compliance letter must be submitted from the email address on file for your program. If you have any questions related to this visit or if I can be of additional assistance, I can be reached at 252-361-3434 or tina.jones@dhhs.nc.gov. You may also contact Susan Fuller, Licensing Supervisor, at 252-373-9809. Please be aware that any written information submitted by you regarding correction of violations documented is legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, Administrative Action, including Revocation of the facility’s license could be issued. Child care licensing requirements are established to ensure a safe and healthy child care environment. Therefore, it is important for you to be knowledgeable of all the licensing requirements that apply to your type of program. It is your responsibility to maintain compliance with the applicable laws and rules; always whether they have been monitored or specifically discussed with you in the past. The best way for you to ensure that you are meeting all requirements is to periodically review the child care laws and rules on the Division of Child Development and Early Education’s website. Rated License: The “hold harmless” state of rated license reassessments had ended, and the new Quality Rating Improvement System standards are here. We discussed in detail the next steps that need to be taken to ensure success. I have provided you with the following documents: CONTINUOUS QUALITY IMPROVEMENT (CQI) PLAN AND PROFESSIONAL DEVELOPMENT PLAN: This plan is meant to be an intentional process that you will use to identify areas of growth and determine a path toward enhanced teaching, learning and practices that achieve better outcomes for children, staff, and programs. This process will build over time, using established goals to support both you in achieving and maintaining long term quality care within your program. All plans should identify a goal, what is needed to accomplish the goal, why the goal is needed, and an annual review of progress toward the goal. It is possible that a goal is achieved, and a new goal is set during your annual review. It is also possible that there were challenges in completing a goal that are documented during the annual review. Revising and changing goals is expected to be part of this process. FAMILY AND COMMUNITY ENGAGEMENT STANDARDS: These new rules require that a program offers engagement opportunities through foundational practices and engagement opportunities. It is up to each individual family to determine if and how they would like to participate in offered activities. At the 3-, 4- and 5-star levels, foundational practices continue but you will choose additional options that best fit the needs of your families. The number of choices increases as the star rating increases. We reviewed and discussed many of the options that you are already providing for your families. We discussed ways that you can document these options. CURRICULUM: This pathway requires curriculum to be implemented for all ages served by the program, ensuring quality practices that are developmentally appropriate for each age group. Child-focused planning through observation of individual growth and development is included in this pathway. We reviewed that at the 3-Star level, a curriculum is required. We reviewed that there is a free curriculum, Early Learning Matters. The link for this is https://elmcurriculum.org/. EDUCATION STANDARDS: We reviewed the requirements in the education standard for you and your staff. We discussed you ensuring everyone is in the WORKS system. In WORKS, we are able to verify all education received by each staff member and seeing where everyone is in the education standards. CONSULTATION: We reviewed that all programs will be required to transition to the new QRIS utilizing the pathway of your choice. We discussed that you can contact me with any questions you may have about this process. I can assist you by making an additional technical assistance visit. You may also contact your local Partnership for Children to discuss the required coaching and training opportunities. Today we set a goal of submitting your rated license application and transition to a pathway by August of 2026. 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. The NC child care rules were last updated as of July 1, 2025. • 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 www.healthychildcare.unc.edu. 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 .1003 · Violation

Name of Operation: CYNTHIA'S GARDEN OF KNOWLEDGE Facility ID: 98000092 Consultant: TINA JONES Operation Type: Center Case Number: Visit Date: 1/14/2026 Number Present: 28 Completed Date: 1/14/2026 Age: From 1 To 4 Total Minutes: 240 Time In: 09:30 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor this program for compliance with applicable child are requirements for a Routine Unannounced visit. Today’s visit was completed with you, C. Morgan, Administrator. You were present when I arrived, and you were notified of the purpose of the visit. You stated no new staff members have been hired since the last Annual Compliance visit completed on July 9, 2025. This center currently operates with a three-star license earning five points in staff education, one point in program standards and one quality point for the administrator completing a business training course of at least 30 clock hours. Twenty-eight (28) children were in care today ranging in age from one (1) to four (4) years old. Children were observed participating in free play in the indoor and outdoor environment with developmentally age-appropriate materials, interacting with caregivers, and having routine care needs met. Prior to today’s visit, the program’s compliance history was 89% over the current 18- month period. A copy of your compliance history report was left with you. Violations documented today may affect your compliance score. The computer-generated visit summary was reviewed with you at the conclusion of the visit and a copy was provided to you. All violations were reviewed with you. I used the Child Care Center Item Number Listing (DCD 0357) as a basic monitoring tool to assess compliance with all applicable child care requirements. The following violations of child care requirements was documented. Violation Number Comment Rule 532 All children were not held or placed in feeding chairs or other appropriate apparatus to be fed. One child in space 1b was drinking from a bottle while walking around the room. The teacher stated that a bouncy seat and a play saucer was used as feeding chairs. These chairs are not easily cleaned; therefore, are not approved feeding apparatus. 10A NCAC 09 .0902(b) 538 Baby bottles were not stored to protect from contamination. Baby bottles were being stored in the refrigerator in the kitchen. Five bottles did not have lids to avoid contamination. 15A NCAC 18A .2804(d) 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. (omit posting for centers located in a residence) Two children under that age of 15 months did not have an individual written feeding plan available for review or posted. 10A NCAC 09 .0902(a) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. The walls and doors throughout the facility were not in good repair. The doors need painting and some of the walls need painting. 15A NCAC 18A .2825(a) 807 A safe indoor and outdoor environment was not provided for the children. There was a staff member's purse in an unlocked closet in space 1a. On the playground, nails were protruding from the wood in a small playhouse and broken plastic toys were accessible to children. In space 1b, adult scissors and push pins were not stored out of the reach of children. 10A NCAC 09 .0601(a) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In space 1a, plastic bags were stored under the sink. Children in this space are one and two years of age. .0604(q) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The last date of the posted EMC Plan was dated August 2022. The plan has not been revised to reflect changes in staffing. 10A NCAC 09 .0802(a) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. Eleven children did not have a photograph used for identifying information in the vehicle used for transporting children. 10A NCAC 09 .1003(d) 1322 A written statement from each child's parent giving standing permission which may be valid for up to twelve months for participation in off premise activities that occur on a regular basis was not available. On the permission statements for transporting children, there were not dates provided to verify the timeframe of the standing permission to transport. .1005(b)(4) 1898 Staff did not complete the health and safety training within one year of employment. A. Mercer's hire date was 8/2024. The Health and Safety trainings were not completed within one year of hire date. The trainings were required to be completed by 8/2025. .1102(a) CONSULTATION AND TECHNICAL ASSISTANCE: The violations documented above must be corrected immediately. A signed and dated letter of compliance must be mailed to me by January 28, 2026, describing how and when the violations were corrected. This two-week time frame is established to allow you time for submitting your compliance letter and is not intended to be used as a guide for correcting violations, as they should be corrected immediately. The letter of compliance should be mailed or emailed to me, Tina Jones, PO Box 10194, Goldsboro, NC 27532. The compliance letter must be submitted from the email address on file for your program. If you have any questions related to this visit or if I can be of additional assistance, I can be reached at 252-361-3434 or tina.jones@dhhs.nc.gov. You may also contact Susan Fuller, Licensing Supervisor, at 252-373-9809. Please be aware that any written information submitted by you regarding correction of violations documented is legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, Administrative Action, including Revocation of the facility’s license could be issued. Child care licensing requirements are established to ensure a safe and healthy child care environment. Therefore, it is important for you to be knowledgeable of all the licensing requirements that apply to your type of program. It is your responsibility to maintain compliance with the applicable laws and rules; always whether they have been monitored or specifically discussed with you in the past. The best way for you to ensure that you are meeting all requirements is to periodically review the child care laws and rules on the Division of Child Development and Early Education’s website. Rated License: The “hold harmless” state of rated license reassessments had ended, and the new Quality Rating Improvement System standards are here. We discussed in detail the next steps that need to be taken to ensure success. I have provided you with the following documents: CONTINUOUS QUALITY IMPROVEMENT (CQI) PLAN AND PROFESSIONAL DEVELOPMENT PLAN: This plan is meant to be an intentional process that you will use to identify areas of growth and determine a path toward enhanced teaching, learning and practices that achieve better outcomes for children, staff, and programs. This process will build over time, using established goals to support both you in achieving and maintaining long term quality care within your program. All plans should identify a goal, what is needed to accomplish the goal, why the goal is needed, and an annual review of progress toward the goal. It is possible that a goal is achieved, and a new goal is set during your annual review. It is also possible that there were challenges in completing a goal that are documented during the annual review. Revising and changing goals is expected to be part of this process. FAMILY AND COMMUNITY ENGAGEMENT STANDARDS: These new rules require that a program offers engagement opportunities through foundational practices and engagement opportunities. It is up to each individual family to determine if and how they would like to participate in offered activities. At the 3-, 4- and 5-star levels, foundational practices continue but you will choose additional options that best fit the needs of your families. The number of choices increases as the star rating increases. We reviewed and discussed many of the options that you are already providing for your families. We discussed ways that you can document these options. CURRICULUM: This pathway requires curriculum to be implemented for all ages served by the program, ensuring quality practices that are developmentally appropriate for each age group. Child-focused planning through observation of individual growth and development is included in this pathway. We reviewed that at the 3-Star level, a curriculum is required. We reviewed that there is a free curriculum, Early Learning Matters. The link for this is https://elmcurriculum.org/. EDUCATION STANDARDS: We reviewed the requirements in the education standard for you and your staff. We discussed you ensuring everyone is in the WORKS system. In WORKS, we are able to verify all education received by each staff member and seeing where everyone is in the education standards. CONSULTATION: We reviewed that all programs will be required to transition to the new QRIS utilizing the pathway of your choice. We discussed that you can contact me with any questions you may have about this process. I can assist you by making an additional technical assistance visit. You may also contact your local Partnership for Children to discuss the required coaching and training opportunities. Today we set a goal of submitting your rated license application and transition to a pathway by August of 2026. 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. The NC child care rules were last updated as of July 1, 2025. • 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 www.healthychildcare.unc.edu. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0901 · Violation

Name of Operation: CYNTHIA'S GARDEN OF KNOWLEDGE Facility ID: 98000092 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 7/9/2025 Number Present: 32 Completed Date: 7/9/2025 Age: From 0 To 10 Total Minutes: 170 Time In: 08:30 AM Time Out: 11:20 AM 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 for during the annual compliance visit. Cynthia Rose-Morgan, Administrator, assisted with the visit. This center currently operates with a three-star license earning five points in staff education, one point in program standards and one quality point for the administrator completing a business training course of at least 30 clock hours. The last annual compliance visit was completed on July 30, 2024. The last sanitation inspection was completed on June 5, 2025, with a “Superior” classification. The last fire inspection was completed on October 8, 2024, and the center was approved for day and nighttime care. Thirty-four (34) children were in care today ranging from zero (0) to ten (10) years old. Children were engaged in free choice play with developmentally age-appropriate materials, outdoor play, completing toileting, and hand washing routines, interacting with caregivers, and eating breakfast. Breakfast consisted of waffles, applesauce, and milk. The following violations were documented. Violation Number Comment Rule 528 Food substitution was not of comparable food value or recorded on the menu prior to the meal or snack being served. Apple sauce served to children for breakfast was not recorded on the menu as required for berry melon as required. 10A NCAC 09 .0901(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 was not on file to verify first aid training was completed for one employee hired on April 2, 2025. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Documentation was not on file to verify CPR training was completed for one employee hired on April 2, 2025. .1102(d) 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 on file to verify Recognizing and Responding to Suspicions of Child Maltreatment was completed by one employee hired on April 2, 2025. .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 July23, 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 88% as of July 7, 2025. CORPORATION STATUS: Cynthia’s Garden of Knowledge, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Cynthia’s Garden of Knowledge Inc. remains current and 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. FACILITY PROFILE INFORMATION: You verified the phone number email address and mailing address listed on the facility profile are correct. If 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. AUTOMATED BACKGROUND CHECK MANAGEMENT SYSTEM (ABCMS) PORTAL: Two staff were listed in the ABCMS portal for your program. We talked about the process for linking staff to the center’s portal. I explained staff should be given the code so they can link themselves to the program. Staff who work at multiple programs should be linked the to all centers where they are employed. Once the code has been added, the individual designated must return to the portal to update staff information. This will ensure staff are shown in the portal when reviewed for verification. NEW TRAINING MODULE in MOODLE – CHILD DEVELOPMENT DCDEE has added a new training module about Child Development on the DCDEE Moodle Learning Platform. This is the first of several planned modules to support orientation and the health and safety training requirements. This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID is needed to access the Child Development Module. If you do not have an NCID, visit MYNCID.nc.gov to register for a free NCID account. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov. HEAT SAFETY: To ensure heat safety in a child care setting, prioritize staying cool, hydrated, and informed, and be aware of the signs of heat-related illnesses. Move outdoor activities to cooler times, dress children in appropriate clothing, and provide plenty of fluids. Regularly check for signs of heat exhaustion or heatstroke and have a plan in place for extreme heat situations. Additionally, always check your vehicle when transporting children. Never leave children unattended in parked cars, even for a short time, as temperatures can rise rapidly. 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 .0902 · Violation

Name of Operation: CYNTHIA'S GARDEN OF KNOWLEDGE Facility ID: 98000092 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 12/17/2024 Number Present: 31 Completed Date: 12/17/2024 Age: From 0 To 5 Total Minutes: 220 Time In: 08:20 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your facility for compliance with applicable child care requirements during a routine unannounced visit. Upon arrival Annette Edwards, teacher assisted with the visit. Staff called and notified you of my presence. You arrived shortly after the visit started and assisted. Twenty-six (26) children were present today ranging from zero (0) to five (5) years old. Children were observed eating breakfast interacting with the caregivers, engaged in morning activities and free choice play, and completing toileting, and hand washing routines. Breakfast consisted of pancakes, apples and milk. Currently this program operates with a three-star license. The last sanitation inspection was completed on June 4, 2024, earning a superior classification. The last fire inspection was completed on October 8, 2024, and the center was approved for day and nighttime care. The last annual compliance visit was completed on June 30, 2024. The following violations were documented today. Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. Departure times were not recorded for nine children from December 2, 2024, to December 11, 2024. 10A NCAC 09 .0302(d)(4) 301 Minimum staff/child ratios and group sizes for the number and ages of children in care were not met. Minimum staff child ratio requirements were not met when six (6) children ages seven months to one year old was cared for by one caregiver between Spaces 1a and 1b. Also, one care giver was observed providing care to elven (11) children ranging from ages one to three in Space #3. GS 110-91(7);.0713(a-d) 318 Children between 12 and 24 months of age were grouped with children 3 years of age or older. A one year old child was grouped with three years old children in Space #3. A one-year-old child was grouped with children four and five years old in Space #4. 10A NCAC 09 .0713(a)(6) 532 All children were not held or placed in feeding chairs or other appropriate apparatus to be fed. A bottle was propped in an infant’s mouth while sleeping in a rocker in Space #1b. 10A NCAC 09 .0902(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. A plastic grocery bag with marshmallows and cocoa was on the diaper table changing table between spaces #1a and 1b. A plastic grocery bag was hanging on the back of the door to the bathroom in Space #3. .0604(q) 871 Center staff did not comply with the safe sleep policy. The center’s safe sleep policy was not followed when an infant was observed sleeping in a rocker in Space #1b. 10A NCAC 09 .0606(a) 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 December31, 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. CORPORATION STATUS: Cynthia's Garden of Knowledge, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Cynthia's Garden of Knowledge, Inc. 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, mailing address and email address listed on the facility profile are correct. If 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. COMPLIANCE HISTORY: The program's compliance history was reviewed with the operator. The program’s compliance history was 88% percent as of December 16, 2024. STAFF/CHILD INTERACTIONS: Upon arrival children in classroom 1a and 1b were grouped together with one caregiver. The gate separating the two classes has been removed. The second caregiver came into the classroom shortly after the observation started and the gate was placed back up separating the two spaces. Children were eating breakfast and engaged in free choice play with age-appropriate materials. Children in Space 3 and 4 were sitting waiting for caregivers to complete other tasks. Later in the visit children Space #4 were allowed to play with manipulatives at the table and number/alphabet mats on the floor. The teacher completed paperwork while the children played. Arguments between children went unnoticed and not addressed. Space #2 was not used during my observation. The school age building was used for occupation services. Upon arrival staff greeted and talked with parents. We discussed encouraging staff to prepare activities and materials prior to children arriving in the morning to cut down on wait times and ensure the caregiver can be actively engaged in plays. When children must wait for long periods of time, it creates space for behaviors to be exposed. Activities should be preplanned and materials readily available for children when they arrive to child care. STAFF/CHILD RATIO AND GROUPING OF CHILDREN: Upon arrival, caregivers were observed providing care to more children than required based on the age of the youngest child in the classroom. Children between ages twelve to twenty-four months old were grouped with children ranging from ages three to four years old. A one-year-old child was observed walking from space to space unattended and independently. The child was observed in Space #4 with preschool four- and five-years-old when I entered the building, and then she came into the infant toddler classroom alone as I was observing. You stated the child was probably your granddaughter who feels she can leave her classroom alone at any time. I shared with you one teacher was observed providing care to two groups of children. I further explained the gate was removed creating one space where children were joined. There were six children ranging form ages five months to one years old was cared for by the one caregiver placing the space out for compliance for staff/child ratio. As I was entering Space #3 the caregiver called for the person cooking to come get two children stating she was over her number. This caregiver had eleven children ranging from ages one to three years old. One child was removed form the space and carried into another classroom. We talked about ensuring staff know and follow the requirements for staff/child ratio grouping children when you are not on site. Children should be closely monitored so they do not roam from space to space alone. The staff/child ratio chart could be used as a guide for determining ages of children for grouping. The ages should also be updated when younger children are placed in other classrooms they are not assigned to. Transitions should take place prior to noncompliance. I reviewed the plan of action developed and approved on February 15, 2024. I explained the steps listed in the plan of action were not followed as stated. I recommended you review the plan of action and revise as needed to ensure your program comes into and maintain compliance with staff/child ratio and grouping . Also be mindful ages of children should be counted in years oppose to months when grouping and meeting ratio requirements. You stated the program’s operation hours are from 6:30am to 7:00pm. Be mindful children can only be grouped together during the first and last hours of operation and staff/child ratio requirements must be maintained for the ages of the youngest child in each group. FOLLOW-UP VISITS: An unannounced follow-up visit will be conducted in the future to monitor compliance staff/child ratio requirements. SAFE SLEEP POLICY/NUTRITION: An infant was observed in a rocker sleep with a bottle propped in his mouth. The caregiver removed the bottle and allowed the infant to remain in the rocker. After a few minutes, I informed the caregiver the infant must be removed from the rocker and placed in his crib. The caregiver stated the infant had just fallen asleep; however, I was in the classroom approximately three minutes prior to informing her to remove the child. I recommended you review the safe sleep policy with staff again as a refresher to ensure the policy is understood and followed. I reminded you bottles should not be propped. You stated staff are aware of this practice and that you remind them constantly to follow the child care rule requirements regarding propping bottles and safe sleep. I recommended you review the safe sleep policy with staff gain as a refresher to ensure the policy is understood and followed. We also discussed the importance of not propping bottles for infants to drink. I explained the safety concerns such as choking from the content of the bottle. It was recommended asking staff to request help when needed to feed younger children which will ensure child care requirements and best practices are implemented. 2024 ANNUAL LICENSE FEE INVOICES: Keep an eye on your inbox for the 2024 annual license fee invoice. Invoices were emailed to the facility addresses on file by November 30, 2024. Online payments are due by December 31, 2024. In accordance with North Carolina General Statute § 110-90(1a), licensed child care facilities are assessed an annual license fee. The amount of your annual license fee is based on the licensed capacity printed on your license as of October 1, 2024, not the number of children enrolled at your facility. Please note that annual license fees do not apply to state or public school-operated child care facilities, or to religious-sponsored facilities operating under a Notice of Compliance. The Division of Child Development and Early Education remains available to assist you. For questions regarding license fees, visit the Frequently Asked Questions (FAQs) on our website. For further assistance regarding your annual license fee, please email DCDEE_LF@dhhs.nc.gov. 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 GET READY for the 3s (ECERS-3, ITERS-3, FCCERS-3) The DCDEE and the North Carolina Rated License Assessment Project (NCRLAP) are collaboratively working on preparations for the transition to the ECERS-3, ITERS-3, and FCCERS-3 that starts February 1, 2025. Don't worry! Visit the Get ready for the 3s webpage to learn what's different and what you can do now to prepare. New resources have just been added. You'll find updated FAQs, factsheets, credit hour trainings, outreach assessment opportunities and more to help you become familiar with these tools. Until February 1, 2025, NCRLAP will use the Revised editions for official environment rating scale assessments for a NC Star Rated License (for new licensees or upon request.) CRIMINAL BACKGROUND CHECK REQUIREMENTS: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. ANNUAL IMMUNIZATION REPORT EXTENSION: The reporting period for child care immunizations has been extended due to Hurricane Helene. Reports will be accepted until January 15, 2025. Send any questions regarding child care immunization reporting to immunization.reports@dhhs.nc.gov. 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. Also, make sure you have the most recent copy of the child care rules dated November 1, 2024. 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 .0302 · Violation

