Bright Horizons AT Wake Forest Baptist Health

NC GS 110-90 · Violation

Name of Operation: BRIGHT HORIZONS AT WAKE FOREST BAPTIST HEALTH Facility ID: 34000829 Consultant: WHITNEY PARKER Operation Type: Center Case Number: Visit Date: 2/16/2026 Number Present: 210 Completed Date: 2/16/2026 Age: From 0 To 5 Total Minutes: 335 Time In: 08:40 AM Time Out: 02:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements. This visit was conducted with Tish Milton, Interim Director, and Angela Sexton, Business Manager. Currently this program operates with a five-star license issued 9/29/2017. License restrictions include first and second shift; meets enhanced ratios; meets enhance space; children under 2 ½ in rooms with direct exits only. The license was observed, and the restrictions were found in compliance. The NC Secretary of State website was reviewed on 01/12/2026 and Bright Horizons Children’s Centers LLC was listed as current and active. The program’s compliance history was 85% prior to today’s visit. All programs are required to maintain at least 75% compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. I observed staff/child interactions today. I observed children engaging in free play, routine activities, and group time. I observed materials and activities that were available to the children in the classrooms. Your program was also monitored for compliance with implementing an approved curriculum as required for all four- and five-star licensed facilities where four-year-old children are enrolled. Your facility uses Discovery Driven Learning, formerly World at Their Fingertips. The last annual compliance visit was conducted on 03/12/2025. A sanitation inspection was completed 01/07/2026 with a approved classification. The last fire inspection was conducted 04/11/2025. Program records and required postings were monitored. A fire drill was conducted on 02/10/2026. A shelter in place drill was documented on 10/23/2025. An outdoor inspection was documented on 01/06/2026. Children’s records were monitored per DCDEE procedures. Nutrition requirements were monitored per DCDEE procedures. Storage of hazardous items was monitored today. Storage and administration of medication were monitored. Medication authorization was monitored. The program does not provide transportation. The following violations were cited during today’s visit: Violation Number Comment Rule 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. During the visit, I observed one tube of Aquaphor in an unlocked drawer less than five (5) vertical feet from the ground. .2820(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. During the visit, I observed plastic grocery bags and/or Ziploc bags in unlocked cabinets not five (5) vertical feet from the ground in spaces 153, 135B, and 125A. .0604(q) 861 Prohibited styrofoam and foam rubber products were accessible to children under 3 years of age and/or approved foam products were used without proper supervision. During the visit, I observed a vinyl covered foam mat with tears in the vinyl exposing the foam on the playground designated for infants. .0604(q) 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. During the visit, I observed two (2) employee files that did not have documentation of First Aid training. .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. During the visit, I observed two (2) employee files that did not have documentation of CPR training. .1102(d) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. During the visit, I observed that the last emergency drill was conducted in October 2025. An emergency drill was not conducted in January 2026. .0604(u);.0302(d)(8) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. During the visit, I observed one child file that did not contain a medical action plan for an allergy but did have an AUVI-Q on site. .0801(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. During the visit, I observed one (1) EpiPen in space 230, one (1) diaper cream tube in space 145, and one (1) bottle of sunscreen in space 146 that did not have medication authorization forms on file. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-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. During the visit, I observed two (2) employee files that did not have documentation of Recognizing and Responding to Suspicions of Child Maltreatment training. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. During the visit, I observed two (2) employee files that did not have documentation of completing the health and safety trainings. .1102(a) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. During the visit, I observed two (2) employee files that did not have documentation of completing the all health and safety trainings. Both files were missing the Medications in Child Care training. .1103(b) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violations cited during today's visit immediately and send me documentation verifying compliance on or before 03/02/2026. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation You may email the letter to whitney.parker@dhhs.nc.gov or mail two copies of the letter to: Whitney Parker P.O. Box 1342 Lexington, NC 27293 If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit related to violations: •We discussed that all medications must have a permission form on file to ensure the medications are given to the correct child in the correct way. You stated you would have the missing forms placed on file. •We discussed that any emergency medication must have an action plan on file to ensure the emergency medication is administered properly if needed. You stated you would have the parents get an action plan for the allergy medication. •We discussed that plastic cannot be accessible to children under three years of age for safety reasons. You removed all the plastic that was in unlocked cabinets less than five feet high during the visit. •We discussed that all medications, including ointments, must be kept out of reach of children. Out of reach means at least five (5) vertical feet from the ground. You removed the Aquaphor from the unlocked drawer during the visit. •We discussed that emergency drills must be completed every three (3) months. Your facility was due for an emergency drill in January 2026. We discussed setting reminders to ensure these are completed quarterly. Information discussed today related to the QRIS modernization plan: •During the visit, we discussed the QRIS modernization plan. I completed a template documenting the pathway you plan to pursue, identifying needs, documenting a timeline for completion, resources, next steps, etc. Over the next few months, I’ll be checking in with you, ahead of your next visit to check on progress and determine if additional assistance is needed with WORKS, NCRLAP/ERS, accreditation, etc. Additional Information/Consultation: •You must notify your consultant 30 days prior to changing the ownership status of your facility. •Make sure all employees have updated WORKS letters on file available for review. When evaluating education, we can only use the WORKS letters to determine each employee’s star rating. •Staff files will be monitored during another visit. •Make sure you continue to rehang all the required postings as the walls are painted. •Make sure you update your EPR and print the first page this month. With administrative changes, this plan will need to be updated to reflect your new administrator once hired. •Make sure you update your Emergency Medical Care Plan with your new administrator once hired. The new one will need to be posted. •Your facility is licensed for more than 200 children. Due to your licensed capacity, you must have two (2) administrators. The second administrator must work at least twenty (20) hours per week and be a Level 1 Administrator. You stated the company is in the process of hiring an Executive Director and that you are appointing a Program Director as well. Once these individuals are in place, please reach out to me so we can update your paperwork and administrator information. •We discussed that all infant classrooms must have a Safe Sleep poster posted. If you need to order new posters from this website: https://healthychildcare.unc.edu/resources/posters/ At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Whitney Parker, Child Care Consultant (336) 590-8765 whitney.parker@dhh.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2204 · Violation

Name of Operation: BRIGHT HORIZONS AT WAKE FOREST BAPTIST HEALTH Facility ID: 34000829 Consultant: WHITNEY PARKER Operation Type: Center Case Number: Visit Date: 11/10/2025 Number Present: 219 Completed Date: 11/10/2025 Age: From 0 To 5 Total Minutes: 95 Time In: 11:30 AM Time Out: 01:05 PM Time In: Time Out: List to Use: Center Type Of Visit: Unannounced Visit Follow-Up Announced/Unannounced: Unannounced An unannounced follow-up visit was conducted at this childcare center to verify correction of a violation documented during my routine unannounced visit on 08/12/2025. Today’s visit was conducted with Melissa Green, Director. Today, the following items were monitored: • Supervision • Staff / Child Ratio • Adequate / Approved Space • Permit Restrictions The license was observed, and the restrictions were found in compliance. Upon arrival, staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. The following violation documented during the routine unannounced visit on 08/12/2025 were monitored for compliance during this visit: •Item 620: All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. During the visit, I observed walls with chipping paint throughout the facility. This is a violation of a requirement in 15A NCAC 18A .2825(a). The following violation was documented today and was a repeated violation as reflected in the violation customization. As stated in the routine unannounced visit summary from 08/12/2025, all violations must be corrected immediately and a compliance letter verifying this must be received by the established due date. At the time of today’s visit, a compliance letter verifying corrections of this violation was not received and completed. A compliance letter was received on 08/22/2025 asking for an extension. An extension was granted through 10/04/2025 based on the plan submitted with the compliance letter. Communication from the Director has been shared since this time verifying that there is a discrepancy between the facility’s maintenance department and the facility’s corporation owner. Violations requiring additional time for correction must be addressed immediately to ensure a safe environment for the children in your care. Continued noncompliance may result in an administrative action per Child Care Rule 10A NCAC 09 .2204(6). Violation Number Comment Rule 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. During the visit, I observed walls with chipping paint throughout the facility which is a repeated violation from 08/12/2025. This is a violation of a requirement in 15A NCAC 18A .2825(a). 15A NCAC 18A .2825(a) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violations cited during today's visit immediately and send me documentation verifying compliance on or before 11/24/2025. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation You may email the letter to whitney.parker@dhhs.nc.gov or mail two copies of the letter to: Whitney Parker P.O. Box 1342 Lexington, NC 27293 If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit related to violations: •We discussed that the walls throughout the facility are not in good repair. Several walls in several classrooms have chipping paint and torn sheetrock. During a sanitation inspection on 06/24/2025, as well as several other sanitation inspections, this was noted as well. We discussed that the wall damage would need to be repaired to ensure children do not have access to chipping paint or damaged sheet rock. Additional Information/Consultation: • You must notify your consultant 30 days prior to changing the ownership status of your facility. At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Whitney Parker, Child Care Consultant (336) 590-8765 whitney.parker@dhh.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: BRIGHT HORIZONS AT WAKE FOREST BAPTIST HEALTH Facility ID: 34000829 Consultant: WHITNEY PARKER Operation Type: Center Case Number: Visit Date: 11/10/2025 Number Present: 219 Completed Date: 11/10/2025 Age: From 0 To 5 Total Minutes: 95 Time In: 11:30 AM Time Out: 01:05 PM Time In: Time Out: List to Use: Center Type Of Visit: Unannounced Visit Follow-Up Announced/Unannounced: Unannounced An unannounced follow-up visit was conducted at this childcare center to verify correction of a violation documented during my routine unannounced visit on 08/12/2025. Today’s visit was conducted with Melissa Green, Director. Today, the following items were monitored: • Supervision • Staff / Child Ratio • Adequate / Approved Space • Permit Restrictions The license was observed, and the restrictions were found in compliance. Upon arrival, staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. The following violation documented during the routine unannounced visit on 08/12/2025 were monitored for compliance during this visit: •Item 620: All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. During the visit, I observed walls with chipping paint throughout the facility. This is a violation of a requirement in 15A NCAC 18A .2825(a). The following violation was documented today and was a repeated violation as reflected in the violation customization. As stated in the routine unannounced visit summary from 08/12/2025, all violations must be corrected immediately and a compliance letter verifying this must be received by the established due date. At the time of today’s visit, a compliance letter verifying corrections of this violation was not received and completed. A compliance letter was received on 08/22/2025 asking for an extension. An extension was granted through 10/04/2025 based on the plan submitted with the compliance letter. Communication from the Director has been shared since this time verifying that there is a discrepancy between the facility’s maintenance department and the facility’s corporation owner. Violations requiring additional time for correction must be addressed immediately to ensure a safe environment for the children in your care. Continued noncompliance may result in an administrative action per Child Care Rule 10A NCAC 09 .2204(6). Violation Number Comment Rule 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. During the visit, I observed walls with chipping paint throughout the facility which is a repeated violation from 08/12/2025. This is a violation of a requirement in 15A NCAC 18A .2825(a). 15A NCAC 18A .2825(a) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violations cited during today's visit immediately and send me documentation verifying compliance on or before 11/24/2025. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation You may email the letter to whitney.parker@dhhs.nc.gov or mail two copies of the letter to: Whitney Parker P.O. Box 1342 Lexington, NC 27293 If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit related to violations: •We discussed that the walls throughout the facility are not in good repair. Several walls in several classrooms have chipping paint and torn sheetrock. During a sanitation inspection on 06/24/2025, as well as several other sanitation inspections, this was noted as well. We discussed that the wall damage would need to be repaired to ensure children do not have access to chipping paint or damaged sheet rock. Additional Information/Consultation: • You must notify your consultant 30 days prior to changing the ownership status of your facility. At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Whitney Parker, Child Care Consultant (336) 590-8765 whitney.parker@dhh.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0604 · Violation

Name of Operation: BRIGHT HORIZONS AT WAKE FOREST BAPTIST HEALTH Facility ID: 34000829 Consultant: WHITNEY PARKER Operation Type: Center Case Number: Visit Date: 8/12/2025 Number Present: 205 Completed Date: 8/12/2025 Age: From 0 To 5 Total Minutes: 265 Time In: 08:45 AM Time Out: 01:10 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable childcare requirements for a routine unannounced visit. This visit was conducted with Melissa Green, Director. Currently this program operates with a five-star license issued 9/29/2017. License restrictions include first and second shift; meets enhanced ratios; meets enhance space; children under 2 ½ in rooms with direct exits only. The NC Secretary of State website was reviewed on 07/10/2025 and Bright Horizons Children’s Centers LLC was listed as current and active. The program’s compliance history was 84% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • CPR / First Aid • Special Training • CBC Qualification • ITS – SIDS • Emergency Medical Care Plan • Administration of Medication • Storage of Hazardous Products • Storage of Medication • General Safety • Discipline • Adequate / Approved Space • Program Records • License Posted • Permit Restrictions The license was observed, and the restrictions were found in compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. I observed staff/child interactions today. I observed children engaging in free play, routine activities, and group time. No new staff were reported at this program. Storage and administration of medication were monitored. Medication authorization was monitored. Storage hazardous items were monitored today. A playground inspection was recorded on 08/10/2025. A fire drill was recorded 07/25/2025. A lock down drill for the facility was recorded 05/13/2025. The most recent fire inspection was on 04/11/2025. I observed a sanitation inspection was last conducted on 06/24/2025 earning a approved classification. The program does not provide transportation. The following violations were cited during today’s visit: Violation Number Comment Rule 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. During the visit, I observed walls with chipping paint throughout the facility. 15A NCAC 18A .2825(a) 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. During the visit, I observed one (1) uncovered outlet in space 812. 10A NCAC 09 .0604(c) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. During the visit, I observed an EMC plan with the name of a former employee. The posted EMC plan had not been updated to reflect an alternate individual responsible. .0802(a)(1)(A-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. During the visit, I observed extra diapers being stored in plastic bags in unlocked cabinets less than five (5) vertical feet high in spaces 131B, 137A, and 146. .0604(q) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. During the visit, I observed six (6) medications that did not have permission forms on file located in spaces 141B, 145, 153, and 146. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violations cited during today's visit immediately and send me documentation verifying compliance on or before 08/26/2025. