Early Start Child Care and Learning Center

Medical exam or health assessment record was not on file before or within 30 days after admission.

“During the review of children’s files. One child’s file did not have a medical exam within 30 days of admission. Enrollment date 9/2025”

Rule Medical exam or health assessment record was not on file before or within 30 days after admission.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Apr 28, 2026. Correction verified: by a letter from the provider.

Children between 12 and 24 months of age were grouped with children 3 years of age or older.

“The group of children the Administrator was caring for in the hallway had one child who was one year of age, one child who was two years of age, six children who were 3 years of age and two children who were four years of age. This was corrected when the teacher who was fixing morning snack returned to the hallway and took the children who were one and two years of age back to their classroom.”

Rule Children between 12 and 24 months of age were grouped with children 3 years of age or older.. Corrected during the inspection.

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

“Upon enter the facility the Administrator was standing in the hallway caring for 10 children with the youngest child be one year of age and the oldest child being four years of age. This was corrected when the other teacher who was preparing morning snack stood with her after I entered the facility.”

Rule Enhanced staff/child ratios and group sizes were not met.. Corrected during the inspection.

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 new staff has not completed Recognizing and Responding to Suspicions of Child Maltreatment within 90 days of hire. Hire date was 8/20/2025.”

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.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jan 12, 2026. Correction verified: by a letter from the provider.

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.

“Two staff did not sign the Shaken Baby Syndrome and Abusive Head Trauma Policy before caring for children. This was corrected during the visit by both sign the Policy during the visit.”

Rule 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.. Corrected during the inspection.

A current activity plan was not posted for each group of children for reference.

“In Space #1, there was no activity plan posted. In space #2, the current activity plan was dated for 4/22-25/2025”

Rule A current activity plan was not posted for each group of children for reference.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: May 13, 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. One Staff member did not complete CPR training on or before the expiration date. 2/2025”

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: May 5, 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. One staff member did not complete First Aid training before expiration date. 2/2025”

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: May 5, 2025. Correction verified: by a letter from the provider.

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.

“Two staff did not complete Recognizing and Responding as part of the Health and Safety training every five years. The training was last taken on 2/6/2020.”

Rule 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.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: May 8, 2025. Correction verified: by a letter from the provider.

All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement.

“One new staff medical statement was more than 12 months old upon hire date of 8/14/2024. The medical was dated 2/22/2023.”

Rule All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Aug 26, 2024. Correction verified: by a letter from the provider.

On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months.

“One new staff TB test was more than 12 months old upon hire date of 8/14/2024. TB test was dated for 2/22/2023. This a repeat violation.”

Rule On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Aug 26, 2024. Correction verified: by a letter from the provider.

On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months.

“One staff did not have a TB test screening on file on or before the first day of work. Start date 7/15/2024.”

Rule On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Aug 15, 2024. Correction verified: by a letter from the provider.

The child care operator did not comply with all State laws, federal laws and/or local ordinances that pertain to child health, safety, and welfare, as required by General Statute 110-91.

“The owner, Early Start Child Care and Learning Center Inc. was active-not current effective April 15, 2024 for failing to comply with requirements set forth by North Carolina Secretary of State.”

Rule The child care operator did not comply with all State laws, federal laws and/or local ordinances that pertain to child health, safety, and welfare, as required by General Statute 110-91.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Aug 15, 2024. Correction verified: by a letter from the provider.

A safe indoor and outdoor environment was not provided for the children.

“The kitchen door was unlocked and unattended. It was corrected when the staff was informed about the procedure, and remained locked through out the visit unless staff was present in the kitchen.”

Rule A safe indoor and outdoor environment was not provided for the children.. Corrected during the inspection.

Discipline was related to food, rest or toileting.

“It was stated that children’s blankets are taken away from children when they will not rest on their cots. This was corrected today because the children were given their blankest at rest time.”

Rule Discipline was related to food, rest or toileting.. Corrected during the inspection.

Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child’s developmental needs.

“It was stated during the visit that staff do have a harsh tone at times and do take blankets form the children at rest time.”

Rule Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jul 1, 2024. Correction verified: by a letter from the provider.

Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas.

“One new staff member has not completed the first two weeks of training in required topic areas. Hire date 1/11/2024”

Rule Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jul 1, 2024. Correction verified: by a letter from the provider.

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.

“The electrical outlets in space #1, #3, and the administrator office space had several outlets did not have a covering over them.”

Rule 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.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jun 26, 2024. Correction verified: by a letter from the provider.

New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks.

“One new staff has not completed at least 16 hrs. of orientation within the fires 6 weeks of hire. Hire date 1/11/2024.”

Rule New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jul 1, 2024. 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 who was hired 1/11/2024 has not completed Recognizing and Responding to Suspicions of Child Maltreatment training in the required 90 days.”

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.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jul 2, 2024. Correction verified: by a letter from the provider.

A current activity plan was not posted for each group of children for reference.