Name of Operation: CYNTHIA'S GARDEN OF KNOWLEDGE Facility ID: 98000092 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 12/17/2024 Number Present: 31 Completed Date: 12/17/2024 Age: From 0 To 5 Total Minutes: 220 Time In: 08:20 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your facility for compliance with applicable child care requirements during a routine unannounced visit. Upon arrival Annette Edwards, teacher assisted with the visit. Staff called and notified you of my presence. You arrived shortly after the visit started and assisted. Twenty-six (26) children were present today ranging from zero (0) to five (5) years old. Children were observed eating breakfast interacting with the caregivers, engaged in morning activities and free choice play, and completing toileting, and hand washing routines. Breakfast consisted of pancakes, apples and milk. Currently this program operates with a three-star license. The last sanitation inspection was completed on June 4, 2024, earning a superior classification. The last fire inspection was completed on October 8, 2024, and the center was approved for day and nighttime care. The last annual compliance visit was completed on June 30, 2024. The following violations were documented today. Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. Departure times were not recorded for nine children from December 2, 2024, to December 11, 2024. 10A NCAC 09 .0302(d)(4) 301 Minimum staff/child ratios and group sizes for the number and ages of children in care were not met. Minimum staff child ratio requirements were not met when six (6) children ages seven months to one year old was cared for by one caregiver between Spaces 1a and 1b. Also, one care giver was observed providing care to elven (11) children ranging from ages one to three in Space #3. GS 110-91(7);.0713(a-d) 318 Children between 12 and 24 months of age were grouped with children 3 years of age or older. A one year old child was grouped with three years old children in Space #3. A one-year-old child was grouped with children four and five years old in Space #4. 10A NCAC 09 .0713(a)(6) 532 All children were not held or placed in feeding chairs or other appropriate apparatus to be fed. A bottle was propped in an infant’s mouth while sleeping in a rocker in Space #1b. 10A NCAC 09 .0902(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. A plastic grocery bag with marshmallows and cocoa was on the diaper table changing table between spaces #1a and 1b. A plastic grocery bag was hanging on the back of the door to the bathroom in Space #3. .0604(q) 871 Center staff did not comply with the safe sleep policy. The center’s safe sleep policy was not followed when an infant was observed sleeping in a rocker in Space #1b. 10A NCAC 09 .0606(a) 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 December31, 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. CORPORATION STATUS: Cynthia's Garden of Knowledge, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Cynthia's Garden of Knowledge, Inc. 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, mailing address and email address listed on the facility profile are correct. If 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. COMPLIANCE HISTORY: The program's compliance history was reviewed with the operator. The program’s compliance history was 88% percent as of December 16, 2024. STAFF/CHILD INTERACTIONS: Upon arrival children in classroom 1a and 1b were grouped together with one caregiver. The gate separating the two classes has been removed. The second caregiver came into the classroom shortly after the observation started and the gate was placed back up separating the two spaces. Children were eating breakfast and engaged in free choice play with age-appropriate materials. Children in Space 3 and 4 were sitting waiting for caregivers to complete other tasks. Later in the visit children Space #4 were allowed to play with manipulatives at the table and number/alphabet mats on the floor. The teacher completed paperwork while the children played. Arguments between children went unnoticed and not addressed. Space #2 was not used during my observation. The school age building was used for occupation services. Upon arrival staff greeted and talked with parents. We discussed encouraging staff to prepare activities and materials prior to children arriving in the morning to cut down on wait times and ensure the caregiver can be actively engaged in plays. When children must wait for long periods of time, it creates space for behaviors to be exposed. Activities should be preplanned and materials readily available for children when they arrive to child care. STAFF/CHILD RATIO AND GROUPING OF CHILDREN: Upon arrival, caregivers were observed providing care to more children than required based on the age of the youngest child in the classroom. Children between ages twelve to twenty-four months old were grouped with children ranging from ages three to four years old. A one-year-old child was observed walking from space to space unattended and independently. The child was observed in Space #4 with preschool four- and five-years-old when I entered the building, and then she came into the infant toddler classroom alone as I was observing. You stated the child was probably your granddaughter who feels she can leave her classroom alone at any time. I shared with you one teacher was observed providing care to two groups of children. I further explained the gate was removed creating one space where children were joined. There were six children ranging form ages five months to one years old was cared for by the one caregiver placing the space out for compliance for staff/child ratio. As I was entering Space #3 the caregiver called for the person cooking to come get two children stating she was over her number. This caregiver had eleven children ranging from ages one to three years old. One child was removed form the space and carried into another classroom. We talked about ensuring staff know and follow the requirements for staff/child ratio grouping children when you are not on site. Children should be closely monitored so they do not roam from space to space alone. The staff/child ratio chart could be used as a guide for determining ages of children for grouping. The ages should also be updated when younger children are placed in other classrooms they are not assigned to. Transitions should take place prior to noncompliance. I reviewed the plan of action developed and approved on February 15, 2024. I explained the steps listed in the plan of action were not followed as stated. I recommended you review the plan of action and revise as needed to ensure your program comes into and maintain compliance with staff/child ratio and grouping . Also be mindful ages of children should be counted in years oppose to months when grouping and meeting ratio requirements. You stated the program’s operation hours are from 6:30am to 7:00pm. Be mindful children can only be grouped together during the first and last hours of operation and staff/child ratio requirements must be maintained for the ages of the youngest child in each group. FOLLOW-UP VISITS: An unannounced follow-up visit will be conducted in the future to monitor compliance staff/child ratio requirements. SAFE SLEEP POLICY/NUTRITION: An infant was observed in a rocker sleep with a bottle propped in his mouth. The caregiver removed the bottle and allowed the infant to remain in the rocker. After a few minutes, I informed the caregiver the infant must be removed from the rocker and placed in his crib. The caregiver stated the infant had just fallen asleep; however, I was in the classroom approximately three minutes prior to informing her to remove the child. I recommended you review the safe sleep policy with staff again as a refresher to ensure the policy is understood and followed. I reminded you bottles should not be propped. You stated staff are aware of this practice and that you remind them constantly to follow the child care rule requirements regarding propping bottles and safe sleep. I recommended you review the safe sleep policy with staff gain as a refresher to ensure the policy is understood and followed. We also discussed the importance of not propping bottles for infants to drink. I explained the safety concerns such as choking from the content of the bottle. It was recommended asking staff to request help when needed to feed younger children which will ensure child care requirements and best practices are implemented. 2024 ANNUAL LICENSE FEE INVOICES: Keep an eye on your inbox for the 2024 annual license fee invoice. Invoices were emailed to the facility addresses on file by November 30, 2024. Online payments are due by December 31, 2024. In accordance with North Carolina General Statute § 110-90(1a), licensed child care facilities are assessed an annual license fee. The amount of your annual license fee is based on the licensed capacity printed on your license as of October 1, 2024, not the number of children enrolled at your facility. Please note that annual license fees do not apply to state or public school-operated child care facilities, or to religious-sponsored facilities operating under a Notice of Compliance. The Division of Child Development and Early Education remains available to assist you. For questions regarding license fees, visit the Frequently Asked Questions (FAQs) on our website. For further assistance regarding your annual license fee, please email DCDEE_LF@dhhs.nc.gov. 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 GET READY for the 3s (ECERS-3, ITERS-3, FCCERS-3) The DCDEE and the North Carolina Rated License Assessment Project (NCRLAP) are collaboratively working on preparations for the transition to the ECERS-3, ITERS-3, and FCCERS-3 that starts February 1, 2025. Don't worry! Visit the Get ready for the 3s webpage to learn what's different and what you can do now to prepare. New resources have just been added. You'll find updated FAQs, factsheets, credit hour trainings, outreach assessment opportunities and more to help you become familiar with these tools. Until February 1, 2025, NCRLAP will use the Revised editions for official environment rating scale assessments for a NC Star Rated License (for new licensees or upon request.) CRIMINAL BACKGROUND CHECK REQUIREMENTS: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. ANNUAL IMMUNIZATION REPORT EXTENSION: The reporting period for child care immunizations has been extended due to Hurricane Helene. Reports will be accepted until January 15, 2025. Send any questions regarding child care immunization reporting to immunization.reports@dhhs.nc.gov. 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. Also, make sure you have the most recent copy of the child care rules dated November 1, 2024. 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 .0606 · Violation

Name of Operation: CYNTHIA'S GARDEN OF KNOWLEDGE Facility ID: 98000092 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 12/17/2024 Number Present: 31 Completed Date: 12/17/2024 Age: From 0 To 5 Total Minutes: 220 Time In: 08:20 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your facility for compliance with applicable child care requirements during a routine unannounced visit. Upon arrival Annette Edwards, teacher assisted with the visit. Staff called and notified you of my presence. You arrived shortly after the visit started and assisted. Twenty-six (26) children were present today ranging from zero (0) to five (5) years old. Children were observed eating breakfast interacting with the caregivers, engaged in morning activities and free choice play, and completing toileting, and hand washing routines. Breakfast consisted of pancakes, apples and milk. Currently this program operates with a three-star license. The last sanitation inspection was completed on June 4, 2024, earning a superior classification. The last fire inspection was completed on October 8, 2024, and the center was approved for day and nighttime care. The last annual compliance visit was completed on June 30, 2024. The following violations were documented today. Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. Departure times were not recorded for nine children from December 2, 2024, to December 11, 2024. 10A NCAC 09 .0302(d)(4) 301 Minimum staff/child ratios and group sizes for the number and ages of children in care were not met. Minimum staff child ratio requirements were not met when six (6) children ages seven months to one year old was cared for by one caregiver between Spaces 1a and 1b. Also, one care giver was observed providing care to elven (11) children ranging from ages one to three in Space #3. GS 110-91(7);.0713(a-d) 318 Children between 12 and 24 months of age were grouped with children 3 years of age or older. A one year old child was grouped with three years old children in Space #3. A one-year-old child was grouped with children four and five years old in Space #4. 10A NCAC 09 .0713(a)(6) 532 All children were not held or placed in feeding chairs or other appropriate apparatus to be fed. A bottle was propped in an infant’s mouth while sleeping in a rocker in Space #1b. 10A NCAC 09 .0902(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. A plastic grocery bag with marshmallows and cocoa was on the diaper table changing table between spaces #1a and 1b. A plastic grocery bag was hanging on the back of the door to the bathroom in Space #3. .0604(q) 871 Center staff did not comply with the safe sleep policy. The center’s safe sleep policy was not followed when an infant was observed sleeping in a rocker in Space #1b. 10A NCAC 09 .0606(a) 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 December31, 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. CORPORATION STATUS: Cynthia's Garden of Knowledge, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Cynthia's Garden of Knowledge, Inc. 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, mailing address and email address listed on the facility profile are correct. If 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. COMPLIANCE HISTORY: The program's compliance history was reviewed with the operator. The program’s compliance history was 88% percent as of December 16, 2024. STAFF/CHILD INTERACTIONS: Upon arrival children in classroom 1a and 1b were grouped together with one caregiver. The gate separating the two classes has been removed. The second caregiver came into the classroom shortly after the observation started and the gate was placed back up separating the two spaces. Children were eating breakfast and engaged in free choice play with age-appropriate materials. Children in Space 3 and 4 were sitting waiting for caregivers to complete other tasks. Later in the visit children Space #4 were allowed to play with manipulatives at the table and number/alphabet mats on the floor. The teacher completed paperwork while the children played. Arguments between children went unnoticed and not addressed. Space #2 was not used during my observation. The school age building was used for occupation services. Upon arrival staff greeted and talked with parents. We discussed encouraging staff to prepare activities and materials prior to children arriving in the morning to cut down on wait times and ensure the caregiver can be actively engaged in plays. When children must wait for long periods of time, it creates space for behaviors to be exposed. Activities should be preplanned and materials readily available for children when they arrive to child care. STAFF/CHILD RATIO AND GROUPING OF CHILDREN: Upon arrival, caregivers were observed providing care to more children than required based on the age of the youngest child in the classroom. Children between ages twelve to twenty-four months old were grouped with children ranging from ages three to four years old. A one-year-old child was observed walking from space to space unattended and independently. The child was observed in Space #4 with preschool four- and five-years-old when I entered the building, and then she came into the infant toddler classroom alone as I was observing. You stated the child was probably your granddaughter who feels she can leave her classroom alone at any time. I shared with you one teacher was observed providing care to two groups of children. I further explained the gate was removed creating one space where children were joined. There were six children ranging form ages five months to one years old was cared for by the one caregiver placing the space out for compliance for staff/child ratio. As I was entering Space #3 the caregiver called for the person cooking to come get two children stating she was over her number. This caregiver had eleven children ranging from ages one to three years old. One child was removed form the space and carried into another classroom. We talked about ensuring staff know and follow the requirements for staff/child ratio grouping children when you are not on site. Children should be closely monitored so they do not roam from space to space alone. The staff/child ratio chart could be used as a guide for determining ages of children for grouping. The ages should also be updated when younger children are placed in other classrooms they are not assigned to. Transitions should take place prior to noncompliance. I reviewed the plan of action developed and approved on February 15, 2024. I explained the steps listed in the plan of action were not followed as stated. I recommended you review the plan of action and revise as needed to ensure your program comes into and maintain compliance with staff/child ratio and grouping . Also be mindful ages of children should be counted in years oppose to months when grouping and meeting ratio requirements. You stated the program’s operation hours are from 6:30am to 7:00pm. Be mindful children can only be grouped together during the first and last hours of operation and staff/child ratio requirements must be maintained for the ages of the youngest child in each group. FOLLOW-UP VISITS: An unannounced follow-up visit will be conducted in the future to monitor compliance staff/child ratio requirements. SAFE SLEEP POLICY/NUTRITION: An infant was observed in a rocker sleep with a bottle propped in his mouth. The caregiver removed the bottle and allowed the infant to remain in the rocker. After a few minutes, I informed the caregiver the infant must be removed from the rocker and placed in his crib. The caregiver stated the infant had just fallen asleep; however, I was in the classroom approximately three minutes prior to informing her to remove the child. I recommended you review the safe sleep policy with staff again as a refresher to ensure the policy is understood and followed. I reminded you bottles should not be propped. You stated staff are aware of this practice and that you remind them constantly to follow the child care rule requirements regarding propping bottles and safe sleep. I recommended you review the safe sleep policy with staff gain as a refresher to ensure the policy is understood and followed. We also discussed the importance of not propping bottles for infants to drink. I explained the safety concerns such as choking from the content of the bottle. It was recommended asking staff to request help when needed to feed younger children which will ensure child care requirements and best practices are implemented. 2024 ANNUAL LICENSE FEE INVOICES: Keep an eye on your inbox for the 2024 annual license fee invoice. Invoices were emailed to the facility addresses on file by November 30, 2024. Online payments are due by December 31, 2024. In accordance with North Carolina General Statute § 110-90(1a), licensed child care facilities are assessed an annual license fee. The amount of your annual license fee is based on the licensed capacity printed on your license as of October 1, 2024, not the number of children enrolled at your facility. Please note that annual license fees do not apply to state or public school-operated child care facilities, or to religious-sponsored facilities operating under a Notice of Compliance. The Division of Child Development and Early Education remains available to assist you. For questions regarding license fees, visit the Frequently Asked Questions (FAQs) on our website. For further assistance regarding your annual license fee, please email DCDEE_LF@dhhs.nc.gov. 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 GET READY for the 3s (ECERS-3, ITERS-3, FCCERS-3) The DCDEE and the North Carolina Rated License Assessment Project (NCRLAP) are collaboratively working on preparations for the transition to the ECERS-3, ITERS-3, and FCCERS-3 that starts February 1, 2025. Don't worry! Visit the Get ready for the 3s webpage to learn what's different and what you can do now to prepare. New resources have just been added. You'll find updated FAQs, factsheets, credit hour trainings, outreach assessment opportunities and more to help you become familiar with these tools. Until February 1, 2025, NCRLAP will use the Revised editions for official environment rating scale assessments for a NC Star Rated License (for new licensees or upon request.) CRIMINAL BACKGROUND CHECK REQUIREMENTS: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. ANNUAL IMMUNIZATION REPORT EXTENSION: The reporting period for child care immunizations has been extended due to Hurricane Helene. Reports will be accepted until January 15, 2025. Send any questions regarding child care immunization reporting to immunization.reports@dhhs.nc.gov. 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. Also, make sure you have the most recent copy of the child care rules dated November 1, 2024. 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 .0713 · Violation