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to whitney.parker@dhhs.nc.gov or mail two copies of the letter to: Whitney Parker P.O. Box 1342 Lexington, NC 27293 Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit related to violations: • We discussed that the EMC plan must be updated to reflect the correct employees who are responsible. You stated you updated the form and would post the correct one. • We discussed that plastic bags must not be accessible to children under three. You moved the extra diapers to an inaccessible place during the visit. • We discussed that all outlets must be covered at all times when not in use. You covered the outlet using a safety plug during the visit. • We discussed that all medications, including diaper creams and sunscreens, must have a permission form on file. You removed the medications without forms and stated you would have the forms completed today. • We discussed that the walls throughout the facility are not in good repair. Several walls in several classrooms have chipping paint and torn sheetrock. During a sanitation inspection on 06/24/2025, this was noted as well. We discussed that the wall damage would need to be repaired to ensure children do not have access to chipping paint or damaged sheet rock. Additional Information/Consultation: • You must notify your consultant 30 days prior to changing the ownership status of your facility. • On June 26th, the North Carolina Rules Review Commission (RRC) approved the QRIS Modernization rules adopted by the NC Child Care Commission during their April meeting. The Division of Child Development and Early Education is preparing a summary of the rules, an online training module for Moodle, and an implementation plan. A webinar will be scheduled later to share the implementation plan and will also provide resources that can assist you with understanding the new rules. The implementation plan will allow time for administrators/operators to learn and understand the different pathways and the changes within our system. We encourage you to visit the QRIS Modernization page on the DCDEE website to learn more now. We discussed that your facility has began the accreditation process with NAEYC and is currently working on the accreditation process. • Recently, Governor Stein signed HB 412 into law, which became Session Law 2025-36. The law includes revisions to several sections within Chapter 110 of the NC General Statutes regarding childcare and early childhood education. It requires DCDEE to develop and propose a possible plan to separate the quality rating improvement system (QRIS) from the requirements and payments for participation in the Subsidized Child Care Assistance (SCCA) Program. Some of the wide-ranging regulatory options and changes include lead teacher requirements and responsibilities, new education equivalencies, space and equipment requirements in a public-school serving school age children, group sizes for centers, and exemptions for Department of Defense certified family childcare homes. In addition, the law addresses childcare business-related issues such as residential building code and liability insurance. DCDEE is working to bring our staff and partners up to date with the new law and will update our materials and website as soon as possible. • Make sure you are signed up to receive the Raise NC Newsletters as information will be shared with you all about important DCDEE updates through these newsletters. • Make sure all employees have updated WORKS letters on file available for review. When evaluating education, we can only use the WORKS letters to determine each employee’s star rating. • Keep a check on the play mat on the infant playground. It is showing signs of wear and tear. • We discussed assistant director needs during the visit. We discussed the following: (f) For centers with a licensed capacity of 200 or more, there shall be a second administrator on-site for a minimum of 20 hours per week who shall have the Level I North Carolina Early Childhood Administration Credential or its equivalent. At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Whitney Parker, Child Care Consultant (336) 590-8765 whitney.parker@dhh.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: BRIGHT HORIZONS AT WAKE FOREST BAPTIST HEALTH Facility ID: 34000829 Consultant: WHITNEY PARKER Operation Type: Center Case Number: Visit Date: 8/12/2025 Number Present: 205 Completed Date: 8/12/2025 Age: From 0 To 5 Total Minutes: 265 Time In: 08:45 AM Time Out: 01:10 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable childcare requirements for a routine unannounced visit. This visit was conducted with Melissa Green, Director. Currently this program operates with a five-star license issued 9/29/2017. License restrictions include first and second shift; meets enhanced ratios; meets enhance space; children under 2 ½ in rooms with direct exits only. The NC Secretary of State website was reviewed on 07/10/2025 and Bright Horizons Children’s Centers LLC was listed as current and active. The program’s compliance history was 84% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • CPR / First Aid • Special Training • CBC Qualification • ITS – SIDS • Emergency Medical Care Plan • Administration of Medication • Storage of Hazardous Products • Storage of Medication • General Safety • Discipline • Adequate / Approved Space • Program Records • License Posted • Permit Restrictions The license was observed, and the restrictions were found in compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. I observed staff/child interactions today. I observed children engaging in free play, routine activities, and group time. No new staff were reported at this program. Storage and administration of medication were monitored. Medication authorization was monitored. Storage hazardous items were monitored today. A playground inspection was recorded on 08/10/2025. A fire drill was recorded 07/25/2025. A lock down drill for the facility was recorded 05/13/2025. The most recent fire inspection was on 04/11/2025. I observed a sanitation inspection was last conducted on 06/24/2025 earning a approved classification. The program does not provide transportation. The following violations were cited during today’s visit: Violation Number Comment Rule 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. During the visit, I observed walls with chipping paint throughout the facility. 15A NCAC 18A .2825(a) 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. During the visit, I observed one (1) uncovered outlet in space 812. 10A NCAC 09 .0604(c) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. During the visit, I observed an EMC plan with the name of a former employee. The posted EMC plan had not been updated to reflect an alternate individual responsible. .0802(a)(1)(A-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. During the visit, I observed extra diapers being stored in plastic bags in unlocked cabinets less than five (5) vertical feet high in spaces 131B, 137A, and 146. .0604(q) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. During the visit, I observed six (6) medications that did not have permission forms on file located in spaces 141B, 145, 153, and 146. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violations cited during today's visit immediately and send me documentation verifying compliance on or before 08/26/2025. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to whitney.parker@dhhs.nc.gov or mail two copies of the letter to: Whitney Parker P.O. Box 1342 Lexington, NC 27293 Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit related to violations: • We discussed that the EMC plan must be updated to reflect the correct employees who are responsible. You stated you updated the form and would post the correct one. • We discussed that plastic bags must not be accessible to children under three. You moved the extra diapers to an inaccessible place during the visit. • We discussed that all outlets must be covered at all times when not in use. You covered the outlet using a safety plug during the visit. • We discussed that all medications, including diaper creams and sunscreens, must have a permission form on file. You removed the medications without forms and stated you would have the forms completed today. • We discussed that the walls throughout the facility are not in good repair. Several walls in several classrooms have chipping paint and torn sheetrock. During a sanitation inspection on 06/24/2025, this was noted as well. We discussed that the wall damage would need to be repaired to ensure children do not have access to chipping paint or damaged sheet rock. Additional Information/Consultation: • You must notify your consultant 30 days prior to changing the ownership status of your facility. • On June 26th, the North Carolina Rules Review Commission (RRC) approved the QRIS Modernization rules adopted by the NC Child Care Commission during their April meeting. The Division of Child Development and Early Education is preparing a summary of the rules, an online training module for Moodle, and an implementation plan. A webinar will be scheduled later to share the implementation plan and will also provide resources that can assist you with understanding the new rules. The implementation plan will allow time for administrators/operators to learn and understand the different pathways and the changes within our system. We encourage you to visit the QRIS Modernization page on the DCDEE website to learn more now. We discussed that your facility has began the accreditation process with NAEYC and is currently working on the accreditation process. • Recently, Governor Stein signed HB 412 into law, which became Session Law 2025-36. The law includes revisions to several sections within Chapter 110 of the NC General Statutes regarding childcare and early childhood education. It requires DCDEE to develop and propose a possible plan to separate the quality rating improvement system (QRIS) from the requirements and payments for participation in the Subsidized Child Care Assistance (SCCA) Program. Some of the wide-ranging regulatory options and changes include lead teacher requirements and responsibilities, new education equivalencies, space and equipment requirements in a public-school serving school age children, group sizes for centers, and exemptions for Department of Defense certified family childcare homes. In addition, the law addresses childcare business-related issues such as residential building code and liability insurance. DCDEE is working to bring our staff and partners up to date with the new law and will update our materials and website as soon as possible. • Make sure you are signed up to receive the Raise NC Newsletters as information will be shared with you all about important DCDEE updates through these newsletters. • Make sure all employees have updated WORKS letters on file available for review. When evaluating education, we can only use the WORKS letters to determine each employee’s star rating. • Keep a check on the play mat on the infant playground. It is showing signs of wear and tear. • We discussed assistant director needs during the visit. We discussed the following: (f) For centers with a licensed capacity of 200 or more, there shall be a second administrator on-site for a minimum of 20 hours per week who shall have the Level I North Carolina Early Childhood Administration Credential or its equivalent. At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Whitney Parker, Child Care Consultant (336) 590-8765 whitney.parker@dhh.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2818 · Violation

Name of Operation: BRIGHT HORIZONS AT WAKE FOREST BAPTIST HEALTH Facility ID: 34000829 Consultant: WHITNEY PARKER Operation Type: Center Case Number: 0625-108L Visit Date: 6/19/2025 Number Present: 153 Completed Date: 6/19/2025 Age: From 0 To 5 Total Minutes: 105 Time In: 08:15 AM Time Out: 10:00 AM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to obtain information regarding alleged violations of childcare requirements. This visit was conducted with Chris Whitaker, Instructional Coach, and Melissa Green, Director. The allegations are as follows: There are allegations of violations of childcare requirements regarding sanitation and health. During today’s visit, the allegations were discussed with you. You had the opportunity to respond. Information shared during this visit is documented in this visit summary. Currently this program operates with a five-star license issued 9/29/2017. License restrictions include first and second shift; meets enhanced ratios; meets enhance space; children under 2 ½ in rooms with direct exits only. The NC Secretary of State website was reviewed on 06/12/2025 and Bright Horizons Children’s Centers LLC was listed as current and active. The program’s compliance history was 84% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • Adequate / Approved Space • License Posted • Permit Restrictions During the visit, a walkthrough of the facility was completed. In space thirteen (13), I observed twelve (12) children two (2) years of age with one (1) teacher. Allegation #1: There are allegations of violations of childcare requirements regarding sanitation and health. Observation #1: During today’s visit, I interviewed eight (8) employees, including six (6) teachers, one (1) Instructional Coach, and the Director. All employees stated they follow their illness policy when determining who and when to send children home. Teaching staff stated they contact the administrative team when concerns arise regarding illness. Administrative staff stated they exclude children based on the facility’s illness policy. The administrative staff stated they have had several cases of hand, foot, and mouth in the toddler pods. The administrative staff stated they have had their cleaning crew use a disinfecting fog on weekends. The administrative staff stated the teachers’ clean toys daily and as needed, especially during outbreaks. During the visit, I observed posted signs on several toddler space doors notifying families that there have been reported cases of hand, foot, and mouth. The notification displayed the diagnosed date, exclusion and return criteria, when the child should remain home, and resources for illness. The toddler teaching staff stated when they have a suspected case of hand, foot, and mouth, they immediately contact the administrative team and send the child home. The toddler teaching staff stated they separate the child until they are picked up, disinfect the toys daily and as needed, change sheets, disinfect the classroom, wear gloves, and conduct more handwashing than normal. The teaching staff stated the administrative team decides who goes home and that children cannot come back until the sores are closed. During the visit, I observed the facility’s illness policy. The illness policy gives specific exclusion guidelines for various illnesses. For hand, foot, and mouth, the policy states that children are to be excluded until fever free for twenty-four (24) hours without the use of a fever reducer and sores have healed. The policy also states that medical clearance is not required. I also observed the infectious control policy that outlines cleaning, sanitizing and disinfecting procedures that must take place when illness occurs. The policy breaks down what to clean, how to clean it, when to clean it, and what to clean it with. Conclusion #1: Based on the above information and observations during today’s visit, there was not enough information to support the allegation. This allegation was unsubstantiated. The following violation was cited during today’s visit: Violation Number Comment Rule 1756 Enhanced staff/child ratios and group sizes were not met. During the visit, I observed twelve (12) children two (2) years of age with one (1) teacher in space thirteen (13). 10A NCAC 09 .2818 Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violations cited during today's visit immediately and send me documentation verifying compliance on or before 07/03/2025. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation You may email the letter to whitney.parker@dhhs.nc.gov or mail two copies of the letter to: Whitney Parker P.O. Box 1342 Lexington, NC 27293 If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits will be conducted to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit related to violations: • We discussed that ratios must always be maintained. We discussed that as soon as a child enters the room, putting the classroom out of ratio, the issue should be addressed. We discussed that children should not be allowed to eat breakfast prior to moving them to another space as the classroom is out of ratio while the child eats. I recommend talking with the staff to ensure she know what the ratio in the class is and reviewing your procedures if the classroom gets out of ratio to ensure the ratio is being met. Additional Information/Consultation: • You must notify your consultant 30 days prior to changing the ownership status of your facility. • We discussed cleaning measures that can be taken to help prevent the spread of contagious diseases. You can use these links for more information: https://www.cdc.gov/hand-foot-mouth/about/index.html and https://www.cdc.gov/norovirus/causes/index.html • We also discussed that if you have additional questions regarding when to exclude children or how to properly clean after any outbreaks, you could reach out to Environmental Health or the local Child Care Health Consultant, Keturah Oglesby. Her contact information is: Keturaho@smartstart-fc.org and 336-714-4370. At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Whitney Parker, Child Care Consultant (336) 590-8765 whitney.parker@dhh.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: BRIGHT HORIZONS AT WAKE FOREST BAPTIST HEALTH Facility ID: 34000829 Consultant: WHITNEY PARKER Operation Type: Center Case Number: 0625-108L Visit Date: 6/19/2025 Number Present: 153 Completed Date: 6/19/2025 Age: From 0 To 5 Total Minutes: 105 Time In: 08:15 AM Time Out: 10:00 AM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to obtain information regarding alleged violations of childcare requirements. This visit was conducted with Chris Whitaker, Instructional Coach, and Melissa Green, Director. The allegations are as follows: There are allegations of violations of childcare requirements regarding sanitation and health. During today’s visit, the allegations were discussed with you. You had the opportunity to respond. Information shared during this visit is documented in this visit summary. Currently this program operates with a five-star license issued 9/29/2017. License restrictions include first and second shift; meets enhanced ratios; meets enhance space; children under 2 ½ in rooms with direct exits only. The NC Secretary of State website was reviewed on 06/12/2025 and Bright Horizons Children’s Centers LLC was listed as current and active. The program’s compliance history was 84% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • Adequate / Approved Space • License Posted • Permit Restrictions During the visit, a walkthrough of the facility was completed. In space thirteen (13), I observed twelve (12) children two (2) years of age with one (1) teacher. Allegation #1: There are allegations of violations of childcare requirements regarding sanitation and health. Observation #1: During today’s visit, I interviewed eight (8) employees, including six (6) teachers, one (1) Instructional Coach, and the Director. All employees stated they follow their illness policy when determining who and when to send children home. Teaching staff stated they contact the administrative team when concerns arise regarding illness. Administrative staff stated they exclude children based on the facility’s illness policy. The administrative staff stated they have had several cases of hand, foot, and mouth in the toddler pods. The administrative staff stated they have had their cleaning crew use a disinfecting fog on weekends. The administrative staff stated the teachers’ clean toys daily and as needed, especially during outbreaks. During the visit, I observed posted signs on several toddler space doors notifying families that there have been reported cases of hand, foot, and mouth. The notification displayed the diagnosed date, exclusion and return criteria, when the child should remain home, and resources for illness. The toddler teaching staff stated when they have a suspected case of hand, foot, and mouth, they immediately contact the administrative team and send the child home. The toddler teaching staff stated they separate the child until they are picked up, disinfect the toys daily and as needed, change sheets, disinfect the classroom, wear gloves, and conduct more handwashing than normal. The teaching staff stated the administrative team decides who goes home and that children cannot come back until the sores are closed. During the visit, I observed the facility’s illness policy. The illness policy gives specific exclusion guidelines for various illnesses. For hand, foot, and mouth, the policy states that children are to be excluded until fever free for twenty-four (24) hours without the use of a fever reducer and sores have healed. The policy also states that medical clearance is not required. I also observed the infectious control policy that outlines cleaning, sanitizing and disinfecting procedures that must take place when illness occurs. The policy breaks down what to clean, how to clean it, when to clean it, and what to clean it with. Conclusion #1: Based on the above information and observations during today’s visit, there was not enough information to support the allegation. This allegation was unsubstantiated. The following violation was cited during today’s visit: Violation Number Comment Rule 1756 Enhanced staff/child ratios and group sizes were not met. During the visit, I observed twelve (12) children two (2) years of age with one (1) teacher in space thirteen (13). 