Kindercare at Duke St

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 plastic grocery bags storing clothes/pull-ups were in cubbies accessible to the children under three years of age.”

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.

A child was handled in a rough way, including shaking, pushing, shoving, pinching, slapping, biting, kicking, or spanking.

“On April 17, 2026,A four-year-old child consumed a soft drink that had been left accessible to children. Following the incident, a staff member flicked the child’s lip approximately seven times, resulting in an injury to the child’s lip that bled.”

Rule A child was handled in a rough way, including shaking, pushing, shoving, pinching, slapping, biting, kicking, or spanking.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jun 11, 2026. Correction verified: at a follow-up visit by DCDEE.

Center staff did not follow the EMC plan.

“First aid or medical attention was not provided by center staff members after a child sustained an injury.”

Rule Center staff did not follow the EMC plan.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jun 11, 2026. Correction verified: at a follow-up visit by DCDEE.

Foods and beverages with little or no nutritional value were available often and not just for special occasions.

“On April 17, 2026, a staff member permitted a four-year-old child to continue drinking a soft drink after the child was disciplined.”

Rule Foods and beverages with little or no nutritional value were available often and not just for special occasions.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jun 11, 2026. Correction verified: at a follow-up visit by DCDEE.

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.

“An incident report was not completed after a four-year-old child received an injury.”

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: Jun 11, 2026. Correction verified: at a follow-up visit by DCDEE.

Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care.

“A staff member left a soft drink on a table accessible to children.”

Rule Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence 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: Jun 11, 2026. Correction verified: at a follow-up visit by DCDEE.

There was a substantiation of child maltreatment.

“On June 16, 2026, the Division substantiated child maltreatment based on the physical injury to a child.”

Rule There was a substantiation of child maltreatment.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jun 11, 2026. Correction verified: at a follow-up visit by DCDEE.

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

“A child in Infant B was given the wrong bottles to drink during two feedings.”

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

A drug or medication was administered without written authorization and/or instructions from a child’s parent or authorized health professional.

“A medication authorization form was not on file for zinc oxide in space #1.”

Rule A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jan 23, 2026. Correction verified: at a follow-up visit by DCDEE.

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 CPR training available for review, the CPR training for one staff expired on 11/11/25, and one staff completed an unapproved course for CPR.”

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: Feb 27, 2026. 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. Two staff did not have first aid training available for review, the first aid training for one staff expired on 11/11/25, and one staff completed an unapproved course for First Aid.”

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: Feb 27, 2026. Correction verified: by a letter from the provider.

Emergency information did not name childs health care professional.

“Two children’s applications did not include the health care professional.”

Rule Emergency information did not name childs health care professional.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jan 23, 2026. Correction verified: at a follow-up visit by DCDEE.

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

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: Feb 25, 2026. Correction verified: at a follow-up visit by DCDEE.

Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements.

“The playground inspections for September, November and December 2025 were not available for review. The monthly playground inspections were not completed by an individual trained in playground safety.”

Rule Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jan 30, 2026. Correction verified: by a letter from the provider.

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 small wiggly eyes were being used for an art project with the children under three years of age.”

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.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jan 23, 2026. Correction verified: at a follow-up visit by DCDEE.

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.

“In space #4 foam letters were in the art area and in space #5 two sets of foam blocks were available to the children under 3 years of age.”

Rule 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.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jan 23, 2026. Correction verified: at a follow-up visit by DCDEE.

Staff/child ratios applicable to a classroom, were not posted in each classroom.

“The center has chosen to meet staff/child ratio requirements set forth by the National Accreditation Commission for Early Care and Education Programs. The staff/child ratio form for accreditation was not posted.”

Rule Staff/child ratios applicable to a classroom, were not posted in each classroom.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Feb 25, 2026. Correction verified: at a follow-up visit by DCDEE.

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

“A three-year old child was grabbed by the front of his/her clothes by the teacher.”

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: Aug 12, 2025. Correction verified: at a follow-up visit by DCDEE.

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

“Of the five staff files reviewed today, one staff did not have a current Health Questionnaire on file.”

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

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.

“Of the five staff files reviewed today, one staff person did not have emergency information 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.. Corrected during the inspection.

Incident logs were not completed and maintained as required.

“The incident log did not have entries for 2025. During today’s visit the director entered an injury and the recent bees strings of three children into the log.”

Rule Incident logs were not completed and maintained as required.. Corrected during the inspection.

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

“The staff person, who began employment on 5/27/25, had completed 3 of the 6 hours of training that was required within the first two weeks of employment.”

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: Jun 30, 2025. Correction verified: by a letter from the provider.

A valid qualification letter was not on file and available to review at the facility.

“The qualification letter on file for one of the therapists, who was working with a child today, was a provisional clearance letter with an expiration date of 3/20/25.”

Rule A valid qualification letter was not on file and available to review at the facility.. Corrected during the inspection.