Name of Operation: CYNTHIA'S GARDEN OF KNOWLEDGE Facility ID: 98000092 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 12/17/2024 Number Present: 31 Completed Date: 12/17/2024 Age: From 0 To 5 Total Minutes: 220 Time In: 08:20 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your facility for compliance with applicable child care requirements during a routine unannounced visit. Upon arrival Annette Edwards, teacher assisted with the visit. Staff called and notified you of my presence. You arrived shortly after the visit started and assisted. Twenty-six (26) children were present today ranging from zero (0) to five (5) years old. Children were observed eating breakfast interacting with the caregivers, engaged in morning activities and free choice play, and completing toileting, and hand washing routines. Breakfast consisted of pancakes, apples and milk. Currently this program operates with a three-star license. The last sanitation inspection was completed on June 4, 2024, earning a superior classification. The last fire inspection was completed on October 8, 2024, and the center was approved for day and nighttime care. The last annual compliance visit was completed on June 30, 2024. The following violations were documented today. Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. Departure times were not recorded for nine children from December 2, 2024, to December 11, 2024. 10A NCAC 09 .0302(d)(4) 301 Minimum staff/child ratios and group sizes for the number and ages of children in care were not met. Minimum staff child ratio requirements were not met when six (6) children ages seven months to one year old was cared for by one caregiver between Spaces 1a and 1b. Also, one care giver was observed providing care to elven (11) children ranging from ages one to three in Space #3. GS 110-91(7);.0713(a-d) 318 Children between 12 and 24 months of age were grouped with children 3 years of age or older. A one year old child was grouped with three years old children in Space #3. A one-year-old child was grouped with children four and five years old in Space #4. 10A NCAC 09 .0713(a)(6) 532 All children were not held or placed in feeding chairs or other appropriate apparatus to be fed. A bottle was propped in an infant’s mouth while sleeping in a rocker in Space #1b. 10A NCAC 09 .0902(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. A plastic grocery bag with marshmallows and cocoa was on the diaper table changing table between spaces #1a and 1b. A plastic grocery bag was hanging on the back of the door to the bathroom in Space #3. .0604(q) 871 Center staff did not comply with the safe sleep policy. The center’s safe sleep policy was not followed when an infant was observed sleeping in a rocker in Space #1b. 10A NCAC 09 .0606(a) 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 December31, 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. CORPORATION STATUS: Cynthia's Garden of Knowledge, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Cynthia's Garden of Knowledge, Inc. 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, mailing address and email address listed on the facility profile are correct. If 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. COMPLIANCE HISTORY: The program's compliance history was reviewed with the operator. The program’s compliance history was 88% percent as of December 16, 2024. STAFF/CHILD INTERACTIONS: Upon arrival children in classroom 1a and 1b were grouped together with one caregiver. The gate separating the two classes has been removed. The second caregiver came into the classroom shortly after the observation started and the gate was placed back up separating the two spaces. Children were eating breakfast and engaged in free choice play with age-appropriate materials. Children in Space 3 and 4 were sitting waiting for caregivers to complete other tasks. Later in the visit children Space #4 were allowed to play with manipulatives at the table and number/alphabet mats on the floor. The teacher completed paperwork while the children played. Arguments between children went unnoticed and not addressed. Space #2 was not used during my observation. The school age building was used for occupation services. Upon arrival staff greeted and talked with parents. We discussed encouraging staff to prepare activities and materials prior to children arriving in the morning to cut down on wait times and ensure the caregiver can be actively engaged in plays. When children must wait for long periods of time, it creates space for behaviors to be exposed. Activities should be preplanned and materials readily available for children when they arrive to child care. STAFF/CHILD RATIO AND GROUPING OF CHILDREN: Upon arrival, caregivers were observed providing care to more children than required based on the age of the youngest child in the classroom. Children between ages twelve to twenty-four months old were grouped with children ranging from ages three to four years old. A one-year-old child was observed walking from space to space unattended and independently. The child was observed in Space #4 with preschool four- and five-years-old when I entered the building, and then she came into the infant toddler classroom alone as I was observing. You stated the child was probably your granddaughter who feels she can leave her classroom alone at any time. I shared with you one teacher was observed providing care to two groups of children. I further explained the gate was removed creating one space where children were joined. There were six children ranging form ages five months to one years old was cared for by the one caregiver placing the space out for compliance for staff/child ratio. As I was entering Space #3 the caregiver called for the person cooking to come get two children stating she was over her number. This caregiver had eleven children ranging from ages one to three years old. One child was removed form the space and carried into another classroom. We talked about ensuring staff know and follow the requirements for staff/child ratio grouping children when you are not on site. Children should be closely monitored so they do not roam from space to space alone. The staff/child ratio chart could be used as a guide for determining ages of children for grouping. The ages should also be updated when younger children are placed in other classrooms they are not assigned to. Transitions should take place prior to noncompliance. I reviewed the plan of action developed and approved on February 15, 2024. I explained the steps listed in the plan of action were not followed as stated. I recommended you review the plan of action and revise as needed to ensure your program comes into and maintain compliance with staff/child ratio and grouping . Also be mindful ages of children should be counted in years oppose to months when grouping and meeting ratio requirements. You stated the program’s operation hours are from 6:30am to 7:00pm. Be mindful children can only be grouped together during the first and last hours of operation and staff/child ratio requirements must be maintained for the ages of the youngest child in each group. FOLLOW-UP VISITS: An unannounced follow-up visit will be conducted in the future to monitor compliance staff/child ratio requirements. SAFE SLEEP POLICY/NUTRITION: An infant was observed in a rocker sleep with a bottle propped in his mouth. The caregiver removed the bottle and allowed the infant to remain in the rocker. After a few minutes, I informed the caregiver the infant must be removed from the rocker and placed in his crib. The caregiver stated the infant had just fallen asleep; however, I was in the classroom approximately three minutes prior to informing her to remove the child. I recommended you review the safe sleep policy with staff again as a refresher to ensure the policy is understood and followed. I reminded you bottles should not be propped. You stated staff are aware of this practice and that you remind them constantly to follow the child care rule requirements regarding propping bottles and safe sleep. I recommended you review the safe sleep policy with staff gain as a refresher to ensure the policy is understood and followed. We also discussed the importance of not propping bottles for infants to drink. I explained the safety concerns such as choking from the content of the bottle. It was recommended asking staff to request help when needed to feed younger children which will ensure child care requirements and best practices are implemented. 2024 ANNUAL LICENSE FEE INVOICES: Keep an eye on your inbox for the 2024 annual license fee invoice. Invoices were emailed to the facility addresses on file by November 30, 2024. Online payments are due by December 31, 2024. In accordance with North Carolina General Statute § 110-90(1a), licensed child care facilities are assessed an annual license fee. The amount of your annual license fee is based on the licensed capacity printed on your license as of October 1, 2024, not the number of children enrolled at your facility. Please note that annual license fees do not apply to state or public school-operated child care facilities, or to religious-sponsored facilities operating under a Notice of Compliance. The Division of Child Development and Early Education remains available to assist you. For questions regarding license fees, visit the Frequently Asked Questions (FAQs) on our website. For further assistance regarding your annual license fee, please email DCDEE_LF@dhhs.nc.gov. 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 GET READY for the 3s (ECERS-3, ITERS-3, FCCERS-3) The DCDEE and the North Carolina Rated License Assessment Project (NCRLAP) are collaboratively working on preparations for the transition to the ECERS-3, ITERS-3, and FCCERS-3 that starts February 1, 2025. Don't worry! Visit the Get ready for the 3s webpage to learn what's different and what you can do now to prepare. New resources have just been added. You'll find updated FAQs, factsheets, credit hour trainings, outreach assessment opportunities and more to help you become familiar with these tools. Until February 1, 2025, NCRLAP will use the Revised editions for official environment rating scale assessments for a NC Star Rated License (for new licensees or upon request.) CRIMINAL BACKGROUND CHECK REQUIREMENTS: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. ANNUAL IMMUNIZATION REPORT EXTENSION: The reporting period for child care immunizations has been extended due to Hurricane Helene. Reports will be accepted until January 15, 2025. Send any questions regarding child care immunization reporting to immunization.reports@dhhs.nc.gov. 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. Also, make sure you have the most recent copy of the child care rules dated November 1, 2024. 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

G.S. 110-90 · Violation

Name of Operation: CYNTHIA'S GARDEN OF KNOWLEDGE Facility ID: 98000092 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 12/17/2024 Number Present: 31 Completed Date: 12/17/2024 Age: From 0 To 5 Total Minutes: 220 Time In: 08:20 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your facility for compliance with applicable child care requirements during a routine unannounced visit. Upon arrival Annette Edwards, teacher assisted with the visit. Staff called and notified you of my presence. You arrived shortly after the visit started and assisted. Twenty-six (26) children were present today ranging from zero (0) to five (5) years old. Children were observed eating breakfast interacting with the caregivers, engaged in morning activities and free choice play, and completing toileting, and hand washing routines. Breakfast consisted of pancakes, apples and milk. Currently this program operates with a three-star license. The last sanitation inspection was completed on June 4, 2024, earning a superior classification. The last fire inspection was completed on October 8, 2024, and the center was approved for day and nighttime care. The last annual compliance visit was completed on June 30, 2024. The following violations were documented today. Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. Departure times were not recorded for nine children from December 2, 2024, to December 11, 2024. 10A NCAC 09 .0302(d)(4) 301 Minimum staff/child ratios and group sizes for the number and ages of children in care were not met. Minimum staff child ratio requirements were not met when six (6) children ages seven months to one year old was cared for by one caregiver between Spaces 1a and 1b. Also, one care giver was observed providing care to elven (11) children ranging from ages one to three in Space #3. GS 110-91(7);.0713(a-d) 318 Children between 12 and 24 months of age were grouped with children 3 years of age or older. A one year old child was grouped with three years old children in Space #3. A one-year-old child was grouped with children four and five years old in Space #4. 10A NCAC 09 .0713(a)(6) 532 All children were not held or placed in feeding chairs or other appropriate apparatus to be fed. A bottle was propped in an infant’s mouth while sleeping in a rocker in Space #1b. 10A NCAC 09 .0902(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. A plastic grocery bag with marshmallows and cocoa was on the diaper table changing table between spaces #1a and 1b. A plastic grocery bag was hanging on the back of the door to the bathroom in Space #3. .0604(q) 871 Center staff did not comply with the safe sleep policy. The center’s safe sleep policy was not followed when an infant was observed sleeping in a rocker in Space #1b. 10A NCAC 09 .0606(a) 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 December31, 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. CORPORATION STATUS: Cynthia's Garden of Knowledge, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Cynthia's Garden of Knowledge, Inc. 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, mailing address and email address listed on the facility profile are correct. If 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. COMPLIANCE HISTORY: The program's compliance history was reviewed with the operator. The program’s compliance history was 88% percent as of December 16, 2024. STAFF/CHILD INTERACTIONS: Upon arrival children in classroom 1a and 1b were grouped together with one caregiver. The gate separating the two classes has been removed. The second caregiver came into the classroom shortly after the observation started and the gate was placed back up separating the two spaces. Children were eating breakfast and engaged in free choice play with age-appropriate materials. Children in Space 3 and 4 were sitting waiting for caregivers to complete other tasks. Later in the visit children Space #4 were allowed to play with manipulatives at the table and number/alphabet mats on the floor. The teacher completed paperwork while the children played. Arguments between children went unnoticed and not addressed. Space #2 was not used during my observation. The school age building was used for occupation services. Upon arrival staff greeted and talked with parents. We discussed encouraging staff to prepare activities and materials prior to children arriving in the morning to cut down on wait times and ensure the caregiver can be actively engaged in plays. When children must wait for long periods of time, it creates space for behaviors to be exposed. Activities should be preplanned and materials readily available for children when they arrive to child care. STAFF/CHILD RATIO AND GROUPING OF CHILDREN: Upon arrival, caregivers were observed providing care to more children than required based on the age of the youngest child in the classroom. Children between ages twelve to twenty-four months old were grouped with children ranging from ages three to four years old. A one-year-old child was observed walking from space to space unattended and independently. The child was observed in Space #4 with preschool four- and five-years-old when I entered the building, and then she came into the infant toddler classroom alone as I was observing. You stated the child was probably your granddaughter who feels she can leave her classroom alone at any time. I shared with you one teacher was observed providing care to two groups of children. I further explained the gate was removed creating one space where children were joined. There were six children ranging form ages five months to one years old was cared for by the one caregiver placing the space out for compliance for staff/child ratio. As I was entering Space #3 the caregiver called for the person cooking to come get two children stating she was over her number. This caregiver had eleven children ranging from ages one to three years old. One child was removed form the space and carried into another classroom. We talked about ensuring staff know and follow the requirements for staff/child ratio grouping children when you are not on site. Children should be closely monitored so they do not roam from space to space alone. The staff/child ratio chart could be used as a guide for determining ages of children for grouping. The ages should also be updated when younger children are placed in other classrooms they are not assigned to. Transitions should take place prior to noncompliance. I reviewed the plan of action developed and approved on February 15, 2024. I explained the steps listed in the plan of action were not followed as stated. I recommended you review the plan of action and revise as needed to ensure your program comes into and maintain compliance with staff/child ratio and grouping . Also be mindful ages of children should be counted in years oppose to months when grouping and meeting ratio requirements. You stated the program’s operation hours are from 6:30am to 7:00pm. Be mindful children can only be grouped together during the first and last hours of operation and staff/child ratio requirements must be maintained for the ages of the youngest child in each group. FOLLOW-UP VISITS: An unannounced follow-up visit will be conducted in the future to monitor compliance staff/child ratio requirements. SAFE SLEEP POLICY/NUTRITION: An infant was observed in a rocker sleep with a bottle propped in his mouth. The caregiver removed the bottle and allowed the infant to remain in the rocker. After a few minutes, I informed the caregiver the infant must be removed from the rocker and placed in his crib. The caregiver stated the infant had just fallen asleep; however, I was in the classroom approximately three minutes prior to informing her to remove the child. I recommended you review the safe sleep policy with staff again as a refresher to ensure the policy is understood and followed. I reminded you bottles should not be propped. You stated staff are aware of this practice and that you remind them constantly to follow the child care rule requirements regarding propping bottles and safe sleep. I recommended you review the safe sleep policy with staff gain as a refresher to ensure the policy is understood and followed. We also discussed the importance of not propping bottles for infants to drink. I explained the safety concerns such as choking from the content of the bottle. It was recommended asking staff to request help when needed to feed younger children which will ensure child care requirements and best practices are implemented. 2024 ANNUAL LICENSE FEE INVOICES: Keep an eye on your inbox for the 2024 annual license fee invoice. Invoices were emailed to the facility addresses on file by November 30, 2024. Online payments are due by December 31, 2024. In accordance with North Carolina General Statute § 110-90(1a), licensed child care facilities are assessed an annual license fee. The amount of your annual license fee is based on the licensed capacity printed on your license as of October 1, 2024, not the number of children enrolled at your facility. Please note that annual license fees do not apply to state or public school-operated child care facilities, or to religious-sponsored facilities operating under a Notice of Compliance. The Division of Child Development and Early Education remains available to assist you. For questions regarding license fees, visit the Frequently Asked Questions (FAQs) on our website. For further assistance regarding your annual license fee, please email DCDEE_LF@dhhs.nc.gov. 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 GET READY for the 3s (ECERS-3, ITERS-3, FCCERS-3) The DCDEE and the North Carolina Rated License Assessment Project (NCRLAP) are collaboratively working on preparations for the transition to the ECERS-3, ITERS-3, and FCCERS-3 that starts February 1, 2025. Don't worry! Visit the Get ready for the 3s webpage to learn what's different and what you can do now to prepare. New resources have just been added. You'll find updated FAQs, factsheets, credit hour trainings, outreach assessment opportunities and more to help you become familiar with these tools. Until February 1, 2025, NCRLAP will use the Revised editions for official environment rating scale assessments for a NC Star Rated License (for new licensees or upon request.) CRIMINAL BACKGROUND CHECK REQUIREMENTS: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. ANNUAL IMMUNIZATION REPORT EXTENSION: The reporting period for child care immunizations has been extended due to Hurricane Helene. Reports will be accepted until January 15, 2025. Send any questions regarding child care immunization reporting to immunization.reports@dhhs.nc.gov. 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. Also, make sure you have the most recent copy of the child care rules dated November 1, 2024. 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