10A NCAC 09 .2818 Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violations cited during today's visit immediately and send me documentation verifying compliance on or before 07/03/2025. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation You may email the letter to whitney.parker@dhhs.nc.gov or mail two copies of the letter to: Whitney Parker P.O. Box 1342 Lexington, NC 27293 If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits will be conducted to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit related to violations: • We discussed that ratios must always be maintained. We discussed that as soon as a child enters the room, putting the classroom out of ratio, the issue should be addressed. We discussed that children should not be allowed to eat breakfast prior to moving them to another space as the classroom is out of ratio while the child eats. I recommend talking with the staff to ensure she know what the ratio in the class is and reviewing your procedures if the classroom gets out of ratio to ensure the ratio is being met. Additional Information/Consultation: • You must notify your consultant 30 days prior to changing the ownership status of your facility. • We discussed cleaning measures that can be taken to help prevent the spread of contagious diseases. You can use these links for more information: https://www.cdc.gov/hand-foot-mouth/about/index.html and https://www.cdc.gov/norovirus/causes/index.html • We also discussed that if you have additional questions regarding when to exclude children or how to properly clean after any outbreaks, you could reach out to Environmental Health or the local Child Care Health Consultant, Keturah Oglesby. Her contact information is: Keturaho@smartstart-fc.org and 336-714-4370. At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Whitney Parker, Child Care Consultant (336) 590-8765 whitney.parker@dhh.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: BRIGHT HORIZONS AT WAKE FOREST BAPTIST HEALTH Facility ID: 34000829 Consultant: WHITNEY PARKER Operation Type: Center Case Number: 0325-216L Visit Date: 3/24/2025 Number Present: 200 Completed Date: 3/24/2025 Age: From 0 To 5 Total Minutes: 160 Time In: 08:50 AM Time Out: 11:30 AM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to obtain information regarding alleged violations of childcare requirements. This visit was conducted by Whitney Parker, Childcare Consultant, with Melissa Green, Director. The allegations are as follows: There are allegations of violations of childcare requirements related to discipline. During today’s visit, the allegations were discussed with you. You had the opportunity to respond. Information shared during this visit is documented in this visit summary. Currently this program operates with a five-star license issued 9/29/2017. License restrictions include first and second shift; meets enhanced ratios; meets enhance space; children under 2 ½ in rooms with direct exits only. The NC Secretary of State website was reviewed on 03/18/2025 and Bright Horizons Children’s Centers LLC was listed as current and active. The program’s compliance history was 85% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • Adequate / Approved Space • License Posted • Permit Restrictions Allegation #1: There are allegations of violations of childcare requirements related to discipline. Observation #1: During today’s visit, I interviewed four (4) employees including the director, Ms. Green, instructional coach for space 235, and two (2) teachers. Ms. Green stated that she was contacted on 03/14/2025 by a family of a child enrolled in space 235 stating they had concerns. The family notified Ms. Green that their child stated that his teacher poked him, shoved him, and grabbed him hard. Ms. Green stated that she immediately required the teacher to provide a written statement and placed her on administrative leave. Ms. Green met with her leadership team and a decision was made to terminate the employee out of an abundance of caution. Ms. Green notified the DCDEE of this incident in a self-report on 03/14/2025. A telephone conversation took place during the visit with the instructional coach for space 235. He stated he had not witnessed any concerns with the former employee during his time working in the classroom with her. The floater that had worked with the former employee for a couple of days during the week of March 10th-14th stated that she had not witnessed anything concerning during the time she worked with her. The regular co-teacher in the classroom stated that there were two instances when working with the former employee where he felt like the former employee’s tone was too loud and he provided guidance to the former employee on ways to handle the situation better. The co-teacher stated he never witnessed any physical punishment that would put a child in harm by the former employee. I also observed space 235, a classroom designated for three (3) and four (4) year old children. I observed staff/child interactions. I observed teachers engaging with children in the classroom during free choice time. During the observation, two children in the space became upset with each other and began hitting each other with soft toys. The teacher immediately intervened and began and using redirection/problem solving strategies on the child’s level. Ms. Green provided me with the facility’s discipline policy. The facility’s discipline policy states staff are to use positive guidance by using redirection, providing alternative choices, and helping the children to make better choices. Ms. Green stated this policy is reviewed with staff upon hire and annually. Ms. Green stated the policy was last reviewed with all staff in January 2025. Ms. Green also provided me with a written statement from a teacher that documented her interactions with children. The statement documented that the teacher had “movements that may have been too rigid for safety”. The statement continues to document that the teacher’s movements are “overly eccentric when engaging with children in an environment that is crowded or loud”. Conclusion #1: Based on the above information and observations during today’s visit, there was not enough information to support the allegation. This allegation was unsubstantiated. The following violation was cited during today’s visit: Violation Number Comment Rule 325 Staff did not interact with children in positive ways by helping them feel welcome and comfortable, treating them with respect, listening to what they say, responding to them with acceptance and appreciation, and/or participating in activities with the children. During the visit, based on interviews with teaching staff, it was confirmed that a former employee did not use a positive, encouraging tone, with children in space 235. .1802 Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violation cited during today's visit immediately and send me documentation verifying compliance on or before 04/07/2025. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation You may email the letter to whitney.parker@dhhs.nc.gov or mail two copies of the letter to: Whitney Parker P.O. Box 1342 Lexington, NC 27293 If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit related to violations: • During the visit, we discussed that section 1802 states that staff shall interact with children in positive ways by helping them feel welcome and comfortable, treating them with respect, listening to what they say, responding to them with acceptance and appreciation, and participating in activities with the children. For example, staff should: (1) make eye contact when speaking to a child; (2) engage children in conversation to share experiences, ideas, and opinions; (3) help children develop problem-solving skills; and (4) facilitate learning by providing positive reinforcement, encouraging efforts, and recognizing accomplishments. Conversation with adults is one of the main channels through which children learn about themselves, others, and the world in which they live. While adults speaking to children teach the children facts and relays information, social and emotional communications and the atmosphere of the exchange are equally important. I encourage you to utilize the resources available to you to encourage your staff to promote positive guidance and interactions. The following resources could be beneficial to your staff for children when situations are heightened: -Challenging Behavior Hotline Information: Telephone Number: 1-888-600-1685 Option 1 Website: https://www.childcareresourcesinc.org/challenging-behaviors-helpline -Smart Start of Forsyth County: (336) 725-6011 -Child Care Resource and Referral: (336) 245-4900 Additional Information/Consultation: • You must notify your consultant 30 days prior to changing the ownership status of your facility. At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Whitney Parker, Child Care Consultant (336) 590-8765 whitney.parker@dhh.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: BRIGHT HORIZONS AT WAKE FOREST BAPTIST HEALTH Facility ID: 34000829 Consultant: WHITNEY PARKER Operation Type: Center Case Number: Visit Date: 3/12/2025 Number Present: 188 Completed Date: 3/12/2025 Age: From 0 To 5 Total Minutes: 260 Time In: 08:25 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements. This visit was conducted by Whitney Parker, Childcare Consultant, with Melissa Green, Director. Currently this program operates with a five-star license issued 9/29/2017. License restrictions include first and second shift; meets enhanced ratios; meets enhance space; children under 2 ½ in rooms with direct exits only. The license was observed, and the restrictions were found in compliance. The NC Secretary of State website was reviewed on 02/11/2025 and Bright Horizons Children’s Centers LLC was listed as current and active. The program’s compliance history was 83% prior to today’s visit. All programs are required to maintain at least 75% compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. I observed staff/child interactions today. I observed children eating breakfast, engaging in free play, group time, and routine activities. I observed materials and activities that were available to the children in the classrooms. Your program was also monitored for compliance with implementing an approved curriculum as required for all four- and five-star licensed facilities where four-year-old children are enrolled. Your facility uses Discovery Driven Learning, formerly World at Their Fingertips. The last annual compliance visit was conducted on 04/02/2024. A sanitation inspection was completed 11/13/2024 with a superior classification. The last fire inspection was conducted 04/25/2024. Program records and required postings were monitored. A fire drill was conducted on 02/13/2025. A shelter in place drill was documented on 03/05/2025. An outdoor inspection was documented on 02/25/2025. Children's records were monitored per DCDEE procedures. Staff files will be monitored per DCDEE procedures during another visit. Nutrition requirements were monitored per DCDEE procedures. Storage of hazardous items was monitored today. Hazardous items were stored in locked cabinets or locked closets. Storage and administration of medication were monitored. Medication authorization was monitored. The program does not provide transportation. The following violations were cited during today’s visit: Violation Number Comment Rule 861 Prohibited styrofoam and foam rubber products were accessible to children under 3 years of age and/or approved foam products were used without proper supervision. During the visit, I observed a vinyl covered foam mat with tears in the vinyl exposing the foam on a toddler playground. .0604(q) 1757 A valid qualification letter was not on file and available to review at the facility. During the visit, I observed one employee that did not have a valid qualification letter on file. G.S. 110-90.2(b) & (d) & .2703(e) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. During the visit, I observed four (4) diaper creams in space 141A and one (1) diaper cream in space 246 that had permission forms that expired in February 2025. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violations cited during today's visit immediately and send me documentation verifying compliance on or before 03/26/2025. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation You may email the letter to whitney.parker@dhhs.nc.gov or mail two copies of the letter to: Whitney Parker P.O. Box 1342 Lexington, NC 27293 If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit related to violations: • We discussed that all medication permission forms must be updated prior to the expiration date to ensure that the medication should still be used. You removed the expired medications from the classrooms during the visit and stated you would have new forms completed immediately. • We discussed that foam must not be accessible to children under three (3) years of age. You had the torn mat removed during the visit. Additional Information/Consultation: • You must notify your consultant 30 days prior to changing the ownership status of your facility. • Staff files will be monitored on a separate visit. • Please email me a copy of your fire inspection next month when you receive it. • The hold harmless was extended until the QRIS modernization has been completed. The previous cohort model is no longer in effect. Starting on February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—will be used for DCDEE environment rating scale assessments. The DCDEE and the North Carolina Rated License Assessment Project (NCRLAP) are collaboratively working on preparations for the transition to the third editions. These third editions come with a spiral binding at the top, replacing the current revised editions. Visit the NCRLAP’s website for more information about updated resources, credit hour trainings, and outreach assessment opportunities to help you become familiar with these tools. For official environment rating scale assessments for a NC Star Rated License, the NCRLAP will use the Revised editions until February 1, 2025. You can find more information at this link: https://ncrlap.org/Resources/pages/get-ready-for-3s/ • The process of notifying the Division of new employees 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. At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Whitney Parker, Child Care Consultant (336) 590-8765 whitney.parker@dhh.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: BRIGHT HORIZONS AT WAKE FOREST BAPTIST HEALTH Facility ID: 34000829 Consultant: WHITNEY PARKER Operation Type: Center Case Number: Visit Date: 3/12/2025 Number Present: 188 Completed Date: 3/12/2025 Age: From 0 To 5 Total Minutes: 260 Time In: 08:25 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements. This visit was conducted by Whitney Parker, Childcare Consultant, with Melissa Green, Director. Currently this program operates with a five-star license issued 9/29/2017. License restrictions include first and second shift; meets enhanced ratios; meets enhance space; children under 2 ½ in rooms with direct exits only. The license was observed, and the restrictions were found in compliance. The NC Secretary of State website was reviewed on 02/11/2025 and Bright Horizons Children’s Centers LLC was listed as current and active. The program’s compliance history was 83% prior to today’s visit. All programs are required to maintain at least 75% compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. I observed staff/child interactions today. I observed children eating breakfast, engaging in free play, group time, and routine activities. I observed materials and activities that were available to the children in the classrooms. Your program was also monitored for compliance with implementing an approved curriculum as required for all four- and five-star licensed facilities where four-year-old children are enrolled. Your facility uses Discovery Driven Learning, formerly World at Their Fingertips. The last annual compliance visit was conducted on 04/02/2024. A sanitation inspection was completed 11/13/2024 with a superior classification. The last fire inspection was conducted 04/25/2024. Program records and required postings were monitored. A fire drill was conducted on 02/13/2025. A shelter in place drill was documented on 03/05/2025. An outdoor inspection was documented on 02/25/2025. Children's records were monitored per DCDEE procedures. Staff files will be monitored per DCDEE procedures during another visit. Nutrition requirements were monitored per DCDEE procedures. Storage of hazardous items was monitored today. Hazardous items were stored in locked cabinets or locked closets. Storage and administration of medication were monitored. Medication authorization was monitored. The program does not provide transportation. The following violations were cited during today’s visit: Violation Number Comment Rule 861 Prohibited styrofoam and foam rubber products were accessible to children under 3 years of age and/or approved foam products were used without proper supervision. During the visit, I observed a vinyl covered foam mat with tears in the vinyl exposing the foam on a toddler playground. .0604(q) 1757 A valid qualification letter was not on file and available to review at the facility. During the visit, I observed one employee that did not have a valid qualification letter on file. G.S. 110-90.2(b) & (d) & .2703(e) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. During the visit, I observed four (4) diaper creams in space 141A and one (1) diaper cream in space 246 that had permission forms that expired in February 2025. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violations cited during today's visit immediately and send me documentation verifying compliance on or before 03/26/2025. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation You may email the letter to whitney.parker@dhhs.nc.gov or mail two copies of the letter to: Whitney Parker P.O. Box 1342 Lexington, NC 27293 If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit related to violations: • We discussed that all medication permission forms must be updated prior to the expiration date to ensure that the medication should still be used. You removed the expired medications from the classrooms during the visit and stated you would have new forms completed immediately. • We discussed that foam must not be accessible to children under three (3) years of age. You had the torn mat removed during the visit. Additional Information/Consultation: • You must notify your consultant 30 days prior to changing the ownership status of your facility. • Staff files will be monitored on a separate visit. • Please email me a copy of your fire inspection next month when you receive it. • The hold harmless was extended until the QRIS modernization has been completed. The previous cohort model is no longer in effect. Starting on February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—will be used for DCDEE environment rating scale assessments. The DCDEE and the North Carolina Rated License Assessment Project (NCRLAP) are collaboratively working on preparations for the transition to the third editions. These third editions come with a spiral binding at the top, replacing the current revised editions. Visit the NCRLAP’s website for more information about updated resources, credit hour trainings, and outreach assessment opportunities to help you become familiar with these tools. For official environment rating scale assessments for a NC Star Rated License, the NCRLAP will use the Revised editions until February 1, 2025. You can find more information at this link: https://ncrlap.org/Resources/pages/get-ready-for-3s/ • The process of notifying the Division of new employees 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. At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Whitney Parker, Child Care Consultant (336) 590-8765 whitney.parker@dhh.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0601 · Violation

