The Pa-Paw Patch

A child care operator did not notify the Division of any new child care providers, as defined in G.S.

“110-90.2(a)(2), who were hired or moved into the child care facility within five business days. A staff roster was not established in the ABCMS portal to notify DCDEE of current and new staff member employment.”

Rule A child care operator did not notify the Division of any new child care providers, as defined in G.S.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Aug 29, 2025. Correction verified: by a letter from the provider.

All staff did not review the center’s EPR Plan during orientation and/or on an annual basis with the trained staff.

“Documentation of the review was not maintained on file. The EPR Plan was updated on 06/09/2025 but had not been reviewed with eleven out of twelve staff members.”

Rule All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Aug 29, 2025. Correction verified: by a letter from the provider.

All staff did not successfully complete certification in CPR training appropriate to the age of the children in care.

“Verification of staff completion of the CPR course from an approved training organization was not in the staff file. The CPR training for one staff member with a date of employment of 04/24/2023 had expired on 05/09/2025.”

Rule All staff did not successfully complete certification in CPR training appropriate to the age of the children in care.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Aug 29, 2025. Correction verified: by a letter from the provider.

All staff did not successfully complete certification in First Aid appropriate to the age of children in care.

“Verification of staff completion of First Aid training from an approved training organization was not in the staff file. The First Aid training for one staff member with a date of employment of 04/24/2023 had expired on 05/09/2025.”

Rule All staff did not successfully complete certification in First Aid appropriate to the age of children in care.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Aug 29, 2025. Correction verified: by a letter from the provider.

Operational policies were not discussed with parents on or before the child’s first day and/or they were not notified in writing of all changes.

“The acknowledgement statement for written notification of operational policy changes was not on file for one child with a date of enrollment of 07/01/2024.”

Rule Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Aug 29, 2025. Correction verified: by a letter from the provider.

Staff required to receive on-going training had not completed the required number of hours according to their education and experience.

“One staff member with a date of employment of 04/24/2023 who was required to complete twenty hours of on-going training had completed some on-going training from an unapproved training agency and had not completed twenty hours as required.”

Rule Staff required to receive on-going training had not completed the required number of hours according to their education and experience.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Sep 3, 2025. Correction verified: by a letter from the provider.

The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment.

“One staff member with a date of employment of 01/21/2025 completed Recognizing and Responding to Suspicions of Child Maltreatment training on 04/27/2025 rather than 04/21/2025 as required.”

Rule 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.. Corrected during the inspection.

The child care center premises, including the outdoor learning environment, was not clean, drained to minimize standing water, free of litter and hazards, and/or maintained in a manner which does not create conditions that attract or harbor pests.

“On Playground 2, one water table with a broken lid and one dump truck had standing water in them.”

Rule The child care center premises, including the outdoor learning environment, was not clean, drained to minimize standing water, free of litter and hazards, and/or maintained in a manner which does not create conditions that attract or harbor pests.. Corrected during the inspection.

The depth of the loose surfacing was not based on critical height of the equipment.

“On Playground 1, the rubber mulch and pea gravel surfacing measured less than one inch to seven inches within the fall zone of the composite structure and the spring rockers.”

Rule The depth of the loose surfacing was not based on critical height of the equipment.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Aug 29, 2025. Correction verified: by a letter from the provider.

All equipment and furnishings were not in good repair.

“In Spaces 3 and 6, the dramatic play set furniture and toy shelves were visibly soiled.”

Rule All equipment and furnishings were not in good repair.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Feb 25, 2025. Correction verified: by a letter from the provider.

All floors and floor coverings were not constructed of nonabsorbent material and/or were not kept clean and in good repair.

“In Spaces 2, 3, and 6, the rugs were visibly soiled.”

Rule All floors and floor coverings were not constructed of nonabsorbent material and/or were not kept clean and in good repair.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Feb 25, 2025. Correction verified: by a letter from the provider.

All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair.

“In Spaces 1, 2, and 3, a black substance that may be mold and/or mildew was seen on the ceiling vents and the ceiling tiles surrounding the ceiling vents. In Space 3, the doors, doorframes, and walls were visibly soiled.”

Rule All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Feb 25, 2025. Correction verified: by a letter from the provider.

Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization.

“In Space 3, the pharmaceutical label on a prescription medication indicated that the medication should be discarded after 11/30/2024 and was not returned to the parent or discarded within 72 hours.”

Rule 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.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Feb 25, 2025. Correction verified: by a letter from the provider.

A child’s hands were not washed after each diaper change.

“In Space 3, the teacher did not wash each child’s hands after changing each diaper.”

Rule A child's hands were not washed after each diaper change.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Sep 18, 2024. Correction verified: by a letter from the provider.