GS 110-91 · Violation

Name of Operation: CYNTHIA'S GARDEN OF KNOWLEDGE Facility ID: 98000092 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 12/17/2024 Number Present: 31 Completed Date: 12/17/2024 Age: From 0 To 5 Total Minutes: 220 Time In: 08:20 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your facility for compliance with applicable child care requirements during a routine unannounced visit. Upon arrival Annette Edwards, teacher assisted with the visit. Staff called and notified you of my presence. You arrived shortly after the visit started and assisted. Twenty-six (26) children were present today ranging from zero (0) to five (5) years old. Children were observed eating breakfast interacting with the caregivers, engaged in morning activities and free choice play, and completing toileting, and hand washing routines. Breakfast consisted of pancakes, apples and milk. Currently this program operates with a three-star license. The last sanitation inspection was completed on June 4, 2024, earning a superior classification. The last fire inspection was completed on October 8, 2024, and the center was approved for day and nighttime care. The last annual compliance visit was completed on June 30, 2024. The following violations were documented today. Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. Departure times were not recorded for nine children from December 2, 2024, to December 11, 2024. 10A NCAC 09 .0302(d)(4) 301 Minimum staff/child ratios and group sizes for the number and ages of children in care were not met. Minimum staff child ratio requirements were not met when six (6) children ages seven months to one year old was cared for by one caregiver between Spaces 1a and 1b. Also, one care giver was observed providing care to elven (11) children ranging from ages one to three in Space #3. GS 110-91(7);.0713(a-d) 318 Children between 12 and 24 months of age were grouped with children 3 years of age or older. A one year old child was grouped with three years old children in Space #3. A one-year-old child was grouped with children four and five years old in Space #4. 10A NCAC 09 .0713(a)(6) 532 All children were not held or placed in feeding chairs or other appropriate apparatus to be fed. A bottle was propped in an infant’s mouth while sleeping in a rocker in Space #1b. 10A NCAC 09 .0902(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. A plastic grocery bag with marshmallows and cocoa was on the diaper table changing table between spaces #1a and 1b. A plastic grocery bag was hanging on the back of the door to the bathroom in Space #3. .0604(q) 871 Center staff did not comply with the safe sleep policy. The center’s safe sleep policy was not followed when an infant was observed sleeping in a rocker in Space #1b. 10A NCAC 09 .0606(a) 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 December31, 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. CORPORATION STATUS: Cynthia's Garden of Knowledge, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Cynthia's Garden of Knowledge, Inc. 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, mailing address and email address listed on the facility profile are correct. If 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. COMPLIANCE HISTORY: The program's compliance history was reviewed with the operator. The program’s compliance history was 88% percent as of December 16, 2024. STAFF/CHILD INTERACTIONS: Upon arrival children in classroom 1a and 1b were grouped together with one caregiver. The gate separating the two classes has been removed. The second caregiver came into the classroom shortly after the observation started and the gate was placed back up separating the two spaces. Children were eating breakfast and engaged in free choice play with age-appropriate materials. Children in Space 3 and 4 were sitting waiting for caregivers to complete other tasks. Later in the visit children Space #4 were allowed to play with manipulatives at the table and number/alphabet mats on the floor. The teacher completed paperwork while the children played. Arguments between children went unnoticed and not addressed. Space #2 was not used during my observation. The school age building was used for occupation services. Upon arrival staff greeted and talked with parents. We discussed encouraging staff to prepare activities and materials prior to children arriving in the morning to cut down on wait times and ensure the caregiver can be actively engaged in plays. When children must wait for long periods of time, it creates space for behaviors to be exposed. Activities should be preplanned and materials readily available for children when they arrive to child care. STAFF/CHILD RATIO AND GROUPING OF CHILDREN: Upon arrival, caregivers were observed providing care to more children than required based on the age of the youngest child in the classroom. Children between ages twelve to twenty-four months old were grouped with children ranging from ages three to four years old. A one-year-old child was observed walking from space to space unattended and independently. The child was observed in Space #4 with preschool four- and five-years-old when I entered the building, and then she came into the infant toddler classroom alone as I was observing. You stated the child was probably your granddaughter who feels she can leave her classroom alone at any time. I shared with you one teacher was observed providing care to two groups of children. I further explained the gate was removed creating one space where children were joined. There were six children ranging form ages five months to one years old was cared for by the one caregiver placing the space out for compliance for staff/child ratio. As I was entering Space #3 the caregiver called for the person cooking to come get two children stating she was over her number. This caregiver had eleven children ranging from ages one to three years old. One child was removed form the space and carried into another classroom. We talked about ensuring staff know and follow the requirements for staff/child ratio grouping children when you are not on site. Children should be closely monitored so they do not roam from space to space alone. The staff/child ratio chart could be used as a guide for determining ages of children for grouping. The ages should also be updated when younger children are placed in other classrooms they are not assigned to. Transitions should take place prior to noncompliance. I reviewed the plan of action developed and approved on February 15, 2024. I explained the steps listed in the plan of action were not followed as stated. I recommended you review the plan of action and revise as needed to ensure your program comes into and maintain compliance with staff/child ratio and grouping . Also be mindful ages of children should be counted in years oppose to months when grouping and meeting ratio requirements. You stated the program’s operation hours are from 6:30am to 7:00pm. Be mindful children can only be grouped together during the first and last hours of operation and staff/child ratio requirements must be maintained for the ages of the youngest child in each group. FOLLOW-UP VISITS: An unannounced follow-up visit will be conducted in the future to monitor compliance staff/child ratio requirements. SAFE SLEEP POLICY/NUTRITION: An infant was observed in a rocker sleep with a bottle propped in his mouth. The caregiver removed the bottle and allowed the infant to remain in the rocker. After a few minutes, I informed the caregiver the infant must be removed from the rocker and placed in his crib. The caregiver stated the infant had just fallen asleep; however, I was in the classroom approximately three minutes prior to informing her to remove the child. I recommended you review the safe sleep policy with staff again as a refresher to ensure the policy is understood and followed. I reminded you bottles should not be propped. You stated staff are aware of this practice and that you remind them constantly to follow the child care rule requirements regarding propping bottles and safe sleep. I recommended you review the safe sleep policy with staff gain as a refresher to ensure the policy is understood and followed. We also discussed the importance of not propping bottles for infants to drink. I explained the safety concerns such as choking from the content of the bottle. It was recommended asking staff to request help when needed to feed younger children which will ensure child care requirements and best practices are implemented. 2024 ANNUAL LICENSE FEE INVOICES: Keep an eye on your inbox for the 2024 annual license fee invoice. Invoices were emailed to the facility addresses on file by November 30, 2024. Online payments are due by December 31, 2024. In accordance with North Carolina General Statute § 110-90(1a), licensed child care facilities are assessed an annual license fee. The amount of your annual license fee is based on the licensed capacity printed on your license as of October 1, 2024, not the number of children enrolled at your facility. Please note that annual license fees do not apply to state or public school-operated child care facilities, or to religious-sponsored facilities operating under a Notice of Compliance. The Division of Child Development and Early Education remains available to assist you. For questions regarding license fees, visit the Frequently Asked Questions (FAQs) on our website. For further assistance regarding your annual license fee, please email DCDEE_LF@dhhs.nc.gov. 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 GET READY for the 3s (ECERS-3, ITERS-3, FCCERS-3) The DCDEE and the North Carolina Rated License Assessment Project (NCRLAP) are collaboratively working on preparations for the transition to the ECERS-3, ITERS-3, and FCCERS-3 that starts February 1, 2025. Don't worry! Visit the Get ready for the 3s webpage to learn what's different and what you can do now to prepare. New resources have just been added. You'll find updated FAQs, factsheets, credit hour trainings, outreach assessment opportunities and more to help you become familiar with these tools. Until February 1, 2025, NCRLAP will use the Revised editions for official environment rating scale assessments for a NC Star Rated License (for new licensees or upon request.) CRIMINAL BACKGROUND CHECK REQUIREMENTS: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. ANNUAL IMMUNIZATION REPORT EXTENSION: The reporting period for child care immunizations has been extended due to Hurricane Helene. Reports will be accepted until January 15, 2025. Send any questions regarding child care immunization reporting to immunization.reports@dhhs.nc.gov. 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. Also, make sure you have the most recent copy of the child care rules dated November 1, 2024. 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 .0601 · Violation

Name of Operation: CYNTHIA'S GARDEN OF KNOWLEDGE Facility ID: 98000092 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 7/30/2024 Number Present: 42 Completed Date: 7/30/2024 Age: From 0 To 12 Total Minutes: 240 Time In: 08:30 AM Time Out: 12:30 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. C. Rose-Morgan, Administrator assisted with the visit. This center currently operates with a three-star license, earning five points in the education component, one point in the program standard component and 1 quality point for the center administrator completing a business training and a wage and hour course that is at least 30 hours of total training time. The last annual compliance visit was completed on August 17, 2023. The last sanitation inspection was completed on June 4, 2024, earning a “Superior” classification. The last fire inspection was completed on October 11, 2023, and the center was approved for day and nighttime care. Forty-two (42) children ranging from ages zero to twelve years old were observed in care today. Children were engaged in morning routine/activities, free-choice play, outdoor play, eating breakfast/lunch, completing hand washing, and toileting routines, interacting with caregivers. Breakfast consisted of pancakes, applesauce and milk. Lunch consisted of chicken nuggets, peaches, mixed vegetables, bread and milk. The following violations were documented. Violation Number Comment Rule 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. A bottle prepared and sent from home was labeled with the child’s name and today’s date in Space #1B. 15A NCAC 18A .2804(d) 807 A safe indoor and outdoor environment was not provided for the children. A bottle of hand soap labeled ‘keep out of reach of children’ was stored on a shelf below five feet from the finished floor in Space #2. Two wooden beams on the playground were cracked exposing splinters and cracked wood. 10A NCAC 09 .0601(a) 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 August 13, 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 85% as of July 29, 2024. CORPORTAION STATUS: Cynthia’s garden of Knowledge, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Cynthia’s Garden of Knowledge, Inc. was listed as current-not active. You contacted the Secretary of State during the visit and were told the annual report was not submitted and the business fee had not been paid. According to you the annual report is not due yet; therefore, you plan to submit documentation to the Secretary of State for verification. You added the representative for the Secretary of state informed you the system would be updated once the documentation is received. I recommend you periodically check the Secretary of State website to remain aware of your corporation status. I asked you to notify me when the process has been completed. Be reminded, the corporation’s status must always remain current and active. FACILITY PROFILE INFORMATION: You verified the phone number email address and mailing address listed on the facility profile are correct. If 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. SAFE ENVIRONMENT: I informed you items labeled keep out of reach of children with no additional warnings must be stored five feet from the finished floor. We discussed replacing the wooden beam on the playground to ensure safety hazards are removed. You stated the large tree limb fell on the beam during the recent storm. You added the wooed beam would be replaced. I advised you to block the area off, so children do not have access to the broken wood. NUTRITION: The bottle used to feed an infant was not labeled with the child’s name and today’s date. The caregiver stated staff are responsible for labeling bottles; however, the child had just arrived, and it had not been done yet. Also, three bottles of water were observed in a diaper bag in the closet. Another bottle with what appeared to be food mixed with water was in the diaper bag as well. Staff stated the bottle was old and the parent must have forgotten to remove it. It was recommended you or the staff check diaper bags upon arrival for items that should be removed and sent home prior to the parents leaving the center. VOLUNTEER: One individual (J. Walker) was observed assisting in the school-age classroom. You stated Ms. Walker was a prospective employee who was volunteering to learn the operation of the center. A file was provided with a valid qualification letter, TB skin test and application. I reminded you volunteers cannot be left alone to provide care for children at any time. We also discussed ensuring the volunteers only function in the capacity of a true volunteer as described in the definition from the child care rules/laws. 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. 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: CYNTHIA'S GARDEN OF KNOWLEDGE Facility ID: 98000092 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 2/1/2024 Number Present: 26 Completed Date: 2/1/2024 Age: From 0 To 5 Total Minutes: 225 Time In: 08:25 AM Time Out: 12:10 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your facility for compliance with applicable child care requirements during a routine unannounced visit. C. Morgan, Administrator assisted with the visit. Twenty-six children were observed in care today ranging from ages zero to five years old. Children were engaged in morning activities, free-choice play, interacting with the caregivers, and completing toileting, and hand washing routines. Staff stated children had already eaten breakfast. Currently this program operates with a Three-Star License earning five points in education, one point in program standards and one quality point for the administrator completing a business training course of at least 30 clock hours. The following violations were documented. Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. Plastic grocery bags were observed in the bathroom on the back of the toilet and on a cubby below five feet in Space #2. A large plastic trash bag was observed on the floor beside the book area while infants were crawling around in Space 1A. 10A NCAC 09 .0302(d)(4) 301 Minimum staff/child ratios and group sizes for the number and ages of children in care were not met. One caregiver was providing care to six children ranging from ages zero to two years old in spaces 1B. GS 110-91(7);.0713(a-d) 316 Children under one year of age were not kept separate from children two years and older. Four infants under one year of age were grouped with two-year-old children in Space 1A and 1B. 10A NCAC 09 .0713(a)(5) 544 Screen time was offered to children under three years of age. Screen time was provided to children ranging form ages zero to two years old in Space 1A. The computer was playing a video and music for children. .0510(f) 807 A safe indoor and outdoor environment was not provided for the children. A staff member’s bag was on a cubby accessible to children between Spaces 1A and 1B. A small blue toy was cracked exposing sharp edges on the playground. 10A NCAC 09 .0601(a) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic grocery bags were observed in the bathroom on the back of the toilet and on a cubby below five feet in Space #2. A large plastic trash bag was observed on the floor beside the book area while infants were crawling around in Space 1A. .0604(q) 1043 All staff records, except financial records, were not made available for review. A file for a new employee working in Space #3 was not on site and available for review. G.S. 110-91( 9) 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 February 15, 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. COMPLIANCE HISTORY: The program's compliance history was reviewed with the operator. The program’s compliance history was 88% percent as of January 31, 2024. CORPORATION STATUS: Cynthia’s Garden of Knowledge, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Cynthia’s Garden of Knowledge, Inc. is suspended. You stated you were not aware of this change. I reminded you the corporation status for your program must always remain Current and Active. Failure to comply may affect your child care license and warrants recommendation of an administrative action. FACILITY PROFILE INFORMATION: You stated the mailing address, phone number and email address listed for your program are correct. If changes in your facility information occurs, please contact me at 252-214-2709 or email keshia.hayward@dhhs.nc.gov to discuss the changes and ensure the information is updated in the system. STAFF/CHILD RATIO: Upon arrival one caregiver was observed providing care to six children ranging from ages zero to two years old. The two older children ages one to two years old were in Space 1A playing while the four infants were in Space 1B with the caregiver. The caregiver stated the second staff member had not arrived yet; therefore, she was providing care to both groups of children. You came in and transferred the two-year-old child to Space 2. During the visit, another child aged two was brought in and grouped with the four infants and one year old child. The caregiver combined the children in Space 1A grouping infants with two-year-old children. I informed you children under the age of one year old must be kept separate from children two years old and older. I also explained a caregiver cannot provide care to two separate groups of children at one time. I informed you during my observation at 8:44am to 8:55am, the children remained grouped together even after the second caregiver arrived. Maintaining adequate staff/child ratios is vital to the health and safety of children. Your program meets minimum ratio requirements which means one caregiver can provide care to five children when the age of the youngest child is under twelve months (infants). Because of the pattern of compliance with staff/child ratio requirements, I requested that you develop a plan of action that describes how your program will always maintain compliance with staff/child ratio requirements. The plan should include but not be limited to the following: •In the classroom, on the playground, and during transition periods; including naptime, meals and snacks, and bathroom time •When groups of children leave the classroom to go to another location, one caregiver to another, and when more than one group of children is combined •Method used to routinely check staff/child ratios and grouping of children •Procedures for informing administration when staff members need to attend to personal care needs or to complete tasks outside the classroom or away from the group •Frequent review of the procedures with staff members, as well as incorporation in the orientation of new staff members •Absence of staff members The plan of action will assist you and the staff with knowing what steps to following in the event an issue arise that could potentially compromise staff/child ratio requirements. Creating and implementing a plan of action could help avoid receiving violations in the future for noncompliance with staff/child ratio. The plan should be submitted to me along with your compliance letter for review and/or approval. Once the plan is approved you should immediately implement it in your program. An unannounced follow-up visit will be conducted to monitor compliance with staff-child ratio requirements. DEPARTURE TIMES: Departure times were not documented for twelve children between the dates of January 2, 2024, to January 26, 2024. You stated parents are responsible for signing children in/out daily. You added staff conduct periodic checks to monitor documentation of arrival/departure times. I explained if signatures are not documented by parents when checked, staff should add the times along with their initials to reflect who recorded the information. I explained inaccurate attendance records could affect the program’s subsidy and food program reimbursements. It is imperative to ensure your records are current and up to date to avoid unwarranted issues in your child care program. SAFE ENVIRONMENT: I informed you the environment used by children should always be safe and free from hazards. Plastic bags were in spaces accessible to children in Spaces 1B and 2. A small blue toy on the playground was cracked exposing sharp edges. You and the staff should conduct safety checks and remove any potential hazards identified. Children are curious of their surroundings and will explore anything within their reach; therefore, caregivers must create and maintain a safe environment for them. Access to plastic items that can be easily torn such as bags can suffocate and choke young children. Being proactive and removing those potential hazards allows children the opportunity to explore their environment free and willingly. STAFF RECORDS: A staff file was not on site and available for review for one caregiver observed providing care to children. You stated the staff member hire date was October 31, 2023. Based on my review of the ABCMS system for criminal records, Shebra Lee was qualified on May 9, 2023. You were finding different components of documents; however, there was not complete file; therefore, a staff/training worksheet was not completed. I advised you to create a staff file for Ms. Lee and add it to the file cabinet with the others. I also recommended you use the staff file checklist when putting the file together. This will help with ensuring all documents are included and obtained by the required due date. UPDATED CHILD CARE RULEBOOK: I informed you of the updated child care rulebook dated January 1, 2024 is located on the Division of Child Development and Early Education website. I recommended you download a copy of the new child care rulebook. You can obtain training regarding clarification of the updated child care rules in MOODLE on the Division’s website. COMING SOON! PROVIDER ACCESS to the BACKGROUND CHECK MANAGEMENT SYSTEM: DCDEE is ready to launch the Provider Portal for ABCMS on February 1, 2024. This access will allow providers to: •See applicants that associate themselves with their facility and allow them to “hire” the applicant to their roster •See the real-time background check status of staff members •Run a printable report of the staff roster to assist with compliance visits To gain access to the Provider Portal complete the ABCMS Child Care Provider Portal Training on DCDEE's Moodle. The training consists of watching a short video then taking a test about the video. A certificate will be issued upon successful completion of the test. Email the certificate along with your full name, position, and Facility ID to DCDEE_ABCMS_Provider@dhhs.nc.gov to get access to the portal. We will grant your access within 2 business days. Please do not use this email account to ask background check questions. If you have general questions, please continue to use DHHS.CBC.Unit@dhhs.nc.gov. FUNDING to ADDRESS ASBESTOS and LEAD-BASED PAINT in LICENSED CHILD CARE FACILITIES: The NCDHHS, Health Hazards Control Unit (HHCU) is providing a presentation regarding the American Rescue Plan Act (ARPA) Reimbursement Program for NC Licensed Child Care Centers and Family Child Care Homes. Under the ARPA Reimbursement Program licensed facilities can be reimbursed up to 100% for eligible expenses related to asbestos or lead-based paint abatement or remediation activities. Funding for reimbursement will be available until December 31, 2026, or until it is depleted, whichever comes first. Session for Licensed Child Care Centers February 5, 2024 1:00-2:00 PM Join the Zoom Meeting Meeting ID: 161 338 4701 Passcode: 327323 Session for Licensed Family Child Care Home February 5, 2024 7:00-8:00 PM Join the Zoom Meeting Meeting ID: 160 302 5830 Passcode: 895316 For more information, visit the Asbestos and Lead-Based Paint Reimbursement Program. At the conclusion of today’s visit, the visit summary report was completed reviewed and left with you. 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 .0302 · Violation