Name of Operation: BRIGHT HORIZONS AT WAKE FOREST BAPTIST HEALTH Facility ID: 34000829 Consultant: WHITNEY PARKER Operation Type: Center Case Number: Visit Date: 9/25/2024 Number Present: 203 Completed Date: 9/25/2024 Age: From 0 To 5 Total Minutes: 365 Time In: 08:45 AM Time Out: 02:50 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable childcare requirements for a routine unannounced visit. This visit was conducted by Whitney Parker and Emily Lamquaye, Childcare Consultants, with Michelle Heath, Business Manager. Currently this program operates with a five-star license issued 9/29/2017. License restrictions include first and second shift; meets enhanced ratios; meets enhance space; children under 2 ½ in rooms with direct exits only. The NC Secretary of State website was reviewed on 08/08/2024 and Bright Horizons Children’s Centers LLC was listed as current and active. The program’s compliance history was 81% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • CPR / First Aid • Special Training • CBC Qualification • ITS – SIDS • Emergency Medical Care Plan • Administration of Medication • Storage of Hazardous Products • Storage of Medication • General Safety • Discipline • Adequate / Approved Space • Program Records • License Posted • Permit Restrictions The license was observed, and the restrictions were found in compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. I observed staff/child interactions today. I observed children engaging in free play, routine activities, and group time. Fifteen new staff were reported at this program. Files for new staff were reviewed. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Storage and administration of medication were monitored. Medication authorization was monitored. Storage hazardous items was monitored today. A playground inspection was recorded 08/20/2024. A fire drill was recorded 09/20/2024. A shelter in place drill for the facility was recorded 09/19/2024. The most recent fire inspection was on 04/25/2024. I observed a sanitation inspection was last conducted on 01/10/2024 earning a superior classification. The program does not provide transportation. The following violations were cited during today’s visit: Violation Number Comment Rule 115 A summary of the NC Child Care Law was not posted in a prominent place in the center. I did not observe a copy of the summary of the NC Child Care Law posted. G.S. 110-102 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. I observed areas of peeling sheetrock and peeling paint in spaces 153, 252, 234, and 242. 15A NCAC 18A .2825(a) 807 A safe indoor and outdoor environment was not provided for the children. I observed exposed stakes on the bottom playground, a torn mat on the toddler playground, and torn chairs in space 145. 10A NCAC 09 .0601(a) 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. I observed uncovered outlets in spaces 131A, 137B, 235, and 234. 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. I observed an unlocked cabinet in space 135B containing a can of shaving cream and an unlocked cabinet in space 145 containing cleaning supplies and potting soil. .2820(b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. I observed a medication for a child no longer enrolled in space 235. .0803(12) 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. I observed plastic bags stored in unlocked cabinets in spaces 135B, 153, and 145. .0604(q) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. I observed three employee files that did not have documentation of reviewing the EMC plan. 10A NCAC 09 .0802(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. I observed three employee files that did not have documentation of having current First Aid training. .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. I observed three employee files that did not have documentation of CPR training. .1102(d) 1757 A valid qualification letter was not on file and available to review at the facility. I observed two employee files that did not have a current qualifying letter on file. G.S. 110-90.2(b) & (d) & .2703(e) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. I observed three employee files that did not have documentation of reviewing the EPR plan. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. I observed six employee files that did not have documentation of reviewing the shaken baby syndrome policy. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. I observed medications without authorization forms on file in spaces 137B(1), 141A(2), 146(2), 153(1), 246(3), 235(3), and 234(1). .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-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. I observed three employee files that did not have documentation of receiving the Recognizing and Responding to Suspicions of Child Maltreatment training. .1102(g) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violations cited during today's visit immediately and send me documentation verifying compliance on or before 10/09/2024. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to whitney.parker@dhhs.nc.gov or mail two copies of the letter to: Whitney Parker P.O. Box 1342 Lexington, NC 27293 Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit regarding cited violations: • A copy of the summary of the law should be posted for families to have access to viewing it. We discussed during the visit that you would print a new summary of the law and post it immediately. • All employees must review the facility’s emergency medical care plan upon hire to ensure they know what to do in the event of an emergency. We discussed that each employee should have documentation on file to ensure this review has occurred. You will need to ensure that all employees have a copy of the required documentation in their file immediately. • All employees must review the facility’s emergency preparedness and response plan upon hire to ensure they know what to do in the event of an emergency. We discussed that each employee should have documentation on file to ensure this review has occurred. You will need to ensure that all employees have a copy of the required documentation in their file immediately. • All employees must review the facility’s shaken baby syndrome policy prior to working with children birth through five years of age. We discussed that each employee should have documentation on file to ensure this review has occurred. You will need to ensure that all employees have a copy of the required documentation in their file immediately. • All employees must have CPR training within 90 days of hire. You stated you had a training class available in September or October. Make sure all employees who do not currently have CPR or who have an expired CPR card complete this training. • All employees must have First Aid training within 90 days of hire. You stated you had a training class available in September or October. Make sure all employees who do not currently have First Aid or who have an expired First Aid card complete this training. • All employees must have Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of hire. Make sure all employees who do not currently have this training complete it immediately if there are past their first 90 days of employment. • All employees are required to have a copy of their criminal background check letters on file for review. During the visit, I was able to view the two employees with missing qualifying letters in the ABCMS system. We discussed that these employees need to have their qualifying letter on file for review immediately. • We discussed that environments should be checked for hazards prior to children being present. We discussed that the exposed stakes on the bottom playground needed to be hammered down, the torn mat on the toddler playground needs to be removed, and the chairs in space 145 need to be recovered or removed. The broken toy was removed during the visit. I recommend doing regular inspections to look for broken toys or safety concerns each day prior to children arriving. You stated you would put in a work order to address this issue. • We discussed that all medications must have an authorization form on file to ensure they are being administered correctly. You removed all medications from the classrooms that did not have authorization forms during the visit to ensure that new forms were completed immediately. • Hazardous materials must be kept in locked storage at all times. You locked all required cabinets during the visit to ensure that items such as shaving creams, baking soda, cleaning supplies, and plastic bags, that must be kept in locked storage were locked. Any item that has more than one warning label has to be in locked storage. • Electrical outlets must be covered at all times when not in use to ensure children cannot access them. You covered all the electrical outlets that were uncovered during the visit. • Plastic cannot be accessible to children under three years of age. You removed all accessible plastic bags during the visit to ensure they were not accessible to the children in each space. • Walls must be in good repair and free of hazards. We discussed that the walls had several holes and areas where sheetrock and paint were peeling. You stated you would put in a work order to address this issue. • Leftover medicines must be returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. You removed the medications from the spaces and stated that they would be returned to the family or discarded. Additional Information/Consultation: • You must notify your consultant 30 days prior to changing the ownership status of your facility. Prior to making any name changes to your facility, call me first. We will discuss this prior to any changes taking place. • You can find update posters at this website: https://healthychildcare.unc.edu/resources/posters/ • Fire drills and emergency drills must be documented on DCDEE’s form. • On your staff orientation document, dates need to be provided when the employee received the training. Make sure all employees have orientation documents on file and accessible for review. • Make sure the employee and director sign all forms that have a required signature line. • Fluff the mulch on all the playgrounds. • Keep a check on the standing water on the large playground/garden area. • Keep a check on the ladder on the large structure on the bottom playground. The paint is chipping. • Keep a check on the green pour and play on the toddler playground. It is beginning to be worn and looks like it is being torn. • Make sure lesson plans are current and posted. • Make sure all employees have orientation documents. • I recommend having an emergency information sheet on file for each of your high school interns. • I recommend going through employee files and making sure all required documents are on file for every employee based on the employee file checklist. At the completion of the visit, this visit summary was reviewed with and provided to you. I left three copies of the visit summary first page and three copies of the completed staff and training worksheets with you during the visit. Please have Melissa Green or Renee Thompson review these documents as soon as possible. If they have any questions, please have them reach out to me. Once they have reviewed these documents, please have them sign all required lines and mail me the original staff and training worksheet, a copy of the staff and training worksheet, and two copies of the first page of the visit summary. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Whitney Parker, Child Care Consultant (336) 590-8765 whitney.parker@dhh.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0604 · Violation

Name of Operation: BRIGHT HORIZONS AT WAKE FOREST BAPTIST HEALTH Facility ID: 34000829 Consultant: WHITNEY PARKER Operation Type: Center Case Number: Visit Date: 9/25/2024 Number Present: 203 Completed Date: 9/25/2024 Age: From 0 To 5 Total Minutes: 365 Time In: 08:45 AM Time Out: 02:50 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable childcare requirements for a routine unannounced visit. This visit was conducted by Whitney Parker and Emily Lamquaye, Childcare Consultants, with Michelle Heath, Business Manager. Currently this program operates with a five-star license issued 9/29/2017. License restrictions include first and second shift; meets enhanced ratios; meets enhance space; children under 2 ½ in rooms with direct exits only. The NC Secretary of State website was reviewed on 08/08/2024 and Bright Horizons Children’s Centers LLC was listed as current and active. The program’s compliance history was 81% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • CPR / First Aid • Special Training • CBC Qualification • ITS – SIDS • Emergency Medical Care Plan • Administration of Medication • Storage of Hazardous Products • Storage of Medication • General Safety • Discipline • Adequate / Approved Space • Program Records • License Posted • Permit Restrictions The license was observed, and the restrictions were found in compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. I observed staff/child interactions today. I observed children engaging in free play, routine activities, and group time. Fifteen new staff were reported at this program. Files for new staff were reviewed. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Storage and administration of medication were monitored. Medication authorization was monitored. Storage hazardous items was monitored today. A playground inspection was recorded 08/20/2024. A fire drill was recorded 09/20/2024. A shelter in place drill for the facility was recorded 09/19/2024. The most recent fire inspection was on 04/25/2024. I observed a sanitation inspection was last conducted on 01/10/2024 earning a superior classification. The program does not provide transportation. The following violations were cited during today’s visit: Violation Number Comment Rule 115 A summary of the NC Child Care Law was not posted in a prominent place in the center. I did not observe a copy of the summary of the NC Child Care Law posted. G.S. 110-102 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. I observed areas of peeling sheetrock and peeling paint in spaces 153, 252, 234, and 242. 15A NCAC 18A .2825(a) 807 A safe indoor and outdoor environment was not provided for the children. I observed exposed stakes on the bottom playground, a torn mat on the toddler playground, and torn chairs in space 145. 10A NCAC 09 .0601(a) 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. I observed uncovered outlets in spaces 131A, 137B, 235, and 234. 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. I observed an unlocked cabinet in space 135B containing a can of shaving cream and an unlocked cabinet in space 145 containing cleaning supplies and potting soil. .2820(b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. I observed a medication for a child no longer enrolled in space 235. .0803(12) 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. I observed plastic bags stored in unlocked cabinets in spaces 135B, 153, and 145. .0604(q) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. I observed three employee files that did not have documentation of reviewing the EMC plan. 10A NCAC 09 .0802(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. I observed three employee files that did not have documentation of having current First Aid training. .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. I observed three employee files that did not have documentation of CPR training. .1102(d) 1757 A valid qualification letter was not on file and available to review at the facility. I observed two employee files that did not have a current qualifying letter on file. G.S. 110-90.2(b) & (d) & .2703(e) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. I observed three employee files that did not have documentation of reviewing the EPR plan. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. I observed six employee files that did not have documentation of reviewing the shaken baby syndrome policy. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. I observed medications without authorization forms on file in spaces 137B(1), 141A(2), 146(2), 153(1), 246(3), 235(3), and 234(1). .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-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. I observed three employee files that did not have documentation of receiving the Recognizing and Responding to Suspicions of Child Maltreatment training. .1102(g) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violations cited during today's visit immediately and send me documentation verifying compliance on or before 10/09/2024. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to whitney.parker@dhhs.nc.gov or mail two copies of the letter to: Whitney Parker P.O. Box 1342 Lexington, NC 27293 Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit regarding cited violations: • A copy of the summary of the law should be posted for families to have access to viewing it. We discussed during the visit that you would print a new summary of the law and post it immediately. • All employees must review the facility’s emergency medical care plan upon hire to ensure they know what to do in the event of an emergency. We discussed that each employee should have documentation on file to ensure this review has occurred. You will need to ensure that all employees have a copy of the required documentation in their file immediately. • All employees must review the facility’s emergency preparedness and response plan upon hire to ensure they know what to do in the event of an emergency. We discussed that each employee should have documentation on file to ensure this review has occurred. You will need to ensure that all employees have a copy of the required documentation in their file immediately. • All employees must review the facility’s shaken baby syndrome policy prior to working with children birth through five years of age. We discussed that each employee should have documentation on file to ensure this review has occurred. You will need to ensure that all employees have a copy of the required documentation in their file immediately. • All employees must have CPR training within 90 days of hire. You stated you had a training class available in September or October. Make sure all employees who do not currently have CPR or who have an expired CPR card complete this training. • All employees must have First Aid training within 90 days of hire. You stated you had a training class available in September or October. Make sure all employees who do not currently have First Aid or who have an expired First Aid card complete this training. • All employees must have Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of hire. Make sure all employees who do not currently have this training complete it immediately if there are past their first 90 days of employment. • All employees are required to have a copy of their criminal background check letters on file for review. During the visit, I was able to view the two employees with missing qualifying letters in the ABCMS system. We discussed that these employees need to have their qualifying letter on file for review immediately. • We discussed that environments should be checked for hazards prior to children being present. We discussed that the exposed stakes on the bottom playground needed to be hammered down, the torn mat on the toddler playground needs to be removed, and the chairs in space 145 need to be recovered or removed. The broken toy was removed during the visit. I recommend doing regular inspections to look for broken toys or safety concerns each day prior to children arriving. You stated you would put in a work order to address this issue. • We discussed that all medications must have an authorization form on file to ensure they are being administered correctly. You removed all medications from the classrooms that did not have authorization forms during the visit to ensure that new forms were completed immediately. • Hazardous materials must be kept in locked storage at all times. You locked all required cabinets during the visit to ensure that items such as shaving creams, baking soda, cleaning supplies, and plastic bags, that must be kept in locked storage were locked. Any item that has more than one warning label has to be in locked storage. • Electrical outlets must be covered at all times when not in use to ensure children cannot access them. You covered all the electrical outlets that were uncovered during the visit. • Plastic cannot be accessible to children under three years of age. You removed all accessible plastic bags during the visit to ensure they were not accessible to the children in each space. • Walls must be in good repair and free of hazards. We discussed that the walls had several holes and areas where sheetrock and paint were peeling. You stated you would put in a work order to address this issue. • Leftover medicines must be returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. You removed the medications from the spaces and stated that they would be returned to the family or discarded. Additional Information/Consultation: • You must notify your consultant 30 days prior to changing the ownership status of your facility. Prior to making any name changes to your facility, call me first. We will discuss this prior to any changes taking place. • You can find update posters at this website: https://healthychildcare.unc.edu/resources/posters/ • Fire drills and emergency drills must be documented on DCDEE’s form. • On your staff orientation document, dates need to be provided when the employee received the training. Make sure all employees have orientation documents on file and accessible for review. • Make sure the employee and director sign all forms that have a required signature line. • Fluff the mulch on all the playgrounds. • Keep a check on the standing water on the large playground/garden area. • Keep a check on the ladder on the large structure on the bottom playground. The paint is chipping. • Keep a check on the green pour and play on the toddler playground. It is beginning to be worn and looks like it is being torn. • Make sure lesson plans are current and posted. • Make sure all employees have orientation documents. • I recommend having an emergency information sheet on file for each of your high school interns. • I recommend going through employee files and making sure all required documents are on file for every employee based on the employee file checklist. At the completion of the visit, this visit summary was reviewed with and provided to you. I left three copies of the visit summary first page and three copies of the completed staff and training worksheets with you during the visit. Please have Melissa Green or Renee Thompson review these documents as soon as possible. If they have any questions, please have them reach out to me. Once they have reviewed these documents, please have them sign all required lines and mail me the original staff and training worksheet, a copy of the staff and training worksheet, and two copies of the first page of the visit summary. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Whitney Parker, Child Care Consultant (336) 590-8765 whitney.parker@dhh.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0802 · Violation

Name of Operation: BRIGHT HORIZONS AT WAKE FOREST BAPTIST HEALTH Facility ID: 34000829 Consultant: WHITNEY PARKER Operation Type: Center Case Number: Visit Date: 9/25/2024 Number Present: 203 Completed Date: 9/25/2024 Age: From 0 To 5 Total Minutes: 365 Time In: 08:45 AM Time Out: 02:50 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable childcare requirements for a routine unannounced visit. This visit was conducted by Whitney Parker and Emily Lamquaye, Childcare Consultants, with Michelle Heath, Business Manager. Currently this program operates with a five-star license issued 9/29/2017. License restrictions include first and second shift; meets enhanced ratios; meets enhance space; children under 2 ½ in rooms with direct exits only. The NC Secretary of State website was reviewed on 08/08/2024 and Bright Horizons Children’s Centers LLC was listed as current and active. The program’s compliance history was 81% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • CPR / First Aid • Special Training • CBC Qualification • ITS – SIDS • Emergency Medical Care Plan • Administration of Medication • Storage of Hazardous Products • Storage of Medication • General Safety • Discipline • Adequate / Approved Space • Program Records • License Posted • Permit Restrictions The license was observed, and the restrictions were found in compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. I observed staff/child interactions today. I observed children engaging in free play, routine activities, and group time. Fifteen new staff were reported at this program. Files for new staff were reviewed. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Storage and administration of medication were monitored. Medication authorization was monitored. Storage hazardous items was monitored today. A playground inspection was recorded 08/20/2024. A fire drill was recorded 09/20/2024. A shelter in place drill for the facility was recorded 09/19/2024. The most recent fire inspection was on 04/25/2024. I observed a sanitation inspection was last conducted on 01/10/2024 earning a superior classification. The program does not provide transportation. The following violations were cited during today’s visit: Violation Number Comment Rule 115 A summary of the NC Child Care Law was not posted in a prominent place in the center. I did not observe a copy of the summary of the NC Child Care Law posted. G.S. 110-102 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. I observed areas of peeling sheetrock and peeling paint in spaces 153, 252, 234, and 242. 15A NCAC 18A .2825(a) 807 A safe indoor and outdoor environment was not provided for the children. I observed exposed stakes on the bottom playground, a torn mat on the toddler playground, and torn chairs in space 145. 10A NCAC 09 .0601(a) 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. I observed uncovered outlets in spaces 131A, 137B, 235, and 234. 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. I observed an unlocked cabinet in space 135B containing a can of shaving cream and an unlocked cabinet in space 145 containing cleaning supplies and potting soil. .2820(b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. I observed a medication for a child no longer enrolled in space 235. .0803(12) 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. I observed plastic bags stored in unlocked cabinets in spaces 135B, 153, and 145. .0604(q) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. I observed three employee files that did not have documentation of reviewing the EMC plan. 10A NCAC 09 .0802(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. I observed three employee files that did not have documentation of having current First Aid training. .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. I observed three employee files that did not have documentation of CPR training. .1102(d) 1757 A valid qualification letter was not on file and available to review at the facility. I observed two employee files that did not have a current qualifying letter on file. G.S. 110-90.2(b) & (d) & .2703(e) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. I observed three employee files that did not have documentation of reviewing the EPR plan. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. I observed six employee files that did not have documentation of reviewing the shaken baby syndrome policy. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. I observed medications without authorization forms on file in spaces 137B(1), 141A(2), 146(2), 153(1), 246(3), 235(3), and 234(1). .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-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. I observed three employee files that did not have documentation of receiving the Recognizing and Responding to Suspicions of Child Maltreatment training. .1102(g) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violations cited during today's visit immediately and send me documentation verifying compliance on or before 10/09/2024. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to whitney.parker@dhhs.nc.gov or mail two copies of the letter to: Whitney Parker P.O. Box 1342 Lexington, NC 27293 Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit regarding cited violations: • A copy of the summary of the law should be posted for families to have access to viewing it. We discussed during the visit that you would print a new summary of the law and post it immediately. • All employees must review the facility’s emergency medical care plan upon hire to ensure they know what to do in the event of an emergency. We discussed that each employee should have documentation on file to ensure this review has occurred. You will need to ensure that all employees have a copy of the required documentation in their file immediately. • All employees must review the facility’s emergency preparedness and response plan upon hire to ensure they know what to do in the event of an emergency. We discussed that each employee should have documentation on file to ensure this review has occurred. You will need to ensure that all employees have a copy of the required documentation in their file immediately. • All employees must review the facility’s shaken baby syndrome policy prior to working with children birth through five years of age. We discussed that each employee should have documentation on file to ensure this review has occurred. You will need to ensure that all employees have a copy of the required documentation in their file immediately. • All employees must have CPR training within 90 days of hire. You stated you had a training class available in September or October. Make sure all employees who do not currently have CPR or who have an expired CPR card complete this training. • All employees must have First Aid training within 90 days of hire. You stated you had a training class available in September or October. Make sure all employees who do not currently have First Aid or who have an expired First Aid card complete this training. • All employees must have Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of hire. Make sure all employees who do not currently have this training complete it immediately if there are past their first 90 days of employment. • All employees are required to have a copy of their criminal background check letters on file for review. During the visit, I was able to view the two employees with missing qualifying letters in the ABCMS system. We discussed that these employees need to have their qualifying letter on file for review immediately. • We discussed that environments should be checked for hazards prior to children being present. We discussed that the exposed stakes on the bottom playground needed to be hammered down, the torn mat on the toddler playground needs to be removed, and the chairs in space 145 need to be recovered or removed. The broken toy was removed during the visit. I recommend doing regular inspections to look for broken toys or safety concerns each day prior to children arriving. You stated you would put in a work order to address this issue. • We discussed that all medications must have an authorization form on file to ensure they are being administered correctly. You removed all medications from the classrooms that did not have authorization forms during the visit to ensure that new forms were completed immediately. • Hazardous materials must be kept in locked storage at all times. You locked all required cabinets during the visit to ensure that items such as shaving creams, baking soda, cleaning supplies, and plastic bags, that must be kept in locked storage were locked. Any item that has more than one warning label has to be in locked storage. • Electrical outlets must be covered at all times when not in use to ensure children cannot access them. You covered all the electrical outlets that were uncovered during the visit. • Plastic cannot be accessible to children under three years of age. You removed all accessible plastic bags during the visit to ensure they were not accessible to the children in each space. • Walls must be in good repair and free of hazards. We discussed that the walls had several holes and areas where sheetrock and paint were peeling. You stated you would put in a work order to address this issue. • Leftover medicines must be returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. You removed the medications from the spaces and stated that they would be returned to the family or discarded. Additional Information/Consultation: • You must notify your consultant 30 days prior to changing the ownership status of your facility. Prior to making any name changes to your facility, call me first. We will discuss this prior to any changes taking place. • You can find update posters at this website: https://healthychildcare.unc.edu/resources/posters/ • Fire drills and emergency drills must be documented on DCDEE’s form. • On your staff orientation document, dates need to be provided when the employee received the training. Make sure all employees have orientation documents on file and accessible for review. • Make sure the employee and director sign all forms that have a required signature line. • Fluff the mulch on all the playgrounds. • Keep a check on the standing water on the large playground/garden area. • Keep a check on the ladder on the large structure on the bottom playground. The paint is chipping. • Keep a check on the green pour and play on the toddler playground. It is beginning to be worn and looks like it is being torn. • Make sure lesson plans are current and posted. • Make sure all employees have orientation documents. • I recommend having an emergency information sheet on file for each of your high school interns. • I recommend going through employee files and making sure all required documents are on file for every employee based on the employee file checklist. At the completion of the visit, this visit summary was reviewed with and provided to you. I left three copies of the visit summary first page and three copies of the completed staff and training worksheets with you during the visit. Please have Melissa Green or Renee Thompson review these documents as soon as possible. If they have any questions, please have them reach out to me. Once they have reviewed these documents, please have them sign all required lines and mail me the original staff and training worksheet, a copy of the staff and training worksheet, and two copies of the first page of the visit summary. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Whitney Parker, Child Care Consultant (336) 590-8765 whitney.parker@dhh.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-102 · Violation

Name of Operation: BRIGHT HORIZONS AT WAKE FOREST BAPTIST HEALTH Facility ID: 34000829 Consultant: WHITNEY PARKER Operation Type: Center Case Number: Visit Date: 9/25/2024 Number Present: 203 Completed Date: 9/25/2024 Age: From 0 To 5 Total Minutes: 365 Time In: 08:45 AM Time Out: 02:50 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable childcare requirements for a routine unannounced visit. This visit was conducted by Whitney Parker and Emily Lamquaye, Childcare Consultants, with Michelle Heath, Business Manager. Currently this program operates with a five-star license issued 9/29/2017. License restrictions include first and second shift; meets enhanced ratios; meets enhance space; children under 2 ½ in rooms with direct exits only. The NC Secretary of State website was reviewed on 08/08/2024 and Bright Horizons Children’s Centers LLC was listed as current and active. The program’s compliance history was 81% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • CPR / First Aid • Special Training • CBC Qualification • ITS – SIDS • Emergency Medical Care Plan • Administration of Medication • Storage of Hazardous Products • Storage of Medication • General Safety • Discipline • Adequate / Approved Space • Program Records • License Posted • Permit Restrictions The license was observed, and the restrictions were found in compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. I observed staff/child interactions today. I observed children engaging in free play, routine activities, and group time. Fifteen new staff were reported at this program. Files for new staff were reviewed. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Storage and administration of medication were monitored. Medication authorization was monitored. Storage hazardous items was monitored today. A playground inspection was recorded 08/20/2024. A fire drill was recorded 09/20/2024. A shelter in place drill for the facility was recorded 09/19/2024. The most recent fire inspection was on 04/25/2024. I observed a sanitation inspection was last conducted on 01/10/2024 earning a superior classification. The program does not provide transportation. The following violations were cited during today’s visit: Violation Number Comment Rule 115 A summary of the NC Child Care Law was not posted in a prominent place in the center. I did not observe a copy of the summary of the NC Child Care Law posted. G.S. 110-102 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. I observed areas of peeling sheetrock and peeling paint in spaces 153, 252, 234, and 242. 15A NCAC 18A .2825(a) 807 A safe indoor and outdoor environment was not provided for the children. I observed exposed stakes on the bottom playground, a torn mat on the toddler playground, and torn chairs in space 145. 10A NCAC 09 .0601(a) 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. I observed uncovered outlets in spaces 131A, 137B, 235, and 234. 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. I observed an unlocked cabinet in space 135B containing a can of shaving cream and an unlocked cabinet in space 145 containing cleaning supplies and potting soil. .2820(b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. I observed a medication for a child no longer enrolled in space 235. .0803(12) 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. I observed plastic bags stored in unlocked cabinets in spaces 135B, 153, and 145. .0604(q) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. I observed three employee files that did not have documentation of reviewing the EMC plan. 10A NCAC 09 .0802(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. I observed three employee files that did not have documentation of having current First Aid training. .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. I observed three employee files that did not have documentation of CPR training. .1102(d) 1757 A valid qualification letter was not on file and available to review at the facility. I observed two employee files that did not have a current qualifying letter on file. G.S. 110-90.2(b) & (d) & .2703(e) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. I observed three employee files that did not have documentation of reviewing the EPR plan. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. I observed six employee files that did not have documentation of reviewing the shaken baby syndrome policy. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. I observed medications without authorization forms on file in spaces 137B(1), 141A(2), 146(2), 153(1), 246(3), 235(3), and 234(1). .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-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. I observed three employee files that did not have documentation of receiving the Recognizing and Responding to Suspicions of Child Maltreatment training. .1102(g) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violations cited during today's visit immediately and send me documentation verifying compliance on or before 10/09/2024. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to whitney.parker@dhhs.nc.gov or mail two copies of the letter to: Whitney Parker P.O. Box 1342 Lexington, NC 27293 Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit regarding cited violations: • A copy of the summary of the law should be posted for families to have access to viewing it. We discussed during the visit that you would print a new summary of the law and post it immediately. • All employees must review the facility’s emergency medical care plan upon hire to ensure they know what to do in the event of an emergency. We discussed that each employee should have documentation on file to ensure this review has occurred. You will need to ensure that all employees have a copy of the required documentation in their file immediately. • All employees must review the facility’s emergency preparedness and response plan upon hire to ensure they know what to do in the event of an emergency. We discussed that each employee should have documentation on file to ensure this review has occurred. You will need to ensure that all employees have a copy of the required documentation in their file immediately. • All employees must review the facility’s shaken baby syndrome policy prior to working with children birth through five years of age. We discussed that each employee should have documentation on file to ensure this review has occurred. You will need to ensure that all employees have a copy of the required documentation in their file immediately. • All employees must have CPR training within 90 days of hire. You stated you had a training class available in September or October. Make sure all employees who do not currently have CPR or who have an expired CPR card complete this training. • All employees must have First Aid training within 90 days of hire. You stated you had a training class available in September or October. Make sure all employees who do not currently have First Aid or who have an expired First Aid card complete this training. • All employees must have Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of hire. Make sure all employees who do not currently have this training complete it immediately if there are past their first 90 days of employment. • All employees are required to have a copy of their criminal background check letters on file for review. During the visit, I was able to view the two employees with missing qualifying letters in the ABCMS system. We discussed that these employees need to have their qualifying letter on file for review immediately. • We discussed that environments should be checked for hazards prior to children being present. We discussed that the exposed stakes on the bottom playground needed to be hammered down, the torn mat on the toddler playground needs to be removed, and the chairs in space 145 need to be recovered or removed. The broken toy was removed during the visit. I recommend doing regular inspections to look for broken toys or safety concerns each day prior to children arriving. You stated you would put in a work order to address this issue. • We discussed that all medications must have an authorization form on file to ensure they are being administered correctly. You removed all medications from the classrooms that did not have authorization forms during the visit to ensure that new forms were completed immediately. • Hazardous materials must be kept in locked storage at all times. You locked all required cabinets during the visit to ensure that items such as shaving creams, baking soda, cleaning supplies, and plastic bags, that must be kept in locked storage were locked. Any item that has more than one warning label has to be in locked storage. • Electrical outlets must be covered at all times when not in use to ensure children cannot access them. You covered all the electrical outlets that were uncovered during the visit. • Plastic cannot be accessible to children under three years of age. You removed all accessible plastic bags during the visit to ensure they were not accessible to the children in each space. • Walls must be in good repair and free of hazards. We discussed that the walls had several holes and areas where sheetrock and paint were peeling. You stated you would put in a work order to address this issue. • Leftover medicines must be returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. You removed the medications from the spaces and stated that they would be returned to the family or discarded. Additional Information/Consultation: • You must notify your consultant 30 days prior to changing the ownership status of your facility. Prior to making any name changes to your facility, call me first. We will discuss this prior to any changes taking place. • You can find update posters at this website: https://healthychildcare.unc.edu/resources/posters/ • Fire drills and emergency drills must be documented on DCDEE’s form. • On your staff orientation document, dates need to be provided when the employee received the training. Make sure all employees have orientation documents on file and accessible for review. • Make sure the employee and director sign all forms that have a required signature line. • Fluff the mulch on all the playgrounds. • Keep a check on the standing water on the large playground/garden area. • Keep a check on the ladder on the large structure on the bottom playground. The paint is chipping. • Keep a check on the green pour and play on the toddler playground. It is beginning to be worn and looks like it is being torn. • Make sure lesson plans are current and posted. • Make sure all employees have orientation documents. • I recommend having an emergency information sheet on file for each of your high school interns. • I recommend going through employee files and making sure all required documents are on file for every employee based on the employee file checklist. At the completion of the visit, this visit summary was reviewed with and provided to you. I left three copies of the visit summary first page and three copies of the completed staff and training worksheets with you during the visit. Please have Melissa Green or Renee Thompson review these documents as soon as possible. If they have any questions, please have them reach out to me. Once they have reviewed these documents, please have them sign all required lines and mail me the original staff and training worksheet, a copy of the staff and training worksheet, and two copies of the first page of the visit summary. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Whitney Parker, Child Care Consultant (336) 590-8765 whitney.parker@dhh.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: BRIGHT HORIZONS AT WAKE FOREST BAPTIST HEALTH Facility ID: 34000829 Consultant: WHITNEY PARKER Operation Type: Center Case Number: Visit Date: 9/25/2024 Number Present: 203 Completed Date: 9/25/2024 Age: From 0 To 5 Total Minutes: 365 Time In: 08:45 AM Time Out: 02:50 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable childcare requirements for a routine unannounced visit. This visit was conducted by Whitney Parker and Emily Lamquaye, Childcare Consultants, with Michelle Heath, Business Manager. Currently this program operates with a five-star license issued 9/29/2017. License restrictions include first and second shift; meets enhanced ratios; meets enhance space; children under 2 ½ in rooms with direct exits only. The NC Secretary of State website was reviewed on 08/08/2024 and Bright Horizons Children’s Centers LLC was listed as current and active. The program’s compliance history was 81% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • CPR / First Aid • Special Training • CBC Qualification • ITS – SIDS • Emergency Medical Care Plan • Administration of Medication • Storage of Hazardous Products • Storage of Medication • General Safety • Discipline • Adequate / Approved Space • Program Records • License Posted • Permit Restrictions The license was observed, and the restrictions were found in compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. I observed staff/child interactions today. I observed children engaging in free play, routine activities, and group time. Fifteen new staff were reported at this program. Files for new staff were reviewed. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Storage and administration of medication were monitored. Medication authorization was monitored. Storage hazardous items was monitored today. A playground inspection was recorded 08/20/2024. A fire drill was recorded 09/20/2024. A shelter in place drill for the facility was recorded 09/19/2024. The most recent fire inspection was on 04/25/2024. I observed a sanitation inspection was last conducted on 01/10/2024 earning a superior classification. The program does not provide transportation. The following violations were cited during today’s visit: Violation Number Comment Rule 115 A summary of the NC Child Care Law was not posted in a prominent place in the center. I did not observe a copy of the summary of the NC Child Care Law posted. G.S. 110-102 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. I observed areas of peeling sheetrock and peeling paint in spaces 153, 252, 234, and 242. 15A NCAC 18A .2825(a) 807 A safe indoor and outdoor environment was not provided for the children. I observed exposed stakes on the bottom playground, a torn mat on the toddler playground, and torn chairs in space 145. 10A NCAC 09 .0601(a) 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. I observed uncovered outlets in spaces 131A, 137B, 235, and 234. 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. I observed an unlocked cabinet in space 135B containing a can of shaving cream and an unlocked cabinet in space 145 containing cleaning supplies and potting soil. .2820(b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. I observed a medication for a child no longer enrolled in space 235. .0803(12) 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. I observed plastic bags stored in unlocked cabinets in spaces 135B, 153, and 145. .0604(q) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. I observed three employee files that did not have documentation of reviewing the EMC plan. 10A NCAC 09 .0802(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. I observed three employee files that did not have documentation of having current First Aid training. .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. I observed three employee files that did not have documentation of CPR training. .1102(d) 1757 A valid qualification letter was not on file and available to review at the facility. I observed two employee files that did not have a current qualifying letter on file. G.S. 110-90.2(b) & (d) & .2703(e) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. I observed three employee files that did not have documentation of reviewing the EPR plan. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. I observed six employee files that did not have documentation of reviewing the shaken baby syndrome policy. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. I observed medications without authorization forms on file in spaces 137B(1), 141A(2), 146(2), 153(1), 246(3), 235(3), and 234(1). .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-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. I observed three employee files that did not have documentation of receiving the Recognizing and Responding to Suspicions of Child Maltreatment training. .1102(g) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violations cited during today's visit immediately and send me documentation verifying compliance on or before 10/09/2024. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to whitney.parker@dhhs.nc.gov or mail two copies of the letter to: Whitney Parker P.O. Box 1342 Lexington, NC 27293 Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit regarding cited violations: • A copy of the summary of the law should be posted for families to have access to viewing it. We discussed during the visit that you would print a new summary of the law and post it immediately. • All employees must review the facility’s emergency medical care plan upon hire to ensure they know what to do in the event of an emergency. We discussed that each employee should have documentation on file to ensure this review has occurred. You will need to ensure that all employees have a copy of the required documentation in their file immediately. • All employees must review the facility’s emergency preparedness and response plan upon hire to ensure they know what to do in the event of an emergency. We discussed that each employee should have documentation on file to ensure this review has occurred. You will need to ensure that all employees have a copy of the required documentation in their file immediately. • All employees must review the facility’s shaken baby syndrome policy prior to working with children birth through five years of age. We discussed that each employee should have documentation on file to ensure this review has occurred. You will need to ensure that all employees have a copy of the required documentation in their file immediately. • All employees must have CPR training within 90 days of hire. You stated you had a training class available in September or October. Make sure all employees who do not currently have CPR or who have an expired CPR card complete this training. • All employees must have First Aid training within 90 days of hire. You stated you had a training class available in September or October. Make sure all employees who do not currently have First Aid or who have an expired First Aid card complete this training. • All employees must have Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of hire. Make sure all employees who do not currently have this training complete it immediately if there are past their first 90 days of employment. • All employees are required to have a copy of their criminal background check letters on file for review. During the visit, I was able to view the two employees with missing qualifying letters in the ABCMS system. We discussed that these employees need to have their qualifying letter on file for review immediately. • We discussed that environments should be checked for hazards prior to children being present. We discussed that the exposed stakes on the bottom playground needed to be hammered down, the torn mat on the toddler playground needs to be removed, and the chairs in space 145 need to be recovered or removed. The broken toy was removed during the visit. I recommend doing regular inspections to look for broken toys or safety concerns each day prior to children arriving. You stated you would put in a work order to address this issue. • We discussed that all medications must have an authorization form on file to ensure they are being administered correctly. You removed all medications from the classrooms that did not have authorization forms during the visit to ensure that new forms were completed immediately. • Hazardous materials must be kept in locked storage at all times. You locked all required cabinets during the visit to ensure that items such as shaving creams, baking soda, cleaning supplies, and plastic bags, that must be kept in locked storage were locked. Any item that has more than one warning label has to be in locked storage. • Electrical outlets must be covered at all times when not in use to ensure children cannot access them. You covered all the electrical outlets that were uncovered during the visit. • Plastic cannot be accessible to children under three years of age. You removed all accessible plastic bags during the visit to ensure they were not accessible to the children in each space. • Walls must be in good repair and free of hazards. We discussed that the walls had several holes and areas where sheetrock and paint were peeling. You stated you would put in a work order to address this issue. • Leftover medicines must be returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. You removed the medications from the spaces and stated that they would be returned to the family or discarded. Additional Information/Consultation: • You must notify your consultant 30 days prior to changing the ownership status of your facility. Prior to making any name changes to your facility, call me first. We will discuss this prior to any changes taking place. • You can find update posters at this website: https://healthychildcare.unc.edu/resources/posters/ • Fire drills and emergency drills must be documented on DCDEE’s form. • On your staff orientation document, dates need to be provided when the employee received the training. Make sure all employees have orientation documents on file and accessible for review. • Make sure the employee and director sign all forms that have a required signature line. • Fluff the mulch on all the playgrounds. • Keep a check on the standing water on the large playground/garden area. • Keep a check on the ladder on the large structure on the bottom playground. The paint is chipping. • Keep a check on the green pour and play on the toddler playground. It is beginning to be worn and looks like it is being torn. • Make sure lesson plans are current and posted. • Make sure all employees have orientation documents. • I recommend having an emergency information sheet on file for each of your high school interns. • I recommend going through employee files and making sure all required documents are on file for every employee based on the employee file checklist. At the completion of the visit, this visit summary was reviewed with and provided to you. I left three copies of the visit summary first page and three copies of the completed staff and training worksheets with you during the visit. Please have Melissa Green or Renee Thompson review these documents as soon as possible. If they have any questions, please have them reach out to me. Once they have reviewed these documents, please have them sign all required lines and mail me the original staff and training worksheet, a copy of the staff and training worksheet, and two copies of the first page of the visit summary. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Whitney Parker, Child Care Consultant (336) 590-8765 whitney.parker@dhh.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: BRIGHT HORIZONS AT WAKE FOREST BAPTIST HEALTH Facility ID: 34000829 Consultant: WHITNEY PARKER Operation Type: Center Case Number: Visit Date: 9/25/2024 Number Present: 203 Completed Date: 9/25/2024 Age: From 0 To 5 Total Minutes: 365 Time In: 08:45 AM Time Out: 02:50 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable childcare requirements for a routine unannounced visit. This visit was conducted by Whitney Parker and Emily Lamquaye, Childcare Consultants, with Michelle Heath, Business Manager. Currently this program operates with a five-star license issued 9/29/2017. License restrictions include first and second shift; meets enhanced ratios; meets enhance space; children under 2 ½ in rooms with direct exits only. The NC Secretary of State website was reviewed on 08/08/2024 and Bright Horizons Children’s Centers LLC was listed as current and active. The program’s compliance history was 81% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • CPR / First Aid • Special Training • CBC Qualification • ITS – SIDS • Emergency Medical Care Plan • Administration of Medication • Storage of Hazardous Products • Storage of Medication • General Safety • Discipline • Adequate / Approved Space • Program Records • License Posted • Permit Restrictions The license was observed, and the restrictions were found in compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. I observed staff/child interactions today. I observed children engaging in free play, routine activities, and group time. Fifteen new staff were reported at this program. Files for new staff were reviewed. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Storage and administration of medication were monitored. Medication authorization was monitored. Storage hazardous items was monitored today. A playground inspection was recorded 08/20/2024. A fire drill was recorded 09/20/2024. A shelter in place drill for the facility was recorded 09/19/2024. The most recent fire inspection was on 04/25/2024. I observed a sanitation inspection was last conducted on 01/10/2024 earning a superior classification. The program does not provide transportation. The following violations were cited during today’s visit: Violation Number Comment Rule 115 A summary of the NC Child Care Law was not posted in a prominent place in the center. I did not observe a copy of the summary of the NC Child Care Law posted. G.S. 110-102 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. I observed areas of peeling sheetrock and peeling paint in spaces 153, 252, 234, and 242. 