All equipment and furnishings were not in good repair.

Rule All equipment and furnishings were not in good repair.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Sep 18, 2024. Correction verified: by a letter from the provider.

All staff did not wash their hands thoroughly after diapering each child.

“In Space 3, the teacher did not wash her hands after diapering each child. The teacher wore a pair of gloves and changed multiple children without removing the gloves and washing her hands in between diapering each child.”

Rule All staff did not wash their hands thoroughly after diapering each child.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Sep 18, 2024. Correction verified: by a letter from the provider.

All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair.

“In Space 1, walls were visibly soiled and the drywall was torn under the soap dispenser at the handwashing sink. In Space 2, walls and baseboards were visibly soiled, the drywall was torn under the soap dispenser at the handwashing sink, and paint was chipping on the baseboards. In Space 3, walls, doorframes, doors, baseboards, and cabinets were visibly soiled and paint was chipping on the interior doors. In Space 4, walls, doorframes, and baseboards were visibly soiled and paint was chipping on four of the interior doors”

Rule All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Sep 18, 2024. Correction verified: by a letter from the provider.

Center did not have a plan to encourage parent participation and inform them about the program and its services.

“The director had posted the child care rule for Parent Participation Plan requirements and had included two of the four components of the Parent Participation Plan in the parent handbook. The Parent Participation Plan did not include procedures to encourage families to visit the center with the child prior to enrolling and attending the facility. The Parent Participation Plan did not include procedures for parents to follow when they have a complaint or grievance.”

Rule Center did not have a plan to encourage parent participation and inform them about the program and its services.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Sep 18, 2024. Correction verified: by a letter from the provider.

Diaper changing surfaces were not cleaned with a detergent solution and disinfected after each use.

“In Space 3, the teacher did not disinfect the diaper changing pad after diapering each child.”

Rule Diaper changing surfaces were not cleaned with a detergent solution and disinfected after each use.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Sep 18, 2024. Correction verified: by a letter from the provider.

Human milk, formula and other bottled beverages including sippy cups, sent from child’s home were not fully prepared, dated, and labeled for the appropriate child.

“In Space 1, one bottle was not labeled with the name of the child and the date the bottle was to be served.”

Rule Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child.. Corrected during the inspection.

Parent’s medication authorization did not include required information.

“In Space 1, authorization to administer one oral non-prescription medication was given using the topical permission form with no medication administration log attached. In Space 1, one permission to administer a non-prescription topical medication was missing the valid dates and when to administer the medication.”

Rule Parent's medication authorization did not include required information.. Corrected during the inspection.

Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age.

“In Space 3, one diaper pail liner full of soiled diapers was left laying in the floor of the bathroom used by girls.”

Rule 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.. Corrected during the inspection.

Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child’s file.

“On May 23, 2024, an injury occurred involving a one-year-old child and an incident report was not completed.”

Rule Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jul 11, 2024. Correction verified: by a letter from the provider.

All staff did not successfully complete certification in CPR training appropriate to the age of the children in care.

“Verification of staff completion of the CPR course from an approved training organization was not in the staff file. CPR training for one staff member with a date of employment of 10/02/2023 was due by 01/02/2024. The staff member completed CPR training on 01/16/2024.”

Rule All staff did not successfully complete certification in CPR training appropriate to the age of the children in care.. Corrected during the inspection.

All staff did not successfully complete certification in First Aid appropriate to the age of children in care.

“Verification of staff completion of First Aid training from an approved training organization was not in the staff file. First Aid training for one staff member with a date of employment of 10/02/2023 was due by 01/02/2024. The staff member completed First Aid training on 01/16/2024.”

Rule All staff did not successfully complete certification in First Aid appropriate to the age of children in care.. Corrected during the inspection.

All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet.

“In Space 6, a first aid kit containing one instant cold pack was stored in an unlocked drawer.”

Rule 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.. Corrected during the inspection.

Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container.

“In Space 6, a first aid kit containing three packs of aspirin, one pack of first aid cream, three packs of acetaminophen, three packs of Ibuprofen, one sting relief pad, and one tube of After Bite was stored in an unlocked drawer.”

Rule Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container.. Corrected during the inspection.

All equipment and furnishings were not in good repair.

“In Space 5, a stand-alone dollhouse had worn edges and torn paper covering and a table in the dramatic play area had broken edges and chipping paint. The administrator removed the dollhouse and the table from the classroom.”

Rule All equipment and furnishings were not in good repair.. Corrected during the inspection.

All walls and ceilings including doors and windows were not kept clean and in good repair.

“In the bathroom shared by Space 5 and 6, the bathroom wall had a tear in the sheet rock where a soap dispenser had been removed from the wall, the walls were visibly soiled, and the rubber baseboards were visibly soiled with buildup.”