Name of Operation: CYNTHIA'S GARDEN OF KNOWLEDGE Facility ID: 98000092 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 2/1/2024 Number Present: 26 Completed Date: 2/1/2024 Age: From 0 To 5 Total Minutes: 225 Time In: 08:25 AM Time Out: 12:10 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your facility for compliance with applicable child care requirements during a routine unannounced visit. C. Morgan, Administrator assisted with the visit. Twenty-six children were observed in care today ranging from ages zero to five years old. Children were engaged in morning activities, free-choice play, interacting with the caregivers, and completing toileting, and hand washing routines. Staff stated children had already eaten breakfast. Currently this program operates with a Three-Star License earning five points in education, one point in program standards and one quality point for the administrator completing a business training course of at least 30 clock hours. The following violations were documented. Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. Plastic grocery bags were observed in the bathroom on the back of the toilet and on a cubby below five feet in Space #2. A large plastic trash bag was observed on the floor beside the book area while infants were crawling around in Space 1A. 10A NCAC 09 .0302(d)(4) 301 Minimum staff/child ratios and group sizes for the number and ages of children in care were not met. One caregiver was providing care to six children ranging from ages zero to two years old in spaces 1B. GS 110-91(7);.0713(a-d) 316 Children under one year of age were not kept separate from children two years and older. Four infants under one year of age were grouped with two-year-old children in Space 1A and 1B. 10A NCAC 09 .0713(a)(5) 544 Screen time was offered to children under three years of age. Screen time was provided to children ranging form ages zero to two years old in Space 1A. The computer was playing a video and music for children. .0510(f) 807 A safe indoor and outdoor environment was not provided for the children. A staff member’s bag was on a cubby accessible to children between Spaces 1A and 1B. A small blue toy was cracked exposing sharp edges on the playground. 10A NCAC 09 .0601(a) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic grocery bags were observed in the bathroom on the back of the toilet and on a cubby below five feet in Space #2. A large plastic trash bag was observed on the floor beside the book area while infants were crawling around in Space 1A. .0604(q) 1043 All staff records, except financial records, were not made available for review. A file for a new employee working in Space #3 was not on site and available for review. G.S. 110-91( 9) 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 February 15, 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. COMPLIANCE HISTORY: The program's compliance history was reviewed with the operator. The program’s compliance history was 88% percent as of January 31, 2024. CORPORATION STATUS: Cynthia’s Garden of Knowledge, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Cynthia’s Garden of Knowledge, Inc. is suspended. You stated you were not aware of this change. I reminded you the corporation status for your program must always remain Current and Active. Failure to comply may affect your child care license and warrants recommendation of an administrative action. FACILITY PROFILE INFORMATION: You stated the mailing address, phone number and email address listed for your program are correct. If changes in your facility information occurs, please contact me at 252-214-2709 or email keshia.hayward@dhhs.nc.gov to discuss the changes and ensure the information is updated in the system. STAFF/CHILD RATIO: Upon arrival one caregiver was observed providing care to six children ranging from ages zero to two years old. The two older children ages one to two years old were in Space 1A playing while the four infants were in Space 1B with the caregiver. The caregiver stated the second staff member had not arrived yet; therefore, she was providing care to both groups of children. You came in and transferred the two-year-old child to Space 2. During the visit, another child aged two was brought in and grouped with the four infants and one year old child. The caregiver combined the children in Space 1A grouping infants with two-year-old children. I informed you children under the age of one year old must be kept separate from children two years old and older. I also explained a caregiver cannot provide care to two separate groups of children at one time. I informed you during my observation at 8:44am to 8:55am, the children remained grouped together even after the second caregiver arrived. Maintaining adequate staff/child ratios is vital to the health and safety of children. Your program meets minimum ratio requirements which means one caregiver can provide care to five children when the age of the youngest child is under twelve months (infants). Because of the pattern of compliance with staff/child ratio requirements, I requested that you develop a plan of action that describes how your program will always maintain compliance with staff/child ratio requirements. The plan should include but not be limited to the following: •In the classroom, on the playground, and during transition periods; including naptime, meals and snacks, and bathroom time •When groups of children leave the classroom to go to another location, one caregiver to another, and when more than one group of children is combined •Method used to routinely check staff/child ratios and grouping of children •Procedures for informing administration when staff members need to attend to personal care needs or to complete tasks outside the classroom or away from the group •Frequent review of the procedures with staff members, as well as incorporation in the orientation of new staff members •Absence of staff members The plan of action will assist you and the staff with knowing what steps to following in the event an issue arise that could potentially compromise staff/child ratio requirements. Creating and implementing a plan of action could help avoid receiving violations in the future for noncompliance with staff/child ratio. The plan should be submitted to me along with your compliance letter for review and/or approval. Once the plan is approved you should immediately implement it in your program. An unannounced follow-up visit will be conducted to monitor compliance with staff-child ratio requirements. DEPARTURE TIMES: Departure times were not documented for twelve children between the dates of January 2, 2024, to January 26, 2024. You stated parents are responsible for signing children in/out daily. You added staff conduct periodic checks to monitor documentation of arrival/departure times. I explained if signatures are not documented by parents when checked, staff should add the times along with their initials to reflect who recorded the information. I explained inaccurate attendance records could affect the program’s subsidy and food program reimbursements. It is imperative to ensure your records are current and up to date to avoid unwarranted issues in your child care program. SAFE ENVIRONMENT: I informed you the environment used by children should always be safe and free from hazards. Plastic bags were in spaces accessible to children in Spaces 1B and 2. A small blue toy on the playground was cracked exposing sharp edges. You and the staff should conduct safety checks and remove any potential hazards identified. Children are curious of their surroundings and will explore anything within their reach; therefore, caregivers must create and maintain a safe environment for them. Access to plastic items that can be easily torn such as bags can suffocate and choke young children. Being proactive and removing those potential hazards allows children the opportunity to explore their environment free and willingly. STAFF RECORDS: A staff file was not on site and available for review for one caregiver observed providing care to children. You stated the staff member hire date was October 31, 2023. Based on my review of the ABCMS system for criminal records, Shebra Lee was qualified on May 9, 2023. You were finding different components of documents; however, there was not complete file; therefore, a staff/training worksheet was not completed. I advised you to create a staff file for Ms. Lee and add it to the file cabinet with the others. I also recommended you use the staff file checklist when putting the file together. This will help with ensuring all documents are included and obtained by the required due date. UPDATED CHILD CARE RULEBOOK: I informed you of the updated child care rulebook dated January 1, 2024 is located on the Division of Child Development and Early Education website. I recommended you download a copy of the new child care rulebook. You can obtain training regarding clarification of the updated child care rules in MOODLE on the Division’s website. COMING SOON! PROVIDER ACCESS to the BACKGROUND CHECK MANAGEMENT SYSTEM: DCDEE is ready to launch the Provider Portal for ABCMS on February 1, 2024. This access will allow providers to: •See applicants that associate themselves with their facility and allow them to “hire” the applicant to their roster •See the real-time background check status of staff members •Run a printable report of the staff roster to assist with compliance visits To gain access to the Provider Portal complete the ABCMS Child Care Provider Portal Training on DCDEE's Moodle. The training consists of watching a short video then taking a test about the video. A certificate will be issued upon successful completion of the test. Email the certificate along with your full name, position, and Facility ID to DCDEE_ABCMS_Provider@dhhs.nc.gov to get access to the portal. We will grant your access within 2 business days. Please do not use this email account to ask background check questions. If you have general questions, please continue to use DHHS.CBC.Unit@dhhs.nc.gov. FUNDING to ADDRESS ASBESTOS and LEAD-BASED PAINT in LICENSED CHILD CARE FACILITIES: The NCDHHS, Health Hazards Control Unit (HHCU) is providing a presentation regarding the American Rescue Plan Act (ARPA) Reimbursement Program for NC Licensed Child Care Centers and Family Child Care Homes. Under the ARPA Reimbursement Program licensed facilities can be reimbursed up to 100% for eligible expenses related to asbestos or lead-based paint abatement or remediation activities. Funding for reimbursement will be available until December 31, 2026, or until it is depleted, whichever comes first. Session for Licensed Child Care Centers February 5, 2024 1:00-2:00 PM Join the Zoom Meeting Meeting ID: 161 338 4701 Passcode: 327323 Session for Licensed Family Child Care Home February 5, 2024 7:00-8:00 PM Join the Zoom Meeting Meeting ID: 160 302 5830 Passcode: 895316 For more information, visit the Asbestos and Lead-Based Paint Reimbursement Program. At the conclusion of today’s visit, the visit summary report was completed reviewed and left with you. 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 .0713 · Violation

Name of Operation: CYNTHIA'S GARDEN OF KNOWLEDGE Facility ID: 98000092 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 2/1/2024 Number Present: 26 Completed Date: 2/1/2024 Age: From 0 To 5 Total Minutes: 225 Time In: 08:25 AM Time Out: 12:10 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your facility for compliance with applicable child care requirements during a routine unannounced visit. C. Morgan, Administrator assisted with the visit. Twenty-six children were observed in care today ranging from ages zero to five years old. Children were engaged in morning activities, free-choice play, interacting with the caregivers, and completing toileting, and hand washing routines. Staff stated children had already eaten breakfast. Currently this program operates with a Three-Star License earning five points in education, one point in program standards and one quality point for the administrator completing a business training course of at least 30 clock hours. The following violations were documented. Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. Plastic grocery bags were observed in the bathroom on the back of the toilet and on a cubby below five feet in Space #2. A large plastic trash bag was observed on the floor beside the book area while infants were crawling around in Space 1A. 10A NCAC 09 .0302(d)(4) 301 Minimum staff/child ratios and group sizes for the number and ages of children in care were not met. One caregiver was providing care to six children ranging from ages zero to two years old in spaces 1B. GS 110-91(7);.0713(a-d) 316 Children under one year of age were not kept separate from children two years and older. Four infants under one year of age were grouped with two-year-old children in Space 1A and 1B. 10A NCAC 09 .0713(a)(5) 544 Screen time was offered to children under three years of age. Screen time was provided to children ranging form ages zero to two years old in Space 1A. The computer was playing a video and music for children. .0510(f) 807 A safe indoor and outdoor environment was not provided for the children. A staff member’s bag was on a cubby accessible to children between Spaces 1A and 1B. A small blue toy was cracked exposing sharp edges on the playground. 10A NCAC 09 .0601(a) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic grocery bags were observed in the bathroom on the back of the toilet and on a cubby below five feet in Space #2. A large plastic trash bag was observed on the floor beside the book area while infants were crawling around in Space 1A. .0604(q) 1043 All staff records, except financial records, were not made available for review. A file for a new employee working in Space #3 was not on site and available for review. G.S. 110-91( 9) 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 February 15, 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. COMPLIANCE HISTORY: The program's compliance history was reviewed with the operator. The program’s compliance history was 88% percent as of January 31, 2024. CORPORATION STATUS: Cynthia’s Garden of Knowledge, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Cynthia’s Garden of Knowledge, Inc. is suspended. You stated you were not aware of this change. I reminded you the corporation status for your program must always remain Current and Active. Failure to comply may affect your child care license and warrants recommendation of an administrative action. FACILITY PROFILE INFORMATION: You stated the mailing address, phone number and email address listed for your program are correct. If changes in your facility information occurs, please contact me at 252-214-2709 or email keshia.hayward@dhhs.nc.gov to discuss the changes and ensure the information is updated in the system. STAFF/CHILD RATIO: Upon arrival one caregiver was observed providing care to six children ranging from ages zero to two years old. The two older children ages one to two years old were in Space 1A playing while the four infants were in Space 1B with the caregiver. The caregiver stated the second staff member had not arrived yet; therefore, she was providing care to both groups of children. You came in and transferred the two-year-old child to Space 2. During the visit, another child aged two was brought in and grouped with the four infants and one year old child. The caregiver combined the children in Space 1A grouping infants with two-year-old children. I informed you children under the age of one year old must be kept separate from children two years old and older. I also explained a caregiver cannot provide care to two separate groups of children at one time. I informed you during my observation at 8:44am to 8:55am, the children remained grouped together even after the second caregiver arrived. Maintaining adequate staff/child ratios is vital to the health and safety of children. Your program meets minimum ratio requirements which means one caregiver can provide care to five children when the age of the youngest child is under twelve months (infants). Because of the pattern of compliance with staff/child ratio requirements, I requested that you develop a plan of action that describes how your program will always maintain compliance with staff/child ratio requirements. The plan should include but not be limited to the following: •In the classroom, on the playground, and during transition periods; including naptime, meals and snacks, and bathroom time •When groups of children leave the classroom to go to another location, one caregiver to another, and when more than one group of children is combined •Method used to routinely check staff/child ratios and grouping of children •Procedures for informing administration when staff members need to attend to personal care needs or to complete tasks outside the classroom or away from the group •Frequent review of the procedures with staff members, as well as incorporation in the orientation of new staff members •Absence of staff members The plan of action will assist you and the staff with knowing what steps to following in the event an issue arise that could potentially compromise staff/child ratio requirements. Creating and implementing a plan of action could help avoid receiving violations in the future for noncompliance with staff/child ratio. The plan should be submitted to me along with your compliance letter for review and/or approval. Once the plan is approved you should immediately implement it in your program. An unannounced follow-up visit will be conducted to monitor compliance with staff-child ratio requirements. DEPARTURE TIMES: Departure times were not documented for twelve children between the dates of January 2, 2024, to January 26, 2024. You stated parents are responsible for signing children in/out daily. You added staff conduct periodic checks to monitor documentation of arrival/departure times. I explained if signatures are not documented by parents when checked, staff should add the times along with their initials to reflect who recorded the information. I explained inaccurate attendance records could affect the program’s subsidy and food program reimbursements. It is imperative to ensure your records are current and up to date to avoid unwarranted issues in your child care program. SAFE ENVIRONMENT: I informed you the environment used by children should always be safe and free from hazards. Plastic bags were in spaces accessible to children in Spaces 1B and 2. A small blue toy on the playground was cracked exposing sharp edges. You and the staff should conduct safety checks and remove any potential hazards identified. Children are curious of their surroundings and will explore anything within their reach; therefore, caregivers must create and maintain a safe environment for them. Access to plastic items that can be easily torn such as bags can suffocate and choke young children. Being proactive and removing those potential hazards allows children the opportunity to explore their environment free and willingly. STAFF RECORDS: A staff file was not on site and available for review for one caregiver observed providing care to children. You stated the staff member hire date was October 31, 2023. Based on my review of the ABCMS system for criminal records, Shebra Lee was qualified on May 9, 2023. You were finding different components of documents; however, there was not complete file; therefore, a staff/training worksheet was not completed. I advised you to create a staff file for Ms. Lee and add it to the file cabinet with the others. I also recommended you use the staff file checklist when putting the file together. This will help with ensuring all documents are included and obtained by the required due date. UPDATED CHILD CARE RULEBOOK: I informed you of the updated child care rulebook dated January 1, 2024 is located on the Division of Child Development and Early Education website. I recommended you download a copy of the new child care rulebook. You can obtain training regarding clarification of the updated child care rules in MOODLE on the Division’s website. COMING SOON! PROVIDER ACCESS to the BACKGROUND CHECK MANAGEMENT SYSTEM: DCDEE is ready to launch the Provider Portal for ABCMS on February 1, 2024. This access will allow providers to: •See applicants that associate themselves with their facility and allow them to “hire” the applicant to their roster •See the real-time background check status of staff members •Run a printable report of the staff roster to assist with compliance visits To gain access to the Provider Portal complete the ABCMS Child Care Provider Portal Training on DCDEE's Moodle. The training consists of watching a short video then taking a test about the video. A certificate will be issued upon successful completion of the test. Email the certificate along with your full name, position, and Facility ID to DCDEE_ABCMS_Provider@dhhs.nc.gov to get access to the portal. We will grant your access within 2 business days. Please do not use this email account to ask background check questions. If you have general questions, please continue to use DHHS.CBC.Unit@dhhs.nc.gov. FUNDING to ADDRESS ASBESTOS and LEAD-BASED PAINT in LICENSED CHILD CARE FACILITIES: The NCDHHS, Health Hazards Control Unit (HHCU) is providing a presentation regarding the American Rescue Plan Act (ARPA) Reimbursement Program for NC Licensed Child Care Centers and Family Child Care Homes. Under the ARPA Reimbursement Program licensed facilities can be reimbursed up to 100% for eligible expenses related to asbestos or lead-based paint abatement or remediation activities. Funding for reimbursement will be available until December 31, 2026, or until it is depleted, whichever comes first. Session for Licensed Child Care Centers February 5, 2024 1:00-2:00 PM Join the Zoom Meeting Meeting ID: 161 338 4701 Passcode: 327323 Session for Licensed Family Child Care Home February 5, 2024 7:00-8:00 PM Join the Zoom Meeting Meeting ID: 160 302 5830 Passcode: 895316 For more information, visit the Asbestos and Lead-Based Paint Reimbursement Program. At the conclusion of today’s visit, the visit summary report was completed reviewed and left with you. 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