15A NCAC 18A .2825(a) 807 A safe indoor and outdoor environment was not provided for the children. I observed exposed stakes on the bottom playground, a torn mat on the toddler playground, and torn chairs in space 145. 10A NCAC 09 .0601(a) 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. I observed uncovered outlets in spaces 131A, 137B, 235, and 234. 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. I observed an unlocked cabinet in space 135B containing a can of shaving cream and an unlocked cabinet in space 145 containing cleaning supplies and potting soil. .2820(b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. I observed a medication for a child no longer enrolled in space 235. .0803(12) 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. I observed plastic bags stored in unlocked cabinets in spaces 135B, 153, and 145. .0604(q) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. I observed three employee files that did not have documentation of reviewing the EMC plan. 10A NCAC 09 .0802(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. I observed three employee files that did not have documentation of having current First Aid training. .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. I observed three employee files that did not have documentation of CPR training. .1102(d) 1757 A valid qualification letter was not on file and available to review at the facility. I observed two employee files that did not have a current qualifying letter on file. G.S. 110-90.2(b) & (d) & .2703(e) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. I observed three employee files that did not have documentation of reviewing the EPR plan. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. I observed six employee files that did not have documentation of reviewing the shaken baby syndrome policy. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. I observed medications without authorization forms on file in spaces 137B(1), 141A(2), 146(2), 153(1), 246(3), 235(3), and 234(1). .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-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. I observed three employee files that did not have documentation of receiving the Recognizing and Responding to Suspicions of Child Maltreatment training. .1102(g) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violations cited during today's visit immediately and send me documentation verifying compliance on or before 10/09/2024. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to whitney.parker@dhhs.nc.gov or mail two copies of the letter to: Whitney Parker P.O. Box 1342 Lexington, NC 27293 Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit regarding cited violations: • A copy of the summary of the law should be posted for families to have access to viewing it. We discussed during the visit that you would print a new summary of the law and post it immediately. • All employees must review the facility’s emergency medical care plan upon hire to ensure they know what to do in the event of an emergency. We discussed that each employee should have documentation on file to ensure this review has occurred. You will need to ensure that all employees have a copy of the required documentation in their file immediately. • All employees must review the facility’s emergency preparedness and response plan upon hire to ensure they know what to do in the event of an emergency. We discussed that each employee should have documentation on file to ensure this review has occurred. You will need to ensure that all employees have a copy of the required documentation in their file immediately. • All employees must review the facility’s shaken baby syndrome policy prior to working with children birth through five years of age. We discussed that each employee should have documentation on file to ensure this review has occurred. You will need to ensure that all employees have a copy of the required documentation in their file immediately. • All employees must have CPR training within 90 days of hire. You stated you had a training class available in September or October. Make sure all employees who do not currently have CPR or who have an expired CPR card complete this training. • All employees must have First Aid training within 90 days of hire. You stated you had a training class available in September or October. Make sure all employees who do not currently have First Aid or who have an expired First Aid card complete this training. • All employees must have Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of hire. Make sure all employees who do not currently have this training complete it immediately if there are past their first 90 days of employment. • All employees are required to have a copy of their criminal background check letters on file for review. During the visit, I was able to view the two employees with missing qualifying letters in the ABCMS system. We discussed that these employees need to have their qualifying letter on file for review immediately. • We discussed that environments should be checked for hazards prior to children being present. We discussed that the exposed stakes on the bottom playground needed to be hammered down, the torn mat on the toddler playground needs to be removed, and the chairs in space 145 need to be recovered or removed. The broken toy was removed during the visit. I recommend doing regular inspections to look for broken toys or safety concerns each day prior to children arriving. You stated you would put in a work order to address this issue. • We discussed that all medications must have an authorization form on file to ensure they are being administered correctly. You removed all medications from the classrooms that did not have authorization forms during the visit to ensure that new forms were completed immediately. • Hazardous materials must be kept in locked storage at all times. You locked all required cabinets during the visit to ensure that items such as shaving creams, baking soda, cleaning supplies, and plastic bags, that must be kept in locked storage were locked. Any item that has more than one warning label has to be in locked storage. • Electrical outlets must be covered at all times when not in use to ensure children cannot access them. You covered all the electrical outlets that were uncovered during the visit. • Plastic cannot be accessible to children under three years of age. You removed all accessible plastic bags during the visit to ensure they were not accessible to the children in each space. • Walls must be in good repair and free of hazards. We discussed that the walls had several holes and areas where sheetrock and paint were peeling. You stated you would put in a work order to address this issue. • Leftover medicines must be returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. You removed the medications from the spaces and stated that they would be returned to the family or discarded. Additional Information/Consultation: • You must notify your consultant 30 days prior to changing the ownership status of your facility. Prior to making any name changes to your facility, call me first. We will discuss this prior to any changes taking place. • You can find update posters at this website: https://healthychildcare.unc.edu/resources/posters/ • Fire drills and emergency drills must be documented on DCDEE’s form. • On your staff orientation document, dates need to be provided when the employee received the training. Make sure all employees have orientation documents on file and accessible for review. • Make sure the employee and director sign all forms that have a required signature line. • Fluff the mulch on all the playgrounds. • Keep a check on the standing water on the large playground/garden area. • Keep a check on the ladder on the large structure on the bottom playground. The paint is chipping. • Keep a check on the green pour and play on the toddler playground. It is beginning to be worn and looks like it is being torn. • Make sure lesson plans are current and posted. • Make sure all employees have orientation documents. • I recommend having an emergency information sheet on file for each of your high school interns. • I recommend going through employee files and making sure all required documents are on file for every employee based on the employee file checklist. At the completion of the visit, this visit summary was reviewed with and provided to you. I left three copies of the visit summary first page and three copies of the completed staff and training worksheets with you during the visit. Please have Melissa Green or Renee Thompson review these documents as soon as possible. If they have any questions, please have them reach out to me. Once they have reviewed these documents, please have them sign all required lines and mail me the original staff and training worksheet, a copy of the staff and training worksheet, and two copies of the first page of the visit summary. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Whitney Parker, Child Care Consultant (336) 590-8765 whitney.parker@dhh.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0803 · Violation

Name of Operation: BRIGHT HORIZONS AT WAKE FOREST BAPTIST HEALTH Facility ID: 34000829 Consultant: WHITNEY PARKER Operation Type: Center Case Number: Visit Date: 4/2/2024 Number Present: 203 Completed Date: 4/2/2024 Age: From 0 To 5 Total Minutes: 275 Time In: 09:00 AM Time Out: 01:35 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements. This visit was conducted by Whitney Parker, Childcare Consultant, with Melissa Green, Director. Currently this program operates with a five-star license issued 9/29/2017. License restrictions include first and second shift; meets enhanced ratios; meets enhance space; children under 2 ½ in rooms with direct exits only. The NC Secretary of State website was reviewed on 04/01/2024 and Bright Horizons Children’s Centers LLC was listed as current and active. The license was observed, and the restrictions were found in compliance. The program’s compliance history was 78% prior to today’s visit. All programs are required to maintain at least 75% compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. I observed staff/child interactions today. I observed children engaging in free play, routine activities, and group time. I observed materials and activities that were available to the children in the classrooms. Your program was also monitored for compliance with implementing an approved curriculum as required for all four- and five-star licensed facilities where four-year-old children are enrolled. Your facility uses Discovery Driven Learning, formerly World at Their Fingertips. The last annual compliance visit was conducted on 05/16/2023. A sanitation inspection was completed 01/10/2024 with a superior classification. The last fire inspection was conducted 06/15/2023. Program records and required postings were monitored. A fire drill was conducted on 03/12/2024. A lockdown drill was documented on 01/05/2024. An outdoor inspection was documented on 03/28/2024. Staff files and children’s records will be monitored per DCDEE procedures during another visit. Nutrition requirements were monitored per DCDEE procedures. Storage of hazardous items was monitored today. Hazardous items were stored in locked closets and locked cabinets. Storage and administration of medication were monitored. Medication authorization was monitored. The program does not provide transportation. The following violations were cited during today’s visit: Violation Number Comment Rule 601 Refrigerator(s) did not maintain a temperature of 45 degrees F. or below. I did not observe a thermometer in the refrigerator used to store bottles in space 125A. 15A NCAC 18A .2806(j)(2) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. I observed a tube of Nystatin in space 153 and four tubes of Hydrocortisone cream located in spaces 141B, 235, and 230 not stored in locked storage. 15A NCAC 18A .2820(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. I observed a container of Butt Paste diaper cream in space 145 that did not have a written authorization form on file. 10A NCAC 09 .0803(1)(a & b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. I observed one tube of Nystatin in space 153 that was not in the original labeled container. .0803(2)(a) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. I observed one employee file that had documentation of completed health and safety training in 2017. .1103(b) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violations cited during today's visit immediately and send me documentation verifying compliance on or before 04/16/2024. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation You may email the letter to whitney.parker@dhhs.nc.gov or mail two copies of the letter to: Whitney Parker P.O. Box 1342 Lexington, NC 27293 If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit: • We reviewed rule 15A NCAC 18A .2820(d). All prescription and non-prescription medications must be stored in locked storage. • We discussed rule .0803(1)(f). All medications must have written authorization from families. • We discussed rule .0803(2)(a). All prescribed medications must be in their original packaging. • We discussed rule 15A NCAC 18A.2806(j)(1). All refrigerators must have a thermometer in them to measure the temperature. Additional Information/Consultation: • You must notify your consultant 30 days prior to changing the ownership status of your facility. • On 02/21/2024, I emailed you a document regarding required Lead and Asbestos Testing. Ms. Green confirmed during today’s visit that the email was received and provided information that Ms. Nunes-Buras completed the webinar on 03/18/2024. Ms. Green stated the survey was completed and they are waiting for information from RTI if they have to have testing. • Staff files and children’s files will be monitored on a separate visit. You will received a copy of the completed staff and training worksheets, children's records form, and AC checklist during that visit once all areas have been monitored. • I recommend adding materials to 135 A and 135 B prior to having the ERS completed. Use the checklists on NCRLAP’s website to ensure you have enough materials in each space. • Keep a check on the chairs in space 145. They are showing signs of wear and need to be recovered or replaced soon. • Make sure to list the validity dates on all medical actions plans. • If you would like to have a prep year assessment completed, let me know as soon as possible. Your prep year ends on June 30th, 2024. We will need to allow for time to schedule and receive the assessment prior to the end of your prep year. At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Whitney Parker, Child Care Consultant (336) 590-8765 whitney.parker@dhh.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: BRIGHT HORIZONS AT WAKE FOREST BAPTIST HEALTH Facility ID: 34000829 Consultant: WHITNEY PARKER Operation Type: Center Case Number: Visit Date: 4/2/2024 Number Present: 203 Completed Date: 4/2/2024 Age: From 0 To 5 Total Minutes: 275 Time In: 09:00 AM Time Out: 01:35 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements. This visit was conducted by Whitney Parker, Childcare Consultant, with Melissa Green, Director. Currently this program operates with a five-star license issued 9/29/2017. License restrictions include first and second shift; meets enhanced ratios; meets enhance space; children under 2 ½ in rooms with direct exits only. The NC Secretary of State website was reviewed on 04/01/2024 and Bright Horizons Children’s Centers LLC was listed as current and active. The license was observed, and the restrictions were found in compliance. The program’s compliance history was 78% prior to today’s visit. All programs are required to maintain at least 75% compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. I observed staff/child interactions today. I observed children engaging in free play, routine activities, and group time. I observed materials and activities that were available to the children in the classrooms. Your program was also monitored for compliance with implementing an approved curriculum as required for all four- and five-star licensed facilities where four-year-old children are enrolled. Your facility uses Discovery Driven Learning, formerly World at Their Fingertips. The last annual compliance visit was conducted on 05/16/2023. A sanitation inspection was completed 01/10/2024 with a superior classification. The last fire inspection was conducted 06/15/2023. Program records and required postings were monitored. A fire drill was conducted on 03/12/2024. A lockdown drill was documented on 01/05/2024. An outdoor inspection was documented on 03/28/2024. Staff files and children’s records will be monitored per DCDEE procedures during another visit. Nutrition requirements were monitored per DCDEE procedures. Storage of hazardous items was monitored today. Hazardous items were stored in locked closets and locked cabinets. Storage and administration of medication were monitored. Medication authorization was monitored. The program does not provide transportation. The following violations were cited during today’s visit: Violation Number Comment Rule 601 Refrigerator(s) did not maintain a temperature of 45 degrees F. or below. I did not observe a thermometer in the refrigerator used to store bottles in space 125A. 15A NCAC 18A .2806(j)(2) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. I observed a tube of Nystatin in space 153 and four tubes of Hydrocortisone cream located in spaces 141B, 235, and 230 not stored in locked storage. 15A NCAC 18A .2820(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. I observed a container of Butt Paste diaper cream in space 145 that did not have a written authorization form on file. 10A NCAC 09 .0803(1)(a & b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. I observed one tube of Nystatin in space 153 that was not in the original labeled container. .0803(2)(a) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. I observed one employee file that had documentation of completed health and safety training in 2017. .1103(b) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violations cited during today's visit immediately and send me documentation verifying compliance on or before 04/16/2024. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation You may email the letter to whitney.parker@dhhs.nc.gov or mail two copies of the letter to: Whitney Parker P.O. Box 1342 Lexington, NC 27293 If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical assistance discussed during today’s visit: • We reviewed rule 15A NCAC 18A .2820(d). All prescription and non-prescription medications must be stored in locked storage. • We discussed rule .0803(1)(f). All medications must have written authorization from families. • We discussed rule .0803(2)(a). All prescribed medications must be in their original packaging. • We discussed rule 15A NCAC 18A.2806(j)(1). All refrigerators must have a thermometer in them to measure the temperature. Additional Information/Consultation: • You must notify your consultant 30 days prior to changing the ownership status of your facility. • On 02/21/2024, I emailed you a document regarding required Lead and Asbestos Testing. Ms. Green confirmed during today’s visit that the email was received and provided information that Ms. Nunes-Buras completed the webinar on 03/18/2024. Ms. Green stated the survey was completed and they are waiting for information from RTI if they have to have testing. • Staff files and children’s files will be monitored on a separate visit. You will received a copy of the completed staff and training worksheets, children's records form, and AC checklist during that visit once all areas have been monitored. • I recommend adding materials to 135 A and 135 B prior to having the ERS completed. Use the checklists on NCRLAP’s website to ensure you have enough materials in each space. • Keep a check on the chairs in space 145. They are showing signs of wear and need to be recovered or replaced soon. • Make sure to list the validity dates on all medical actions plans. • If you would like to have a prep year assessment completed, let me know as soon as possible. Your prep year ends on June 30th, 2024. We will need to allow for time to schedule and receive the assessment prior to the end of your prep year. At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Whitney Parker, Child Care Consultant (336) 590-8765 whitney.parker@dhh.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0803 · Violation