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

“The staff person, who began employment on 4/21/25, had not received the orientation.”

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: May 22, 2025. Correction verified: by a letter from the provider.

Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member’s individual personnel file.

“The medical report and negative TB report for the staff person, who began employment on 4/21/25, were dated 2/27/24.”

Rule Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: May 22, 2025. Correction verified: by a letter from the provider.

Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements.

“The last documented playground inspection located today was dated 12/2/24.”

Rule Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: May 22, 2025. Correction verified: by a letter from the provider.

The materials and equipment indoors and outdoors were not sufficient to provide a variety of play experiences to promote the children’s emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development.

“There were empty shelving units in classroom #5, where additional materials were needed for the children (age 2) present in the classroom. The director stated that additional materials had been ordered.”

Rule The materials and equipment indoors and outdoors were not sufficient to provide a variety of play experiences to promote the children's emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: May 22, 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. Five staff had expired CPR training.”

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: Mar 18, 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. Five staff had expired First Aid training.”

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: Mar 18, 2025. Correction verified: by a letter from the provider.

Documentation of staff’s education, training, and experience was not on file.

“There was no verification of education on file for nine staff.”

Rule Documentation of staff's education, training, and experience was not on file.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Feb 5, 2025. 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.

“Annual evaluation had not been conducted for any staff in 2024.”

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

Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member’s individual personnel file.

“(1) One staff, who transferred to this center, did not have a medical assessment or TB test on file. (2) Two staff had outdated Health Questionnaires and emergency information on file.”

Rule Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Feb 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.

“Three staff had not completed Recognizing and Responding to Suspicions of Child Maltreatment after five years.”

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: Mar 18, 2025. 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.

“It could not be determined that seven staff had completed their 16 hours of new staff orientation.”

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

Rule violated (DCDEE’s description below)

“NC Sanitation Rule 15A NCAC 18A .2808 (f) states that the kitchen shall be inaccessible to children. During today’s visit the kitchen was open, and food was cooking on the stove. The cook was visiting the classrooms to get her daily lunch count.”

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

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

“During today’s visit it could not be determined that two staff had completed their in-service training hour requirement for the past year.”

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: Feb 19, 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, who began employment on 3/18/24, had not completed the training.”

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

The materials and equipment indoors and outdoors were not sufficient to provide a variety of play experiences to promote the children’s emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development.

“During today’s visit there were at least two empty shelving units in classrooms #4, #5, and #7. Additional materials needed to be available for the children. This is a repeat violation from the 12/17/24 and 11/14/24 visits.”

Rule The materials and equipment indoors and outdoors were not sufficient to provide a variety of play experiences to promote the children's emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Feb 5, 2025. Correction verified: by a letter from the provider.

An incident report was not completed and mailed to a Division representative within seven days after the incident when medical treatment was required.

“On November 12, 2024, a one-year-old child received medical attention after sustaining an injury. The administrator failed to report the incident to an DCDEE representative.”

Rule An incident report was not completed and mailed to a Division representative within seven days after the incident when medical treatment was required.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jan 13, 2025. Correction verified: by a letter from the provider.

Child was handled roughly.

“On November 12 2024 and December 23, 2024, a staff member lifted a one-year-old child by the arm, resulting in the child sustaining injuries on both occasions. The child received medical attention for these injuries.”

Rule Child was handled roughly.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jan 13, 2025. Correction verified: by a letter from the provider.

All staff records, except financial records, were not made available for review.

“The temporary director did not have a file on site.”

Rule All staff records, except financial records, were not made available for review.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jan 2, 2025. Correction verified: by a letter from the provider.

Application for employment and date of birth was not on file for all staff.

“The staff person, who began employment on 11/25/24, did not have an application on file.”

Rule Application for employment and date of birth was not on file for all staff.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jan 2, 2025. Correction verified: by a letter from the provider.

Children were not adequately supervised at all times.

“On the afternoon of 12/13/24, a child (age 2) was left unsupervised and alone on the playground for a short period of time.”

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: Jan 2, 2025. Correction verified: by a letter from the provider.

Each child did not have an opportunity to be outdoors daily, if weather conditions permitted.

“During a teacher interview, the teacher stated that 12/13/24 was the first day, since her employment on 11/25/24, that the children in classroom space #5 had been taken outside to play.”

Rule Each child did not have an opportunity to be outdoors daily, if weather conditions permitted.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jan 2, 2025. 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.

“There was no documentation of the new staff training for the staff person, who began employment on 11/25/24.”

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: Jan 2, 2025. Correction verified: by a letter from the provider.

Minimum staff/child ratios and group sizes for the number and ages of children in care were not met.

“(1) Classroom space #5 was maintaining a staff/child ratio of 12 children (ages 1 to school age) with one staff during a portion of the day on 12/13/24. This occurrence happened prior to naptime. (2) For a period time during the afternoon of 12/13/24, there were 15 children in with two teachers (ages 1 to school age).”