G.S. 110-91 · Violation

Name of Operation: CYNTHIA'S GARDEN OF KNOWLEDGE Facility ID: 98000092 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 2/1/2024 Number Present: 26 Completed Date: 2/1/2024 Age: From 0 To 5 Total Minutes: 225 Time In: 08:25 AM Time Out: 12:10 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your facility for compliance with applicable child care requirements during a routine unannounced visit. C. Morgan, Administrator assisted with the visit. Twenty-six children were observed in care today ranging from ages zero to five years old. Children were engaged in morning activities, free-choice play, interacting with the caregivers, and completing toileting, and hand washing routines. Staff stated children had already eaten breakfast. Currently this program operates with a Three-Star License earning five points in education, one point in program standards and one quality point for the administrator completing a business training course of at least 30 clock hours. The following violations were documented. Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. Plastic grocery bags were observed in the bathroom on the back of the toilet and on a cubby below five feet in Space #2. A large plastic trash bag was observed on the floor beside the book area while infants were crawling around in Space 1A. 10A NCAC 09 .0302(d)(4) 301 Minimum staff/child ratios and group sizes for the number and ages of children in care were not met. One caregiver was providing care to six children ranging from ages zero to two years old in spaces 1B. GS 110-91(7);.0713(a-d) 316 Children under one year of age were not kept separate from children two years and older. Four infants under one year of age were grouped with two-year-old children in Space 1A and 1B. 10A NCAC 09 .0713(a)(5) 544 Screen time was offered to children under three years of age. Screen time was provided to children ranging form ages zero to two years old in Space 1A. The computer was playing a video and music for children. .0510(f) 807 A safe indoor and outdoor environment was not provided for the children. A staff member’s bag was on a cubby accessible to children between Spaces 1A and 1B. A small blue toy was cracked exposing sharp edges on the playground. 10A NCAC 09 .0601(a) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic grocery bags were observed in the bathroom on the back of the toilet and on a cubby below five feet in Space #2. A large plastic trash bag was observed on the floor beside the book area while infants were crawling around in Space 1A. .0604(q) 1043 All staff records, except financial records, were not made available for review. A file for a new employee working in Space #3 was not on site and available for review. G.S. 110-91( 9) 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 February 15, 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. COMPLIANCE HISTORY: The program's compliance history was reviewed with the operator. The program’s compliance history was 88% percent as of January 31, 2024. CORPORATION STATUS: Cynthia’s Garden of Knowledge, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Cynthia’s Garden of Knowledge, Inc. is suspended. You stated you were not aware of this change. I reminded you the corporation status for your program must always remain Current and Active. Failure to comply may affect your child care license and warrants recommendation of an administrative action. FACILITY PROFILE INFORMATION: You stated the mailing address, phone number and email address listed for your program are correct. If changes in your facility information occurs, please contact me at 252-214-2709 or email keshia.hayward@dhhs.nc.gov to discuss the changes and ensure the information is updated in the system. STAFF/CHILD RATIO: Upon arrival one caregiver was observed providing care to six children ranging from ages zero to two years old. The two older children ages one to two years old were in Space 1A playing while the four infants were in Space 1B with the caregiver. The caregiver stated the second staff member had not arrived yet; therefore, she was providing care to both groups of children. You came in and transferred the two-year-old child to Space 2. During the visit, another child aged two was brought in and grouped with the four infants and one year old child. The caregiver combined the children in Space 1A grouping infants with two-year-old children. I informed you children under the age of one year old must be kept separate from children two years old and older. I also explained a caregiver cannot provide care to two separate groups of children at one time. I informed you during my observation at 8:44am to 8:55am, the children remained grouped together even after the second caregiver arrived. Maintaining adequate staff/child ratios is vital to the health and safety of children. Your program meets minimum ratio requirements which means one caregiver can provide care to five children when the age of the youngest child is under twelve months (infants). Because of the pattern of compliance with staff/child ratio requirements, I requested that you develop a plan of action that describes how your program will always maintain compliance with staff/child ratio requirements. The plan should include but not be limited to the following: •In the classroom, on the playground, and during transition periods; including naptime, meals and snacks, and bathroom time •When groups of children leave the classroom to go to another location, one caregiver to another, and when more than one group of children is combined •Method used to routinely check staff/child ratios and grouping of children •Procedures for informing administration when staff members need to attend to personal care needs or to complete tasks outside the classroom or away from the group •Frequent review of the procedures with staff members, as well as incorporation in the orientation of new staff members •Absence of staff members The plan of action will assist you and the staff with knowing what steps to following in the event an issue arise that could potentially compromise staff/child ratio requirements. Creating and implementing a plan of action could help avoid receiving violations in the future for noncompliance with staff/child ratio. The plan should be submitted to me along with your compliance letter for review and/or approval. Once the plan is approved you should immediately implement it in your program. An unannounced follow-up visit will be conducted to monitor compliance with staff-child ratio requirements. DEPARTURE TIMES: Departure times were not documented for twelve children between the dates of January 2, 2024, to January 26, 2024. You stated parents are responsible for signing children in/out daily. You added staff conduct periodic checks to monitor documentation of arrival/departure times. I explained if signatures are not documented by parents when checked, staff should add the times along with their initials to reflect who recorded the information. I explained inaccurate attendance records could affect the program’s subsidy and food program reimbursements. It is imperative to ensure your records are current and up to date to avoid unwarranted issues in your child care program. SAFE ENVIRONMENT: I informed you the environment used by children should always be safe and free from hazards. Plastic bags were in spaces accessible to children in Spaces 1B and 2. A small blue toy on the playground was cracked exposing sharp edges. You and the staff should conduct safety checks and remove any potential hazards identified. Children are curious of their surroundings and will explore anything within their reach; therefore, caregivers must create and maintain a safe environment for them. Access to plastic items that can be easily torn such as bags can suffocate and choke young children. Being proactive and removing those potential hazards allows children the opportunity to explore their environment free and willingly. STAFF RECORDS: A staff file was not on site and available for review for one caregiver observed providing care to children. You stated the staff member hire date was October 31, 2023. Based on my review of the ABCMS system for criminal records, Shebra Lee was qualified on May 9, 2023. You were finding different components of documents; however, there was not complete file; therefore, a staff/training worksheet was not completed. I advised you to create a staff file for Ms. Lee and add it to the file cabinet with the others. I also recommended you use the staff file checklist when putting the file together. This will help with ensuring all documents are included and obtained by the required due date. UPDATED CHILD CARE RULEBOOK: I informed you of the updated child care rulebook dated January 1, 2024 is located on the Division of Child Development and Early Education website. I recommended you download a copy of the new child care rulebook. You can obtain training regarding clarification of the updated child care rules in MOODLE on the Division’s website. COMING SOON! PROVIDER ACCESS to the BACKGROUND CHECK MANAGEMENT SYSTEM: DCDEE is ready to launch the Provider Portal for ABCMS on February 1, 2024. This access will allow providers to: •See applicants that associate themselves with their facility and allow them to “hire” the applicant to their roster •See the real-time background check status of staff members •Run a printable report of the staff roster to assist with compliance visits To gain access to the Provider Portal complete the ABCMS Child Care Provider Portal Training on DCDEE's Moodle. The training consists of watching a short video then taking a test about the video. A certificate will be issued upon successful completion of the test. Email the certificate along with your full name, position, and Facility ID to DCDEE_ABCMS_Provider@dhhs.nc.gov to get access to the portal. We will grant your access within 2 business days. Please do not use this email account to ask background check questions. If you have general questions, please continue to use DHHS.CBC.Unit@dhhs.nc.gov. FUNDING to ADDRESS ASBESTOS and LEAD-BASED PAINT in LICENSED CHILD CARE FACILITIES: The NCDHHS, Health Hazards Control Unit (HHCU) is providing a presentation regarding the American Rescue Plan Act (ARPA) Reimbursement Program for NC Licensed Child Care Centers and Family Child Care Homes. Under the ARPA Reimbursement Program licensed facilities can be reimbursed up to 100% for eligible expenses related to asbestos or lead-based paint abatement or remediation activities. Funding for reimbursement will be available until December 31, 2026, or until it is depleted, whichever comes first. Session for Licensed Child Care Centers February 5, 2024 1:00-2:00 PM Join the Zoom Meeting Meeting ID: 161 338 4701 Passcode: 327323 Session for Licensed Family Child Care Home February 5, 2024 7:00-8:00 PM Join the Zoom Meeting Meeting ID: 160 302 5830 Passcode: 895316 For more information, visit the Asbestos and Lead-Based Paint Reimbursement Program. At the conclusion of today’s visit, the visit summary report was completed reviewed and left with you. 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 110-91 · Violation

Name of Operation: CYNTHIA'S GARDEN OF KNOWLEDGE Facility ID: 98000092 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 2/1/2024 Number Present: 26 Completed Date: 2/1/2024 Age: From 0 To 5 Total Minutes: 225 Time In: 08:25 AM Time Out: 12:10 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your facility for compliance with applicable child care requirements during a routine unannounced visit. C. Morgan, Administrator assisted with the visit. Twenty-six children were observed in care today ranging from ages zero to five years old. Children were engaged in morning activities, free-choice play, interacting with the caregivers, and completing toileting, and hand washing routines. Staff stated children had already eaten breakfast. Currently this program operates with a Three-Star License earning five points in education, one point in program standards and one quality point for the administrator completing a business training course of at least 30 clock hours. The following violations were documented. Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. Plastic grocery bags were observed in the bathroom on the back of the toilet and on a cubby below five feet in Space #2. A large plastic trash bag was observed on the floor beside the book area while infants were crawling around in Space 1A. 10A NCAC 09 .0302(d)(4) 301 Minimum staff/child ratios and group sizes for the number and ages of children in care were not met. One caregiver was providing care to six children ranging from ages zero to two years old in spaces 1B. GS 110-91(7);.0713(a-d) 316 Children under one year of age were not kept separate from children two years and older. Four infants under one year of age were grouped with two-year-old children in Space 1A and 1B. 10A NCAC 09 .0713(a)(5) 544 Screen time was offered to children under three years of age. Screen time was provided to children ranging form ages zero to two years old in Space 1A. The computer was playing a video and music for children. .0510(f) 807 A safe indoor and outdoor environment was not provided for the children. A staff member’s bag was on a cubby accessible to children between Spaces 1A and 1B. A small blue toy was cracked exposing sharp edges on the playground. 10A NCAC 09 .0601(a) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic grocery bags were observed in the bathroom on the back of the toilet and on a cubby below five feet in Space #2. A large plastic trash bag was observed on the floor beside the book area while infants were crawling around in Space 1A. .0604(q) 1043 All staff records, except financial records, were not made available for review. A file for a new employee working in Space #3 was not on site and available for review. G.S. 110-91( 9) 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 February 15, 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. COMPLIANCE HISTORY: The program's compliance history was reviewed with the operator. The program’s compliance history was 88% percent as of January 31, 2024. CORPORATION STATUS: Cynthia’s Garden of Knowledge, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Cynthia’s Garden of Knowledge, Inc. is suspended. You stated you were not aware of this change. I reminded you the corporation status for your program must always remain Current and Active. Failure to comply may affect your child care license and warrants recommendation of an administrative action. FACILITY PROFILE INFORMATION: You stated the mailing address, phone number and email address listed for your program are correct. If changes in your facility information occurs, please contact me at 252-214-2709 or email keshia.hayward@dhhs.nc.gov to discuss the changes and ensure the information is updated in the system. STAFF/CHILD RATIO: Upon arrival one caregiver was observed providing care to six children ranging from ages zero to two years old. The two older children ages one to two years old were in Space 1A playing while the four infants were in Space 1B with the caregiver. The caregiver stated the second staff member had not arrived yet; therefore, she was providing care to both groups of children. You came in and transferred the two-year-old child to Space 2. During the visit, another child aged two was brought in and grouped with the four infants and one year old child. The caregiver combined the children in Space 1A grouping infants with two-year-old children. I informed you children under the age of one year old must be kept separate from children two years old and older. I also explained a caregiver cannot provide care to two separate groups of children at one time. I informed you during my observation at 8:44am to 8:55am, the children remained grouped together even after the second caregiver arrived. Maintaining adequate staff/child ratios is vital to the health and safety of children. Your program meets minimum ratio requirements which means one caregiver can provide care to five children when the age of the youngest child is under twelve months (infants). Because of the pattern of compliance with staff/child ratio requirements, I requested that you develop a plan of action that describes how your program will always maintain compliance with staff/child ratio requirements. The plan should include but not be limited to the following: •In the classroom, on the playground, and during transition periods; including naptime, meals and snacks, and bathroom time •When groups of children leave the classroom to go to another location, one caregiver to another, and when more than one group of children is combined •Method used to routinely check staff/child ratios and grouping of children •Procedures for informing administration when staff members need to attend to personal care needs or to complete tasks outside the classroom or away from the group •Frequent review of the procedures with staff members, as well as incorporation in the orientation of new staff members •Absence of staff members The plan of action will assist you and the staff with knowing what steps to following in the event an issue arise that could potentially compromise staff/child ratio requirements. Creating and implementing a plan of action could help avoid receiving violations in the future for noncompliance with staff/child ratio. The plan should be submitted to me along with your compliance letter for review and/or approval. Once the plan is approved you should immediately implement it in your program. An unannounced follow-up visit will be conducted to monitor compliance with staff-child ratio requirements. DEPARTURE TIMES: Departure times were not documented for twelve children between the dates of January 2, 2024, to January 26, 2024. You stated parents are responsible for signing children in/out daily. You added staff conduct periodic checks to monitor documentation of arrival/departure times. I explained if signatures are not documented by parents when checked, staff should add the times along with their initials to reflect who recorded the information. I explained inaccurate attendance records could affect the program’s subsidy and food program reimbursements. It is imperative to ensure your records are current and up to date to avoid unwarranted issues in your child care program. SAFE ENVIRONMENT: I informed you the environment used by children should always be safe and free from hazards. Plastic bags were in spaces accessible to children in Spaces 1B and 2. A small blue toy on the playground was cracked exposing sharp edges. You and the staff should conduct safety checks and remove any potential hazards identified. Children are curious of their surroundings and will explore anything within their reach; therefore, caregivers must create and maintain a safe environment for them. Access to plastic items that can be easily torn such as bags can suffocate and choke young children. Being proactive and removing those potential hazards allows children the opportunity to explore their environment free and willingly. STAFF RECORDS: A staff file was not on site and available for review for one caregiver observed providing care to children. You stated the staff member hire date was October 31, 2023. Based on my review of the ABCMS system for criminal records, Shebra Lee was qualified on May 9, 2023. You were finding different components of documents; however, there was not complete file; therefore, a staff/training worksheet was not completed. I advised you to create a staff file for Ms. Lee and add it to the file cabinet with the others. I also recommended you use the staff file checklist when putting the file together. This will help with ensuring all documents are included and obtained by the required due date. UPDATED CHILD CARE RULEBOOK: I informed you of the updated child care rulebook dated January 1, 2024 is located on the Division of Child Development and Early Education website. I recommended you download a copy of the new child care rulebook. You can obtain training regarding clarification of the updated child care rules in MOODLE on the Division’s website. COMING SOON! PROVIDER ACCESS to the BACKGROUND CHECK MANAGEMENT SYSTEM: DCDEE is ready to launch the Provider Portal for ABCMS on February 1, 2024. This access will allow providers to: •See applicants that associate themselves with their facility and allow them to “hire” the applicant to their roster •See the real-time background check status of staff members •Run a printable report of the staff roster to assist with compliance visits To gain access to the Provider Portal complete the ABCMS Child Care Provider Portal Training on DCDEE's Moodle. The training consists of watching a short video then taking a test about the video. A certificate will be issued upon successful completion of the test. Email the certificate along with your full name, position, and Facility ID to DCDEE_ABCMS_Provider@dhhs.nc.gov to get access to the portal. We will grant your access within 2 business days. Please do not use this email account to ask background check questions. If you have general questions, please continue to use DHHS.CBC.Unit@dhhs.nc.gov. FUNDING to ADDRESS ASBESTOS and LEAD-BASED PAINT in LICENSED CHILD CARE FACILITIES: The NCDHHS, Health Hazards Control Unit (HHCU) is providing a presentation regarding the American Rescue Plan Act (ARPA) Reimbursement Program for NC Licensed Child Care Centers and Family Child Care Homes. Under the ARPA Reimbursement Program licensed facilities can be reimbursed up to 100% for eligible expenses related to asbestos or lead-based paint abatement or remediation activities. Funding for reimbursement will be available until December 31, 2026, or until it is depleted, whichever comes first. Session for Licensed Child Care Centers February 5, 2024 1:00-2:00 PM Join the Zoom Meeting Meeting ID: 161 338 4701 Passcode: 327323 Session for Licensed Family Child Care Home February 5, 2024 7:00-8:00 PM Join the Zoom Meeting Meeting ID: 160 302 5830 Passcode: 895316 For more information, visit the Asbestos and Lead-Based Paint Reimbursement Program. At the conclusion of today’s visit, the visit summary report was completed reviewed and left with you. 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: CYNTHIA'S GARDEN OF KNOWLEDGE Facility ID: 98000092 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 8/17/2023 Number Present: 47 Completed Date: 8/17/2023 Age: From 0 To 9 Total Minutes: 240 Time In: 08:15 AM Time Out: 12:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor this program for compliance with applicable child care requirements for an annual compliance visit. You were not onsite upon arrival; however, you arrived shortly after and assisted with the visit. This center currently operates with a three-star license, earning five points in the education component, one point in the program standard component and 1 quality point for the administrator completing a business training course of at least 30 clock hours. The last annual compliance visit was completed on September 1, 2022. The last sanitation inspection was completed on May 24, 2023, with a “Superior” classification. The last fire inspection was completed on October 12, 2022, and the center was approved for daytime and night care. Forty-seven children were observed in care today ranging from ages zero to nine years old. Children were engaged in morning activities, free-choice play with developmentally age-appropriate materials, teacher-directed activities, outdoor play, and completing hand washing, and toileting routines. Breakfast and lunch were also observed. Breakfast consisted of grits, mixed fruits, and milk. Lunch consisted on turkey and cheese sandwiches, corn, fruit cocktail, bread and milk. The center’s compliance history score was reviewed with the operator. The program’s compliance history was (90%) as of August 16, 2023. The following violation of the child care requirements was documented today. Violation Number Comment Rule 115 A summary of the NC Child Care Law was not posted in a prominent place in the center. Documentation was not on file acknowledging the summary of law was reviewed and given to the parent of one child enrolled. G.S. 110-102 201 A room was occupied by more children than the space allowed at 25-sq. ft. of floor space per child. Upon arrival twenty-three children were observed being cared for in Space #4 with a capacity of fourteen. GS 110-91(6); .1401(f) 301 Minimum staff/child ratios and group sizes for the number and ages of children in care were not met. Minimum staff/child ratio requirements were not met when one caregiver was observed providing care to twenty-three children ranging from ages three to five years old in Space #4. GS 110-91(7);.0713(a-d) 316 Children under one year of age were not kept separate from children two years and older. Two infants ages four and six months were grouped with a two-year-old child in Space 1A. 10A NCAC 09 .0713(a)(5) 609 Staff did not wash their hands thoroughly before beginning work, before/after handling food, before bottle feeding or serving to other children, after toileting or handling body fluids, after diaper changing and after handling soiled items. One child’s hands was not washed upon arrival in Space #1B. 15A NCAC 18A .2803(a) 807 A safe indoor and outdoor environment was not provided for the children. Staff purses/bags were observed in an unlocked closet in Space #2 and on a cubby in Space #3, a plastic cubed play structure on the playground was cracked exposing sharp edges, a metal rake was on the playground in space accessible to children and roots were protruding above ground posing tripping hazards. 10A NCAC 09 .0601(a) 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 employee with a hire date of 11/16/2021. 10A NCAC 09 .0514(f) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. An immunization record was not on file for one preschool child enrolled on August 10, 2022. 10A NCAC 09 .0302(d)(2) The violations documented must be corrected immediately. Please send a compliance verification letter to me describing how the violation was 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 August 31, 2023. 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 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. CORPORATION STATUS: Cynthia’s Garden of Knowledge, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Cynthia’s Garden of Knowledge, Inc. remains Current and Active. Prior to making any changes in the corporation status, please contact me to discuss change of ownership procedures. 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, mailing address and email address listed on the facility profile are correct. If 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 REQUIREMENTS: Upon arrival one caregiver was observed providing care to twenty-three children ranging from ages three to five years old. Also, two infants ages four and six months were grouped with a two-year-old child in Space #1A. Your program is currently meeting minimum staff/child ratio requirements; therefore, two caregivers were needed to maintain compliance. When additional staff arrived, children were transitioned to their assigned classrooms and staff/child ratios were maintained. I reminded you children under the age of one shall be kept separate from children two years and older. We discussed developing a scheduling pattern to ensure enough staff are present to provide care to the number of children present and that children are cared for with their assigned age group. I recommended developing a plan to follow in case staff need to be late or an emergency arise. Maintaining adequate staff/child ratio is important maintain a safe and healthy environment to children. CAPACITY: Twenty-three children were observed in Space #3 with a licensed capacity of 14. I advised you to develop a plan for transitions children once the classroom space meets the capacity required. Having more children that allowed creates an unsafe environment. I recommended reviewing the space capacity with all staff to ensure they understand the number of children allowed in each classroom. SAFE ENVIRONMENT: We discussed the hazards observed during the walk-through. One caregiver removed the bag on the cubby in Space # 2. I shared hazardous items were observed on and inside the purse. Be reminded staff personal items should be stored in locked spaces. I recommended posting a copy of the storage of hazardous items poster in each space for easy reference. You removed the metal rake from the playground. I suggested covering the tree roots or covering them to remove the tripping hazards. REDORDS: Required documents were missing from children records reviewed. I recommended conducting periodic file reviews to ensure all items have been completed and placed in the files. UNANNOUNCED FOLLOW-UP VISIT: I informed you an unannounced follow-up visit will be conducted to monitor staff/child ratio and capacity requirements. STAR RATED LICENSE: I informed you information regarding the preparation for the star rated license assessment process is located on the Division of Child Development & Early Education and North Carolina Rated License Project websites. I recommended you and staff visit ncrlap.org to obtain detailed information about how the process will be implemented and review prep year activities and ideas offered. More information will be provided regarding your programs rated license assessment timeframe. GETTING HELP WITH CHALLENGING BEHAVIORS: Assistance can be requested for help with handling challenging behaviors. The Healthy Social Behaviors in Child Care Centers Project (HSB) provides ideas to create a learning environment that can assist in preventing challenging behaviors. They provide free technical assistance, professional development, and they offer a variety of additional resources. For additional information on the Healthy Social Behaviors Project or to view a current listing of scheduled trainings, browse the NC Child Care Resource & Referral Council website. For information about Pyramid Model CEU-level trainings, contact the HSB Education Specialist, Liz Tuttle at etuttle@childcareresourcesinc.org. To obtain a Request for TA Services, contact your local Behavior Specialist or email the Statewide Project Manager, Smokie Brawley, at sbrawley@childcareresourcesinc.org. You and staff can also contact the challenging behavior helpline at 1-888- 600-1685 option 2. You can speak to a Behavior Support Advisor or submit questions about specific behaviors in your program. You will also be able to post questions in the “Talk to the Expert” group in the online network. 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 .0302 · Violation