Rule All walls and ceilings including doors and windows were not kept clean and in good repair.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Mar 14, 2024. Correction verified: by a letter from the provider.

Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review.

“In Space 1, the arrival time for one child was not recorded. The administrator added the missing arrival time for the child.”

Rule Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review.. Corrected during the inspection.

Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization.

“In Space 2, the permission to administer form for one over the counter diaper ointment had expired and the diaper ointment was being administered. In Space 3, one over the counter expired in 01/2024 and was not returned to the parent. In Space 6, the permission to administer from for one over the counter medication had expired and the medication had not been returned to the parent. The administrator removed the three over the counter medications from the classrooms and brought them her office to return to the parents.”

Rule 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.. Corrected during the inspection.

Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container.

“In Space 2, 5, and 6, four prescription medications for chronic illnesses were stored in locked cabinets making them not readily accessible to the staff in the event of an emergency. The administrator moved these emergency medications to shelves above five feet in cabinets in the classroom making them inaccessible to children but easily assessible to teachers.”

Rule Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container.. Corrected during the inspection.

Toilet fixtures were not cleaned and disinfected at least daily and when visibly soiled.

“In the bathroom shared by Space 5 and 6, the toilet basins were soiled with build up.”

Rule Toilet fixtures were not cleaned and disinfected at least daily and when visibly soiled.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Mar 8, 2024. Correction verified: by a letter from the provider.

At least one child care provider, who has completed ITS-SIDS training was not present in the infant room, while children were in care.

“Two staff members with dates of employment of 01/08/2024 and 01/11/2024 were working alone in the infant room and had not completed ITS-SIDS training.”

Rule At least one child care provider, who has completed ITS-SIDS training was not present in the infant room, while children were in care.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jan 19, 2024. Correction verified: by a letter from the provider.

Prior to employment a Criminal Background Check was not completed.

“New staff orientation training was started with three new staff members employed on 01/08/2024, 01/11/2024, and 01/16/2024 prior to receiving their Criminal Background Check qualification letters.”

Rule Prior to employment a Criminal Background Check was not completed.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jan 19, 2024. Correction verified: by a letter from the provider.

All beds,cots, or mats with individual linen were not provided for each child.

“One three-year-old child was allowed to sleep on the floor during the early morning arrival hours instead of being given their cot on which to sleep.”

Rule All beds,cots, or mats with individual linen were not provided for each child.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Dec 8, 2023. Correction verified: at a follow-up visit by DCDEE.

Children under one year of age were not kept separate from children two years and older.

“During the months of October and November, children zero, one, two, and three years of age were grouped together for longer than the first hour of operation during the early morning arrival hours of 6:00am and 7:30am.”

Rule Children under one year of age were not kept separate from children two years and older.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Dec 8, 2023. Correction verified: at a follow-up visit by DCDEE.

Children were not adequately supervised at all times.

“On one occasion in November 2023, one three-year-old child was left unattended in the two-year-old classroom for an unknown period of time while the teacher and the rest of the children were outside on the playground. On November 17, 2023, one three-year-old child was left outside on the playground for an unknown period of time while the teacher and the rest of the children went inside the classroom.”

Rule Children were not adequately supervised at all times.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Dec 8, 2023. Correction verified: at a follow-up visit by DCDEE.

Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review.

“In Space 5, an arrival time was not recorded for two children in attendance. The teacher recorded the arrival times during the visit.”

Rule Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review.. Corrected during the inspection.

Enhanced staff/child ratios and group sizes were not met.

“The enhanced staff to child ratio was not maintained for the youngest child in the group. During the visit, nine three-year-old children and one two-year-old child were grouped together in Space 6. On numerous occasions in October 2023 and November 2023, the staff to child ratios were not maintained during the early morning hours. On at least one occasion in October, one teacher on-site from 6:00am to 7:00am opened the one-year-old classroom and supervised nine children ranging in age from zero to three years of age.”

Rule Enhanced staff/child ratios and group sizes were not met.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Dec 8, 2023. Correction verified: at a follow-up visit by DCDEE.

The activity plan was not designed to stimulate emotional and social, health and physical, approaches to play and learning, language development and communication, and cognitive development for each group of children in care.

“In Space 2, daily art activities were planned but were not carried out. In Space 5, snow-theme sensory and science materials were not available to carry out the planned activities. In Space 6, farm-theme materials and toys were not available to carry out the planned activities. In Space 6, black-line worksheets were planned daily as “art work”.”

Rule The activity plan was not designed to stimulate emotional and social, health and physical, approaches to play and learning, language development and communication, and cognitive development for each group of children in care.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Dec 8, 2023. Correction verified: at a follow-up visit by DCDEE.