“In space #2, the current activity plan that was posted was dated 4/29-5/3/2024. During the visit the teacher posted a current activity plan.”

Rule A current activity plan was not posted for each group of children for reference.. Corrected during the inspection.

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. One staff did not have documentation of review of the EPR plan on file.”

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: May 16, 2024. Correction verified: by a letter from the provider.

All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement.

“One staff did not have a signed annual health questionnaire on file.”

Rule All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: May 16, 2024. Correction verified: by a letter from the provider.

Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually.

“One staff did not have an updated emergency information form on file.”

Rule Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: May 16, 2024. Correction verified: by a letter from the provider.

Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan.

“One staff file did not have a signed annual staff evaluation on file for review.”

Rule Each employee's personnel file did not contain an annual staff evaluation and a staff development plan.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: May 16, 2024. Correction verified: by a letter from the provider.

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.

“One staff did not complete health and safety trainings within five years of completing previous health and safety trainings on 6/16/2017”

Rule 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.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: May 16, 2024. Correction verified: by a letter from the provider.

Medical exam or health assessment record was not on file before or within 30 days after admission.

“While monitoring three children’s file, one child’s file did not have a health assessment on file for review. The child’s start date 7/2023.”

Rule Medical exam or health assessment record was not on file before or within 30 days after admission.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: May 16, 2024. Correction verified: by a letter from the provider.

On-going training received was not within the 9 topic areas listed in GS 110-91(11) and/or the health and safety training topic areas in rule .1102.

“One staff did not complete on-going training hours since last annual compliance visit 5/9/2023. During the visit the teacher submitted her transcript showing the classes that she completed for fall semester. The teacher is working towards BA in Early Childhood Education.”

Rule On-going training received was not within the 9 topic areas listed in GS 110-91(11) and/or the health and safety training topic areas in rule .1102.. Corrected during the inspection.

The EMC plan was not reviewed with all staff annually and whenever the plan was revised.

“EMC Plan was not reviewed with one staff annually. The staff did not have a signed statement on file.”

Rule The EMC plan was not reviewed with all staff annually and whenever the plan was revised.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: May 16, 2024. Correction verified: by a letter from the provider.

The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current.

“EPR plan was not updated annually for updated of changes and current information.”

Rule The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: May 16, 2024. Correction verified: by a letter from the provider.

Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months.

“One new staff member had a medical report on file that was more than 12 months. The date on medical report was 10/26/2022.”

Rule Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Apr 19, 2024. Correction verified: by a letter from the provider.

Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas.

“One new staff file was monitored. There was no orientation form or any other documents that show the required six clock hours of training was completed. The administrator stated that she had completed but had not documented the form. This was corrected during today’s visit by the administrator documenting the orientation form.”

Rule Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas.. Corrected during the inspection.

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. Two staff did not have current CPR Certification on file. Once expired 6/2023 and the other expired 12/2023.”

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: Jan 23, 2024. Correction verified: at a follow-up visit by DCDEE.

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. Two staff did not have current First Aid Certification on file. One expired 6/2023 and the other expired 12/2023.”

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: Jan 23, 2024. Correction verified: at a follow-up visit by DCDEE.

Children were not adequately supervised at all times.

“Two staff members confirmed that a child was left outside for approximately two minutes. This was corrected during this visit based on my observation and a plan implemented by administration requiring staff members take clips boards outside and doing name to face recognition during transitions between indoors and outdoors.”

Rule Children were not adequately supervised at all times.. Corrected during the inspection.

Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child’s developmental needs.

“During interviews and review of video, it was confirmed two staff had a disagreement resulting in raised voices and inappropriate language. Children were not in the space however, staff in the space with children confirmed the altercation was heard.”

Rule Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs.. Corrected during the inspection.

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.

“An infant bottle of milk was stored in the refrigerator in the kitchen and was dated 1/22/2024. This was corrected during the visit when the staff discarded the milk and placed the bottle in the child’s bag.”

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.

Rule violated (DCDEE’s description below)

Rule Rule violated (DCDEE’s description below). Corrected during the inspection.

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.

“Two new staff did not have Shaken Baby Syndrome and Abusive Head Trauma policy on file prior to working with children. This was corrected by the operator reviewing and providing the document to the staff members and having them to sign the acknowledgment today. This is a repeat violation from visit completed on 11/2/2023”

Rule 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.. Corrected during the inspection.

Baby bottles were not stored to protect from contamination.

“In space #2, there were two bottles sitting out on a sink for over an hour. The provider remove the bottle and discarded the milk.”

Rule Baby bottles were not stored to protect from contamination.. Corrected during the inspection.

Each infant was not served only bottles labeled with their individual name.

“In space #2, the labels on the bottles were dated for 11/6/2023. The provider removed the labels and placed bottles in the child’s cubby to return to the parent.”

Rule Each infant was not served only bottles labeled with their individual name.. Corrected during the inspection.