Name of Operation: CYNTHIA'S GARDEN OF KNOWLEDGE Facility ID: 98000092 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 8/17/2023 Number Present: 47 Completed Date: 8/17/2023 Age: From 0 To 9 Total Minutes: 240 Time In: 08:15 AM Time Out: 12:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor this program for compliance with applicable child care requirements for an annual compliance visit. You were not onsite upon arrival; however, you arrived shortly after and assisted with the visit. This center currently operates with a three-star license, earning five points in the education component, one point in the program standard component and 1 quality point for the administrator completing a business training course of at least 30 clock hours. The last annual compliance visit was completed on September 1, 2022. The last sanitation inspection was completed on May 24, 2023, with a “Superior” classification. The last fire inspection was completed on October 12, 2022, and the center was approved for daytime and night care. Forty-seven children were observed in care today ranging from ages zero to nine years old. Children were engaged in morning activities, free-choice play with developmentally age-appropriate materials, teacher-directed activities, outdoor play, and completing hand washing, and toileting routines. Breakfast and lunch were also observed. Breakfast consisted of grits, mixed fruits, and milk. Lunch consisted on turkey and cheese sandwiches, corn, fruit cocktail, bread and milk. The center’s compliance history score was reviewed with the operator. The program’s compliance history was (90%) as of August 16, 2023. The following violation of the child care requirements was documented today. Violation Number Comment Rule 115 A summary of the NC Child Care Law was not posted in a prominent place in the center. Documentation was not on file acknowledging the summary of law was reviewed and given to the parent of one child enrolled. G.S. 110-102 201 A room was occupied by more children than the space allowed at 25-sq. ft. of floor space per child. Upon arrival twenty-three children were observed being cared for in Space #4 with a capacity of fourteen. GS 110-91(6); .1401(f) 301 Minimum staff/child ratios and group sizes for the number and ages of children in care were not met. Minimum staff/child ratio requirements were not met when one caregiver was observed providing care to twenty-three children ranging from ages three to five years old in Space #4. GS 110-91(7);.0713(a-d) 316 Children under one year of age were not kept separate from children two years and older. Two infants ages four and six months were grouped with a two-year-old child in Space 1A. 10A NCAC 09 .0713(a)(5) 609 Staff did not wash their hands thoroughly before beginning work, before/after handling food, before bottle feeding or serving to other children, after toileting or handling body fluids, after diaper changing and after handling soiled items. One child’s hands was not washed upon arrival in Space #1B. 15A NCAC 18A .2803(a) 807 A safe indoor and outdoor environment was not provided for the children. Staff purses/bags were observed in an unlocked closet in Space #2 and on a cubby in Space #3, a plastic cubed play structure on the playground was cracked exposing sharp edges, a metal rake was on the playground in space accessible to children and roots were protruding above ground posing tripping hazards. 10A NCAC 09 .0601(a) 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 employee with a hire date of 11/16/2021. 10A NCAC 09 .0514(f) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. An immunization record was not on file for one preschool child enrolled on August 10, 2022. 10A NCAC 09 .0302(d)(2) The violations documented must be corrected immediately. Please send a compliance verification letter to me describing how the violation was 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 August 31, 2023. 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 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. CORPORATION STATUS: Cynthia’s Garden of Knowledge, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Cynthia’s Garden of Knowledge, Inc. remains Current and Active. Prior to making any changes in the corporation status, please contact me to discuss change of ownership procedures. 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, mailing address and email address listed on the facility profile are correct. If 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 REQUIREMENTS: Upon arrival one caregiver was observed providing care to twenty-three children ranging from ages three to five years old. Also, two infants ages four and six months were grouped with a two-year-old child in Space #1A. Your program is currently meeting minimum staff/child ratio requirements; therefore, two caregivers were needed to maintain compliance. When additional staff arrived, children were transitioned to their assigned classrooms and staff/child ratios were maintained. I reminded you children under the age of one shall be kept separate from children two years and older. We discussed developing a scheduling pattern to ensure enough staff are present to provide care to the number of children present and that children are cared for with their assigned age group. I recommended developing a plan to follow in case staff need to be late or an emergency arise. Maintaining adequate staff/child ratio is important maintain a safe and healthy environment to children. CAPACITY: Twenty-three children were observed in Space #3 with a licensed capacity of 14. I advised you to develop a plan for transitions children once the classroom space meets the capacity required. Having more children that allowed creates an unsafe environment. I recommended reviewing the space capacity with all staff to ensure they understand the number of children allowed in each classroom. SAFE ENVIRONMENT: We discussed the hazards observed during the walk-through. One caregiver removed the bag on the cubby in Space # 2. I shared hazardous items were observed on and inside the purse. Be reminded staff personal items should be stored in locked spaces. I recommended posting a copy of the storage of hazardous items poster in each space for easy reference. You removed the metal rake from the playground. I suggested covering the tree roots or covering them to remove the tripping hazards. REDORDS: Required documents were missing from children records reviewed. I recommended conducting periodic file reviews to ensure all items have been completed and placed in the files. UNANNOUNCED FOLLOW-UP VISIT: I informed you an unannounced follow-up visit will be conducted to monitor staff/child ratio and capacity requirements. STAR RATED LICENSE: I informed you information regarding the preparation for the star rated license assessment process is located on the Division of Child Development & Early Education and North Carolina Rated License Project websites. I recommended you and staff visit ncrlap.org to obtain detailed information about how the process will be implemented and review prep year activities and ideas offered. More information will be provided regarding your programs rated license assessment timeframe. GETTING HELP WITH CHALLENGING BEHAVIORS: Assistance can be requested for help with handling challenging behaviors. The Healthy Social Behaviors in Child Care Centers Project (HSB) provides ideas to create a learning environment that can assist in preventing challenging behaviors. They provide free technical assistance, professional development, and they offer a variety of additional resources. For additional information on the Healthy Social Behaviors Project or to view a current listing of scheduled trainings, browse the NC Child Care Resource & Referral Council website. For information about Pyramid Model CEU-level trainings, contact the HSB Education Specialist, Liz Tuttle at etuttle@childcareresourcesinc.org. To obtain a Request for TA Services, contact your local Behavior Specialist or email the Statewide Project Manager, Smokie Brawley, at sbrawley@childcareresourcesinc.org. You and staff can also contact the challenging behavior helpline at 1-888- 600-1685 option 2. You can speak to a Behavior Support Advisor or submit questions about specific behaviors in your program. You will also be able to post questions in the “Talk to the Expert” group in the online network. 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 .0514 · Violation

Name of Operation: CYNTHIA'S GARDEN OF KNOWLEDGE Facility ID: 98000092 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 8/17/2023 Number Present: 47 Completed Date: 8/17/2023 Age: From 0 To 9 Total Minutes: 240 Time In: 08:15 AM Time Out: 12:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor this program for compliance with applicable child care requirements for an annual compliance visit. You were not onsite upon arrival; however, you arrived shortly after and assisted with the visit. This center currently operates with a three-star license, earning five points in the education component, one point in the program standard component and 1 quality point for the administrator completing a business training course of at least 30 clock hours. The last annual compliance visit was completed on September 1, 2022. The last sanitation inspection was completed on May 24, 2023, with a “Superior” classification. The last fire inspection was completed on October 12, 2022, and the center was approved for daytime and night care. Forty-seven children were observed in care today ranging from ages zero to nine years old. Children were engaged in morning activities, free-choice play with developmentally age-appropriate materials, teacher-directed activities, outdoor play, and completing hand washing, and toileting routines. Breakfast and lunch were also observed. Breakfast consisted of grits, mixed fruits, and milk. Lunch consisted on turkey and cheese sandwiches, corn, fruit cocktail, bread and milk. The center’s compliance history score was reviewed with the operator. The program’s compliance history was (90%) as of August 16, 2023. The following violation of the child care requirements was documented today. Violation Number Comment Rule 115 A summary of the NC Child Care Law was not posted in a prominent place in the center. Documentation was not on file acknowledging the summary of law was reviewed and given to the parent of one child enrolled. G.S. 110-102 201 A room was occupied by more children than the space allowed at 25-sq. ft. of floor space per child. Upon arrival twenty-three children were observed being cared for in Space #4 with a capacity of fourteen. GS 110-91(6); .1401(f) 301 Minimum staff/child ratios and group sizes for the number and ages of children in care were not met. Minimum staff/child ratio requirements were not met when one caregiver was observed providing care to twenty-three children ranging from ages three to five years old in Space #4. GS 110-91(7);.0713(a-d) 316 Children under one year of age were not kept separate from children two years and older. Two infants ages four and six months were grouped with a two-year-old child in Space 1A. 10A NCAC 09 .0713(a)(5) 609 Staff did not wash their hands thoroughly before beginning work, before/after handling food, before bottle feeding or serving to other children, after toileting or handling body fluids, after diaper changing and after handling soiled items. One child’s hands was not washed upon arrival in Space #1B. 15A NCAC 18A .2803(a) 807 A safe indoor and outdoor environment was not provided for the children. Staff purses/bags were observed in an unlocked closet in Space #2 and on a cubby in Space #3, a plastic cubed play structure on the playground was cracked exposing sharp edges, a metal rake was on the playground in space accessible to children and roots were protruding above ground posing tripping hazards. 10A NCAC 09 .0601(a) 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 employee with a hire date of 11/16/2021. 10A NCAC 09 .0514(f) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. An immunization record was not on file for one preschool child enrolled on August 10, 2022. 10A NCAC 09 .0302(d)(2) The violations documented must be corrected immediately. Please send a compliance verification letter to me describing how the violation was 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 August 31, 2023. 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 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. CORPORATION STATUS: Cynthia’s Garden of Knowledge, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Cynthia’s Garden of Knowledge, Inc. remains Current and Active. Prior to making any changes in the corporation status, please contact me to discuss change of ownership procedures. 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, mailing address and email address listed on the facility profile are correct. If 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 REQUIREMENTS: Upon arrival one caregiver was observed providing care to twenty-three children ranging from ages three to five years old. Also, two infants ages four and six months were grouped with a two-year-old child in Space #1A. Your program is currently meeting minimum staff/child ratio requirements; therefore, two caregivers were needed to maintain compliance. When additional staff arrived, children were transitioned to their assigned classrooms and staff/child ratios were maintained. I reminded you children under the age of one shall be kept separate from children two years and older. We discussed developing a scheduling pattern to ensure enough staff are present to provide care to the number of children present and that children are cared for with their assigned age group. I recommended developing a plan to follow in case staff need to be late or an emergency arise. Maintaining adequate staff/child ratio is important maintain a safe and healthy environment to children. CAPACITY: Twenty-three children were observed in Space #3 with a licensed capacity of 14. I advised you to develop a plan for transitions children once the classroom space meets the capacity required. Having more children that allowed creates an unsafe environment. I recommended reviewing the space capacity with all staff to ensure they understand the number of children allowed in each classroom. SAFE ENVIRONMENT: We discussed the hazards observed during the walk-through. One caregiver removed the bag on the cubby in Space # 2. I shared hazardous items were observed on and inside the purse. Be reminded staff personal items should be stored in locked spaces. I recommended posting a copy of the storage of hazardous items poster in each space for easy reference. You removed the metal rake from the playground. I suggested covering the tree roots or covering them to remove the tripping hazards. REDORDS: Required documents were missing from children records reviewed. I recommended conducting periodic file reviews to ensure all items have been completed and placed in the files. UNANNOUNCED FOLLOW-UP VISIT: I informed you an unannounced follow-up visit will be conducted to monitor staff/child ratio and capacity requirements. STAR RATED LICENSE: I informed you information regarding the preparation for the star rated license assessment process is located on the Division of Child Development & Early Education and North Carolina Rated License Project websites. I recommended you and staff visit ncrlap.org to obtain detailed information about how the process will be implemented and review prep year activities and ideas offered. More information will be provided regarding your programs rated license assessment timeframe. GETTING HELP WITH CHALLENGING BEHAVIORS: Assistance can be requested for help with handling challenging behaviors. The Healthy Social Behaviors in Child Care Centers Project (HSB) provides ideas to create a learning environment that can assist in preventing challenging behaviors. They provide free technical assistance, professional development, and they offer a variety of additional resources. For additional information on the Healthy Social Behaviors Project or to view a current listing of scheduled trainings, browse the NC Child Care Resource & Referral Council website. For information about Pyramid Model CEU-level trainings, contact the HSB Education Specialist, Liz Tuttle at etuttle@childcareresourcesinc.org. To obtain a Request for TA Services, contact your local Behavior Specialist or email the Statewide Project Manager, Smokie Brawley, at sbrawley@childcareresourcesinc.org. You and staff can also contact the challenging behavior helpline at 1-888- 600-1685 option 2. You can speak to a Behavior Support Advisor or submit questions about specific behaviors in your program. You will also be able to post questions in the “Talk to the Expert” group in the online network. 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 .0713 · Violation