Name of Operation: BRIGHT HORIZONS AT WAKE FOREST BAPTIST HEALTH Facility ID: 34000829 Consultant: WHITNEY PARKER Operation Type: Center Case Number: Visit Date: 11/15/2023 Number Present: 232 Completed Date: 11/15/2023 Age: From 0 To 5 Total Minutes: 330 Time In: 08:45 AM Time Out: 02:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable childcare requirements for a routine unannounced visit. This visit was conducted by Whitney Parker, Childcare Consultant, with Melissa Green, Director, and Thais Nuenes Burris, Assistant Director. Currently this program operates with a five-star license issued 9/29/2017. License restrictions include first and second shift; meets enhanced ratios; meets enhance space; children under 2 ½ in rooms with direct exits only. The NC Secretary of State website was reviewed on 11/15/2023 and Bright Horizons Children’s Centers LLC was listed as current and active. The program’s compliance history was 78% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • CPR / First Aid • Special Training • CBC Qualification • ITS – SIDS • Emergency Medical Care Plan • Administration of Medication • Storage of Hazardous Products • Storage of Medication • General Safety • Discipline • Adequate / Approved Space • Program Records • License Posted • Permit Restrictions The license was observed, and the restrictions were found in compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. In space 230, I observed an attendance roster that had not been updated since 11/05/2023. Staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. I observed staff/child interactions today. I observed children engaging in free play, group time, routine activities, and eating lunch. Four new staff were reported at this program. Files for new staff were reviewed. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Storage and administration of medication were monitored. Medication authorization was monitored. In space 135B, I observed one sunscreen that did not have a medication authorization form. In spaces 145, 252, 246, and 224, I observed medications that have expired. In space 246, I observed an EpiPen that was not stored in its original packaging. Storage hazardous items was monitored today. Hazardous items are stored in locked custodial closets. A playground inspection was recorded 11/01/2023. A fire drill was recorded on 10/04/2023. A lock down drill for the facility was recorded 09/13/2023. The most recent fire inspection was on 06/09/2023. A copy of this inspection was provided to me during today’s visit. I observed a sanitation inspection was last conducted on 08/31/2023 earning a superior classification. The program does not provide transportation. The following violations were cited during today’s visit: Violation Number Comment Rule 843 A drug or medicine was administered after its expiration date. In spaces 145, 252, 246, and 224, I observed medications that have expired that were still being used. 10A NCAC 09 .0803(1)(d) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space 246, I observed an EpiPen that was not stored in it’s original packaging. .0803(2)(a) 1301 Center did not maintain a record of daily attendance. In space 230, I observed an attendance roster that had not been updated since 11/05/2023. GS 110-91(9) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space 135B, I observed one sunscreen that did not have a medication authorization form. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violations cited during today's visit immediately and send me documentation verifying compliance on or before 11/29/2023. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to whitney.parker@dhhs.nc.gov or mail two copies of the letter to: Whitney Parker P.O. Box 1342 Lexington, NC 27293 Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. We discussed during today’s visit that new measurements will need to be taken of your facility. On 11/16/2023, Tammy Childress, Lead Consultant, and I will come to measure the entire facility and playgrounds. I will use these measurements to update your floor plan and create a space calculation worksheet to determine the capacity in each space. I will reach out to you regarding these calculations once they have been entered on the new floor plan and space calculation worksheets. Technical assistance discussed during today’s visit: •Medications must be kept in the original packaging or be accompanied by signed directions from a physician or health care provider. We discussed that families could provide the original packaging or have written instructions to accompany the medication. •All medications must have a permission form with them. We discussed making sure all medicines have forms and are transferred when children move up. •Medications must be disposed of or returned to families when they expire. We discussed monitoring medication expiration dates. •Attendance rosters must be logged daily. We discussed making sure staff are keeping a current attendance record on each child daily. Additional Information/Consultation: •You must notify your consultant 30 days prior to changing the ownership status of your facility. •During today’s visit, we discussed that you would need to create an EPR Plan. This Plan must be on a template provided by the Division available at https://rmp.nc.gov/portal/#. When you click on the website, click on Planning Tools, scroll down, then click on Childcare Emergency Preparedness and Response. You will log in using an NCID and develop the plan using the template provided on the website. You will also need to compile a Ready to Go File. A Ready to Go File means a collection of information on children, staff, and the facility to utilize, if an evacuation occurs. The file shall include, a copy of the Emergency Preparedness and Response Plan, contact information for individuals to pick-up children, each child's Application for Childcare, medication authorizations and instructions, any action plans for children with special health care needs, a list of any known food allergies of children and staff, staff contact information, Incident Report forms, an area map, and emergency telephone numbers. •Make sure to keep a check on the chairs with vinyl covering. As they begin to wear out, replace them or use covers. •Make sure to label all diaper creams and sunscreens with the child’s name as they are brought in. •Keep a check on the yoga mats in space 235. As these begin to show signs of wear, remove or replace them. At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Whitney Parker, Child Care Consultant (336) 590-8765 whitney.parker@dhh.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-91 · Violation

Name of Operation: BRIGHT HORIZONS AT WAKE FOREST BAPTIST HEALTH Facility ID: 34000829 Consultant: WHITNEY PARKER Operation Type: Center Case Number: Visit Date: 11/15/2023 Number Present: 232 Completed Date: 11/15/2023 Age: From 0 To 5 Total Minutes: 330 Time In: 08:45 AM Time Out: 02:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable childcare requirements for a routine unannounced visit. This visit was conducted by Whitney Parker, Childcare Consultant, with Melissa Green, Director, and Thais Nuenes Burris, Assistant Director. Currently this program operates with a five-star license issued 9/29/2017. License restrictions include first and second shift; meets enhanced ratios; meets enhance space; children under 2 ½ in rooms with direct exits only. The NC Secretary of State website was reviewed on 11/15/2023 and Bright Horizons Children’s Centers LLC was listed as current and active. The program’s compliance history was 78% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • CPR / First Aid • Special Training • CBC Qualification • ITS – SIDS • Emergency Medical Care Plan • Administration of Medication • Storage of Hazardous Products • Storage of Medication • General Safety • Discipline • Adequate / Approved Space • Program Records • License Posted • Permit Restrictions The license was observed, and the restrictions were found in compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. In space 230, I observed an attendance roster that had not been updated since 11/05/2023. Staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. I observed staff/child interactions today. I observed children engaging in free play, group time, routine activities, and eating lunch. Four new staff were reported at this program. Files for new staff were reviewed. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Storage and administration of medication were monitored. Medication authorization was monitored. In space 135B, I observed one sunscreen that did not have a medication authorization form. In spaces 145, 252, 246, and 224, I observed medications that have expired. In space 246, I observed an EpiPen that was not stored in its original packaging. Storage hazardous items was monitored today. Hazardous items are stored in locked custodial closets. A playground inspection was recorded 11/01/2023. A fire drill was recorded on 10/04/2023. A lock down drill for the facility was recorded 09/13/2023. The most recent fire inspection was on 06/09/2023. A copy of this inspection was provided to me during today’s visit. I observed a sanitation inspection was last conducted on 08/31/2023 earning a superior classification. The program does not provide transportation. The following violations were cited during today’s visit: Violation Number Comment Rule 843 A drug or medicine was administered after its expiration date. In spaces 145, 252, 246, and 224, I observed medications that have expired that were still being used. 10A NCAC 09 .0803(1)(d) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space 246, I observed an EpiPen that was not stored in it’s original packaging. .0803(2)(a) 1301 Center did not maintain a record of daily attendance. In space 230, I observed an attendance roster that had not been updated since 11/05/2023. GS 110-91(9) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space 135B, I observed one sunscreen that did not have a medication authorization form. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violations cited during today's visit immediately and send me documentation verifying compliance on or before 11/29/2023. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to whitney.parker@dhhs.nc.gov or mail two copies of the letter to: Whitney Parker P.O. Box 1342 Lexington, NC 27293 Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. We discussed during today’s visit that new measurements will need to be taken of your facility. On 11/16/2023, Tammy Childress, Lead Consultant, and I will come to measure the entire facility and playgrounds. I will use these measurements to update your floor plan and create a space calculation worksheet to determine the capacity in each space. I will reach out to you regarding these calculations once they have been entered on the new floor plan and space calculation worksheets. Technical assistance discussed during today’s visit: •Medications must be kept in the original packaging or be accompanied by signed directions from a physician or health care provider. We discussed that families could provide the original packaging or have written instructions to accompany the medication. •All medications must have a permission form with them. We discussed making sure all medicines have forms and are transferred when children move up. •Medications must be disposed of or returned to families when they expire. We discussed monitoring medication expiration dates. •Attendance rosters must be logged daily. We discussed making sure staff are keeping a current attendance record on each child daily. Additional Information/Consultation: •You must notify your consultant 30 days prior to changing the ownership status of your facility. •During today’s visit, we discussed that you would need to create an EPR Plan. This Plan must be on a template provided by the Division available at https://rmp.nc.gov/portal/#. When you click on the website, click on Planning Tools, scroll down, then click on Childcare Emergency Preparedness and Response. You will log in using an NCID and develop the plan using the template provided on the website. You will also need to compile a Ready to Go File. A Ready to Go File means a collection of information on children, staff, and the facility to utilize, if an evacuation occurs. The file shall include, a copy of the Emergency Preparedness and Response Plan, contact information for individuals to pick-up children, each child's Application for Childcare, medication authorizations and instructions, any action plans for children with special health care needs, a list of any known food allergies of children and staff, staff contact information, Incident Report forms, an area map, and emergency telephone numbers. •Make sure to keep a check on the chairs with vinyl covering. As they begin to wear out, replace them or use covers. •Make sure to label all diaper creams and sunscreens with the child’s name as they are brought in. •Keep a check on the yoga mats in space 235. As these begin to show signs of wear, remove or replace them. At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Whitney Parker, Child Care Consultant (336) 590-8765 whitney.parker@dhh.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: BRIGHT HORIZONS AT WAKE FOREST BAPTIST HEALTH Facility ID: 34000829 Consultant: WHITNEY PARKER Operation Type: Center Case Number: Visit Date: 11/15/2023 Number Present: 232 Completed Date: 11/15/2023 Age: From 0 To 5 Total Minutes: 330 Time In: 08:45 AM Time Out: 02:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable childcare requirements for a routine unannounced visit. This visit was conducted by Whitney Parker, Childcare Consultant, with Melissa Green, Director, and Thais Nuenes Burris, Assistant Director. Currently this program operates with a five-star license issued 9/29/2017. License restrictions include first and second shift; meets enhanced ratios; meets enhance space; children under 2 ½ in rooms with direct exits only. The NC Secretary of State website was reviewed on 11/15/2023 and Bright Horizons Children’s Centers LLC was listed as current and active. The program’s compliance history was 78% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • CPR / First Aid • Special Training • CBC Qualification • ITS – SIDS • Emergency Medical Care Plan • Administration of Medication • Storage of Hazardous Products • Storage of Medication • General Safety • Discipline • Adequate / Approved Space • Program Records • License Posted • Permit Restrictions The license was observed, and the restrictions were found in compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. In space 230, I observed an attendance roster that had not been updated since 11/05/2023. Staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. I observed staff/child interactions today. I observed children engaging in free play, group time, routine activities, and eating lunch. Four new staff were reported at this program. Files for new staff were reviewed. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Storage and administration of medication were monitored. Medication authorization was monitored. In space 135B, I observed one sunscreen that did not have a medication authorization form. In spaces 145, 252, 246, and 224, I observed medications that have expired. In space 246, I observed an EpiPen that was not stored in its original packaging. Storage hazardous items was monitored today. Hazardous items are stored in locked custodial closets. A playground inspection was recorded 11/01/2023. A fire drill was recorded on 10/04/2023. A lock down drill for the facility was recorded 09/13/2023. The most recent fire inspection was on 06/09/2023. A copy of this inspection was provided to me during today’s visit. I observed a sanitation inspection was last conducted on 08/31/2023 earning a superior classification. The program does not provide transportation. The following violations were cited during today’s visit: Violation Number Comment Rule 843 A drug or medicine was administered after its expiration date. In spaces 145, 252, 246, and 224, I observed medications that have expired that were still being used. 10A NCAC 09 .0803(1)(d) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space 246, I observed an EpiPen that was not stored in it’s original packaging. .0803(2)(a) 1301 Center did not maintain a record of daily attendance. In space 230, I observed an attendance roster that had not been updated since 11/05/2023. GS 110-91(9) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space 135B, I observed one sunscreen that did not have a medication authorization form. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. You must correct the violations cited during today's visit immediately and send me documentation verifying compliance on or before 11/29/2023. The following information must be included in your signed and dated compliance letter: • the name of your center • facility ID number • date • title of the person who signs the letter • each violation number(s) • describes accurately and in detail how and when you corrected each violation If you state in your letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to whitney.parker@dhhs.nc.gov or mail two copies of the letter to: Whitney Parker P.O. Box 1342 Lexington, NC 27293 Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. We discussed during today’s visit that new measurements will need to be taken of your facility. On 11/16/2023, Tammy Childress, Lead Consultant, and I will come to measure the entire facility and playgrounds. I will use these measurements to update your floor plan and create a space calculation worksheet to determine the capacity in each space. I will reach out to you regarding these calculations once they have been entered on the new floor plan and space calculation worksheets. Technical assistance discussed during today’s visit: •Medications must be kept in the original packaging or be accompanied by signed directions from a physician or health care provider. We discussed that families could provide the original packaging or have written instructions to accompany the medication. •All medications must have a permission form with them. We discussed making sure all medicines have forms and are transferred when children move up. •Medications must be disposed of or returned to families when they expire. We discussed monitoring medication expiration dates. •Attendance rosters must be logged daily. We discussed making sure staff are keeping a current attendance record on each child daily. Additional Information/Consultation: •You must notify your consultant 30 days prior to changing the ownership status of your facility. •During today’s visit, we discussed that you would need to create an EPR Plan. This Plan must be on a template provided by the Division available at https://rmp.nc.gov/portal/#. When you click on the website, click on Planning Tools, scroll down, then click on Childcare Emergency Preparedness and Response. You will log in using an NCID and develop the plan using the template provided on the website. You will also need to compile a Ready to Go File. A Ready to Go File means a collection of information on children, staff, and the facility to utilize, if an evacuation occurs. The file shall include, a copy of the Emergency Preparedness and Response Plan, contact information for individuals to pick-up children, each child's Application for Childcare, medication authorizations and instructions, any action plans for children with special health care needs, a list of any known food allergies of children and staff, staff contact information, Incident Report forms, an area map, and emergency telephone numbers. •Make sure to keep a check on the chairs with vinyl covering. As they begin to wear out, replace them or use covers. •Make sure to label all diaper creams and sunscreens with the child’s name as they are brought in. •Keep a check on the yoga mats in space 235. As these begin to show signs of wear, remove or replace them. At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Whitney Parker, Child Care Consultant (336) 590-8765 whitney.parker@dhh.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times