Name of Operation: CYNTHIA'S GARDEN OF KNOWLEDGE Facility ID: 98000092 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 8/17/2023 Number Present: 47 Completed Date: 8/17/2023 Age: From 0 To 9 Total Minutes: 240 Time In: 08:15 AM Time Out: 12:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor this program for compliance with applicable child care requirements for an annual compliance visit. You were not onsite upon arrival; however, you arrived shortly after and assisted with the visit. This center currently operates with a three-star license, earning five points in the education component, one point in the program standard component and 1 quality point for the administrator completing a business training course of at least 30 clock hours. The last annual compliance visit was completed on September 1, 2022. The last sanitation inspection was completed on May 24, 2023, with a “Superior” classification. The last fire inspection was completed on October 12, 2022, and the center was approved for daytime and night care. Forty-seven children were observed in care today ranging from ages zero to nine years old. Children were engaged in morning activities, free-choice play with developmentally age-appropriate materials, teacher-directed activities, outdoor play, and completing hand washing, and toileting routines. Breakfast and lunch were also observed. Breakfast consisted of grits, mixed fruits, and milk. Lunch consisted on turkey and cheese sandwiches, corn, fruit cocktail, bread and milk. The center’s compliance history score was reviewed with the operator. The program’s compliance history was (90%) as of August 16, 2023. The following violation of the child care requirements was documented today. Violation Number Comment Rule 115 A summary of the NC Child Care Law was not posted in a prominent place in the center. Documentation was not on file acknowledging the summary of law was reviewed and given to the parent of one child enrolled. G.S. 110-102 201 A room was occupied by more children than the space allowed at 25-sq. ft. of floor space per child. Upon arrival twenty-three children were observed being cared for in Space #4 with a capacity of fourteen. GS 110-91(6); .1401(f) 301 Minimum staff/child ratios and group sizes for the number and ages of children in care were not met. Minimum staff/child ratio requirements were not met when one caregiver was observed providing care to twenty-three children ranging from ages three to five years old in Space #4. GS 110-91(7);.0713(a-d) 316 Children under one year of age were not kept separate from children two years and older. Two infants ages four and six months were grouped with a two-year-old child in Space 1A. 10A NCAC 09 .0713(a)(5) 609 Staff did not wash their hands thoroughly before beginning work, before/after handling food, before bottle feeding or serving to other children, after toileting or handling body fluids, after diaper changing and after handling soiled items. One child’s hands was not washed upon arrival in Space #1B. 15A NCAC 18A .2803(a) 807 A safe indoor and outdoor environment was not provided for the children. Staff purses/bags were observed in an unlocked closet in Space #2 and on a cubby in Space #3, a plastic cubed play structure on the playground was cracked exposing sharp edges, a metal rake was on the playground in space accessible to children and roots were protruding above ground posing tripping hazards. 10A NCAC 09 .0601(a) 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 employee with a hire date of 11/16/2021. 10A NCAC 09 .0514(f) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. An immunization record was not on file for one preschool child enrolled on August 10, 2022. 10A NCAC 09 .0302(d)(2) The violations documented must be corrected immediately. Please send a compliance verification letter to me describing how the violation was 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 August 31, 2023. 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 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. CORPORATION STATUS: Cynthia’s Garden of Knowledge, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Cynthia’s Garden of Knowledge, Inc. remains Current and Active. Prior to making any changes in the corporation status, please contact me to discuss change of ownership procedures. 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, mailing address and email address listed on the facility profile are correct. If 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 REQUIREMENTS: Upon arrival one caregiver was observed providing care to twenty-three children ranging from ages three to five years old. Also, two infants ages four and six months were grouped with a two-year-old child in Space #1A. Your program is currently meeting minimum staff/child ratio requirements; therefore, two caregivers were needed to maintain compliance. When additional staff arrived, children were transitioned to their assigned classrooms and staff/child ratios were maintained. I reminded you children under the age of one shall be kept separate from children two years and older. We discussed developing a scheduling pattern to ensure enough staff are present to provide care to the number of children present and that children are cared for with their assigned age group. I recommended developing a plan to follow in case staff need to be late or an emergency arise. Maintaining adequate staff/child ratio is important maintain a safe and healthy environment to children. CAPACITY: Twenty-three children were observed in Space #3 with a licensed capacity of 14. I advised you to develop a plan for transitions children once the classroom space meets the capacity required. Having more children that allowed creates an unsafe environment. I recommended reviewing the space capacity with all staff to ensure they understand the number of children allowed in each classroom. SAFE ENVIRONMENT: We discussed the hazards observed during the walk-through. One caregiver removed the bag on the cubby in Space # 2. I shared hazardous items were observed on and inside the purse. Be reminded staff personal items should be stored in locked spaces. I recommended posting a copy of the storage of hazardous items poster in each space for easy reference. You removed the metal rake from the playground. I suggested covering the tree roots or covering them to remove the tripping hazards. REDORDS: Required documents were missing from children records reviewed. I recommended conducting periodic file reviews to ensure all items have been completed and placed in the files. UNANNOUNCED FOLLOW-UP VISIT: I informed you an unannounced follow-up visit will be conducted to monitor staff/child ratio and capacity requirements. STAR RATED LICENSE: I informed you information regarding the preparation for the star rated license assessment process is located on the Division of Child Development & Early Education and North Carolina Rated License Project websites. I recommended you and staff visit ncrlap.org to obtain detailed information about how the process will be implemented and review prep year activities and ideas offered. More information will be provided regarding your programs rated license assessment timeframe. GETTING HELP WITH CHALLENGING BEHAVIORS: Assistance can be requested for help with handling challenging behaviors. The Healthy Social Behaviors in Child Care Centers Project (HSB) provides ideas to create a learning environment that can assist in preventing challenging behaviors. They provide free technical assistance, professional development, and they offer a variety of additional resources. For additional information on the Healthy Social Behaviors Project or to view a current listing of scheduled trainings, browse the NC Child Care Resource & Referral Council website. For information about Pyramid Model CEU-level trainings, contact the HSB Education Specialist, Liz Tuttle at etuttle@childcareresourcesinc.org. To obtain a Request for TA Services, contact your local Behavior Specialist or email the Statewide Project Manager, Smokie Brawley, at sbrawley@childcareresourcesinc.org. You and staff can also contact the challenging behavior helpline at 1-888- 600-1685 option 2. You can speak to a Behavior Support Advisor or submit questions about specific behaviors in your program. You will also be able to post questions in the “Talk to the Expert” group in the online network. 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

G.S. 110-102 · Violation

Name of Operation: CYNTHIA'S GARDEN OF KNOWLEDGE Facility ID: 98000092 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 8/17/2023 Number Present: 47 Completed Date: 8/17/2023 Age: From 0 To 9 Total Minutes: 240 Time In: 08:15 AM Time Out: 12:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor this program for compliance with applicable child care requirements for an annual compliance visit. You were not onsite upon arrival; however, you arrived shortly after and assisted with the visit. This center currently operates with a three-star license, earning five points in the education component, one point in the program standard component and 1 quality point for the administrator completing a business training course of at least 30 clock hours. The last annual compliance visit was completed on September 1, 2022. The last sanitation inspection was completed on May 24, 2023, with a “Superior” classification. The last fire inspection was completed on October 12, 2022, and the center was approved for daytime and night care. Forty-seven children were observed in care today ranging from ages zero to nine years old. Children were engaged in morning activities, free-choice play with developmentally age-appropriate materials, teacher-directed activities, outdoor play, and completing hand washing, and toileting routines. Breakfast and lunch were also observed. Breakfast consisted of grits, mixed fruits, and milk. Lunch consisted on turkey and cheese sandwiches, corn, fruit cocktail, bread and milk. The center’s compliance history score was reviewed with the operator. The program’s compliance history was (90%) as of August 16, 2023. The following violation of the child care requirements was documented today. Violation Number Comment Rule 115 A summary of the NC Child Care Law was not posted in a prominent place in the center. Documentation was not on file acknowledging the summary of law was reviewed and given to the parent of one child enrolled. G.S. 110-102 201 A room was occupied by more children than the space allowed at 25-sq. ft. of floor space per child. Upon arrival twenty-three children were observed being cared for in Space #4 with a capacity of fourteen. GS 110-91(6); .1401(f) 301 Minimum staff/child ratios and group sizes for the number and ages of children in care were not met. Minimum staff/child ratio requirements were not met when one caregiver was observed providing care to twenty-three children ranging from ages three to five years old in Space #4. GS 110-91(7);.0713(a-d) 316 Children under one year of age were not kept separate from children two years and older. Two infants ages four and six months were grouped with a two-year-old child in Space 1A. 10A NCAC 09 .0713(a)(5) 609 Staff did not wash their hands thoroughly before beginning work, before/after handling food, before bottle feeding or serving to other children, after toileting or handling body fluids, after diaper changing and after handling soiled items. One child’s hands was not washed upon arrival in Space #1B. 15A NCAC 18A .2803(a) 807 A safe indoor and outdoor environment was not provided for the children. Staff purses/bags were observed in an unlocked closet in Space #2 and on a cubby in Space #3, a plastic cubed play structure on the playground was cracked exposing sharp edges, a metal rake was on the playground in space accessible to children and roots were protruding above ground posing tripping hazards. 10A NCAC 09 .0601(a) 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 employee with a hire date of 11/16/2021. 10A NCAC 09 .0514(f) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. An immunization record was not on file for one preschool child enrolled on August 10, 2022. 10A NCAC 09 .0302(d)(2) The violations documented must be corrected immediately. Please send a compliance verification letter to me describing how the violation was 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 August 31, 2023. 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 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. CORPORATION STATUS: Cynthia’s Garden of Knowledge, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Cynthia’s Garden of Knowledge, Inc. remains Current and Active. Prior to making any changes in the corporation status, please contact me to discuss change of ownership procedures. 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, mailing address and email address listed on the facility profile are correct. If 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 REQUIREMENTS: Upon arrival one caregiver was observed providing care to twenty-three children ranging from ages three to five years old. Also, two infants ages four and six months were grouped with a two-year-old child in Space #1A. Your program is currently meeting minimum staff/child ratio requirements; therefore, two caregivers were needed to maintain compliance. When additional staff arrived, children were transitioned to their assigned classrooms and staff/child ratios were maintained. I reminded you children under the age of one shall be kept separate from children two years and older. We discussed developing a scheduling pattern to ensure enough staff are present to provide care to the number of children present and that children are cared for with their assigned age group. I recommended developing a plan to follow in case staff need to be late or an emergency arise. Maintaining adequate staff/child ratio is important maintain a safe and healthy environment to children. CAPACITY: Twenty-three children were observed in Space #3 with a licensed capacity of 14. I advised you to develop a plan for transitions children once the classroom space meets the capacity required. Having more children that allowed creates an unsafe environment. I recommended reviewing the space capacity with all staff to ensure they understand the number of children allowed in each classroom. SAFE ENVIRONMENT: We discussed the hazards observed during the walk-through. One caregiver removed the bag on the cubby in Space # 2. I shared hazardous items were observed on and inside the purse. Be reminded staff personal items should be stored in locked spaces. I recommended posting a copy of the storage of hazardous items poster in each space for easy reference. You removed the metal rake from the playground. I suggested covering the tree roots or covering them to remove the tripping hazards. REDORDS: Required documents were missing from children records reviewed. I recommended conducting periodic file reviews to ensure all items have been completed and placed in the files. UNANNOUNCED FOLLOW-UP VISIT: I informed you an unannounced follow-up visit will be conducted to monitor staff/child ratio and capacity requirements. STAR RATED LICENSE: I informed you information regarding the preparation for the star rated license assessment process is located on the Division of Child Development & Early Education and North Carolina Rated License Project websites. I recommended you and staff visit ncrlap.org to obtain detailed information about how the process will be implemented and review prep year activities and ideas offered. More information will be provided regarding your programs rated license assessment timeframe. GETTING HELP WITH CHALLENGING BEHAVIORS: Assistance can be requested for help with handling challenging behaviors. The Healthy Social Behaviors in Child Care Centers Project (HSB) provides ideas to create a learning environment that can assist in preventing challenging behaviors. They provide free technical assistance, professional development, and they offer a variety of additional resources. For additional information on the Healthy Social Behaviors Project or to view a current listing of scheduled trainings, browse the NC Child Care Resource & Referral Council website. For information about Pyramid Model CEU-level trainings, contact the HSB Education Specialist, Liz Tuttle at etuttle@childcareresourcesinc.org. To obtain a Request for TA Services, contact your local Behavior Specialist or email the Statewide Project Manager, Smokie Brawley, at sbrawley@childcareresourcesinc.org. You and staff can also contact the challenging behavior helpline at 1-888- 600-1685 option 2. You can speak to a Behavior Support Advisor or submit questions about specific behaviors in your program. You will also be able to post questions in the “Talk to the Expert” group in the online network. 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 110-91 · Violation

Name of Operation: CYNTHIA'S GARDEN OF KNOWLEDGE Facility ID: 98000092 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 8/17/2023 Number Present: 47 Completed Date: 8/17/2023 Age: From 0 To 9 Total Minutes: 240 Time In: 08:15 AM Time Out: 12:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor this program for compliance with applicable child care requirements for an annual compliance visit. You were not onsite upon arrival; however, you arrived shortly after and assisted with the visit. This center currently operates with a three-star license, earning five points in the education component, one point in the program standard component and 1 quality point for the administrator completing a business training course of at least 30 clock hours. The last annual compliance visit was completed on September 1, 2022. The last sanitation inspection was completed on May 24, 2023, with a “Superior” classification. The last fire inspection was completed on October 12, 2022, and the center was approved for daytime and night care. Forty-seven children were observed in care today ranging from ages zero to nine years old. Children were engaged in morning activities, free-choice play with developmentally age-appropriate materials, teacher-directed activities, outdoor play, and completing hand washing, and toileting routines. Breakfast and lunch were also observed. Breakfast consisted of grits, mixed fruits, and milk. Lunch consisted on turkey and cheese sandwiches, corn, fruit cocktail, bread and milk. The center’s compliance history score was reviewed with the operator. The program’s compliance history was (90%) as of August 16, 2023. The following violation of the child care requirements was documented today. Violation Number Comment Rule 115 A summary of the NC Child Care Law was not posted in a prominent place in the center. Documentation was not on file acknowledging the summary of law was reviewed and given to the parent of one child enrolled. G.S. 110-102 201 A room was occupied by more children than the space allowed at 25-sq. ft. of floor space per child. Upon arrival twenty-three children were observed being cared for in Space #4 with a capacity of fourteen. GS 110-91(6); .1401(f) 301 Minimum staff/child ratios and group sizes for the number and ages of children in care were not met. Minimum staff/child ratio requirements were not met when one caregiver was observed providing care to twenty-three children ranging from ages three to five years old in Space #4. GS 110-91(7);.0713(a-d) 316 Children under one year of age were not kept separate from children two years and older. Two infants ages four and six months were grouped with a two-year-old child in Space 1A. 10A NCAC 09 .0713(a)(5) 609 Staff did not wash their hands thoroughly before beginning work, before/after handling food, before bottle feeding or serving to other children, after toileting or handling body fluids, after diaper changing and after handling soiled items. One child’s hands was not washed upon arrival in Space #1B. 15A NCAC 18A .2803(a) 807 A safe indoor and outdoor environment was not provided for the children. Staff purses/bags were observed in an unlocked closet in Space #2 and on a cubby in Space #3, a plastic cubed play structure on the playground was cracked exposing sharp edges, a metal rake was on the playground in space accessible to children and roots were protruding above ground posing tripping hazards. 10A NCAC 09 .0601(a) 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 employee with a hire date of 11/16/2021. 10A NCAC 09 .0514(f) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. An immunization record was not on file for one preschool child enrolled on August 10, 2022. 10A NCAC 09 .0302(d)(2) The violations documented must be corrected immediately. Please send a compliance verification letter to me describing how the violation was 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 August 31, 2023. 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 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. CORPORATION STATUS: Cynthia’s Garden of Knowledge, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Cynthia’s Garden of Knowledge, Inc. remains Current and Active. Prior to making any changes in the corporation status, please contact me to discuss change of ownership procedures. 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, mailing address and email address listed on the facility profile are correct. If 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 REQUIREMENTS: Upon arrival one caregiver was observed providing care to twenty-three children ranging from ages three to five years old. Also, two infants ages four and six months were grouped with a two-year-old child in Space #1A. Your program is currently meeting minimum staff/child ratio requirements; therefore, two caregivers were needed to maintain compliance. When additional staff arrived, children were transitioned to their assigned classrooms and staff/child ratios were maintained. I reminded you children under the age of one shall be kept separate from children two years and older. We discussed developing a scheduling pattern to ensure enough staff are present to provide care to the number of children present and that children are cared for with their assigned age group. I recommended developing a plan to follow in case staff need to be late or an emergency arise. Maintaining adequate staff/child ratio is important maintain a safe and healthy environment to children. CAPACITY: Twenty-three children were observed in Space #3 with a licensed capacity of 14. I advised you to develop a plan for transitions children once the classroom space meets the capacity required. Having more children that allowed creates an unsafe environment. I recommended reviewing the space capacity with all staff to ensure they understand the number of children allowed in each classroom. SAFE ENVIRONMENT: We discussed the hazards observed during the walk-through. One caregiver removed the bag on the cubby in Space # 2. I shared hazardous items were observed on and inside the purse. Be reminded staff personal items should be stored in locked spaces. I recommended posting a copy of the storage of hazardous items poster in each space for easy reference. You removed the metal rake from the playground. I suggested covering the tree roots or covering them to remove the tripping hazards. REDORDS: Required documents were missing from children records reviewed. I recommended conducting periodic file reviews to ensure all items have been completed and placed in the files. UNANNOUNCED FOLLOW-UP VISIT: I informed you an unannounced follow-up visit will be conducted to monitor staff/child ratio and capacity requirements. STAR RATED LICENSE: I informed you information regarding the preparation for the star rated license assessment process is located on the Division of Child Development & Early Education and North Carolina Rated License Project websites. I recommended you and staff visit ncrlap.org to obtain detailed information about how the process will be implemented and review prep year activities and ideas offered. More information will be provided regarding your programs rated license assessment timeframe. GETTING HELP WITH CHALLENGING BEHAVIORS: Assistance can be requested for help with handling challenging behaviors. The Healthy Social Behaviors in Child Care Centers Project (HSB) provides ideas to create a learning environment that can assist in preventing challenging behaviors. They provide free technical assistance, professional development, and they offer a variety of additional resources. For additional information on the Healthy Social Behaviors Project or to view a current listing of scheduled trainings, browse the NC Child Care Resource & Referral Council website. For information about Pyramid Model CEU-level trainings, contact the HSB Education Specialist, Liz Tuttle at etuttle@childcareresourcesinc.org. To obtain a Request for TA Services, contact your local Behavior Specialist or email the Statewide Project Manager, Smokie Brawley, at sbrawley@childcareresourcesinc.org. You and staff can also contact the challenging behavior helpline at 1-888- 600-1685 option 2. You can speak to a Behavior Support Advisor or submit questions about specific behaviors in your program. You will also be able to post questions in the “Talk to the Expert” group in the online network. 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