Rule Minimum staff/child ratios and group sizes for the number and ages of children in care were not met.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jan 2, 2025. Correction verified: by a letter from the provider.

Special diet or food allergy information was not posted where they can be seen in food preparation and eating areas.

“The posted allergy listed had not been updated since July 2024. Many of the children on the list no longer attended. Staff was concerned that children who had enrolled after July and may have a food allergy, had not been added to the allergy list.”

Rule Special diet or food allergy information was not posted where they can be seen in food preparation and eating areas.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jan 2, 2025. Correction verified: by a letter from the provider.

The materials and equipment indoors and outdoors were not sufficient to provide a variety of play experiences to promote the children’s emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development.

“(1) Classroom space #4 needs more materials for empty shelving. (2) In classroom space #5 the shelving was turned together, denying children access to required materials.”

Rule The materials and equipment indoors and outdoors were not sufficient to provide a variety of play experiences to promote the children's emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jan 2, 2025. 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.

“The bottles for one child in classroom space #2 were not labeled and dated.”

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.

The materials and equipment indoors and outdoors were not sufficient to provide a variety of play experiences to promote the children’s emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development.

“Classroom #6 needed more materials for the empty shelving.”

Rule The materials and equipment indoors and outdoors were not sufficient to provide a variety of play experiences to promote the children's emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Dec 3, 2024. Correction verified: by a letter from the provider.

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

“The posted activity plan for classroom space #1 was dated September.”

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: Oct 18, 2024. Correction verified: by a letter from the provider.

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

“Two of the three playground areas had hose that needed to be wound to eliminate a tripping hazard for children.”

Rule A safe indoor and outdoor environment was not provided for the children.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Oct 18, 2024. Correction verified: by a letter from the provider.

An individual written feeding plan was not provided by child’s parent or health care provider or was not followed and posted.

“(omit posting for centers located in a residence). (1) Classroom space #3 needed feeding schedules for 3 children. (2) The feeding schedules for the infants in classroom space #1 were not available today, becauses the cabinet door would not open.”

Rule An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Oct 18, 2024. Correction verified: by a letter from the provider.

Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month.

“There were safe sleep monitoring charts for the month of October for 4 of the 10 infants enrolled in classroom space #1. The information on the 4 charts indicated that the children were last monitored on 10/3/24.”

Rule Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Oct 18, 2024. Correction verified: by a letter from the provider.

Center did not maintain a record of daily attendance.

“Attendance for the school age children, enrolled in classroom space #8 after school, could not be located today.”

Rule Center did not maintain a record of daily attendance.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Oct 18, 2024. Correction verified: by a letter from the provider.

Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member’s individual personnel file.

“The medical assessment for the staff person, who began employment on 10/1/24, was dated 9/25/23. The TB test for the staff person, who began empllyment on 10/1/24, was dated 9/14/23.”

Rule Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Oct 18, 2024. Correction verified: by a letter from the provider.

Menus for all meals and snacks were not current or posted where easily seen by parents and cook.

“The posted menus were for the month of August.”

Rule Menus for all meals and snacks were not current or posted where easily seen by parents and cook.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Oct 18, 2024. Correction verified: by a letter from the provider.

The materials and equipment indoors and outdoors were not sufficient to provide a variety of play experiences to promote the children’s emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development.

“Additional materials were needed for the children in care in classroom space #3 and #4. Both classrooms had empty shelving to accommodate needed materials.”

Rule The materials and equipment indoors and outdoors were not sufficient to provide a variety of play experiences to promote the children's emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Oct 18, 2024. Correction verified: by a letter from the provider.

All children were not held or placed in feeding chairs or other appropriate apparatus to be fed.

“Upon arrival in classroom space #1 there was an infant lying in her crib, drinking her bottle of milk.”

Rule All children were not held or placed in feeding chairs or other appropriate apparatus to be fed.. Corrected during the inspection.

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

“The activity plans for two classrooms were for the week of 8/26 - 8/30. The activity plans for four classrooms were not dated.”

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: Sep 20, 2024. Correction verified: by a letter from the provider.

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

“The hose needed to be kept wound to eliminate a tripping hazard for the children in two of the playground spaces.”

Rule A safe indoor and outdoor environment was not provided for the children.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Sep 20, 2024. Correction verified: by a letter from the provider.

Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member’s individual personnel file.

“The staff person, who began employment on 8/5/24, did not have a medical assessment on file.”

Rule Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Sep 20, 2024. Correction verified: by a letter from the provider.

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

“Upon arrival there were 10 children, age 2, in classroom space #5 with one teacher.”

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

Refrigerator(s) did not maintain a temperature of 45 degrees F. or below.

“The refrigerator thermometer in the infant classroom (classroom space #1) was broken.”

Rule Refrigerator(s) did not maintain a temperature of 45 degrees F. or 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.

“The staff person, who began employment on 8/29/24, did not have a signed Shaken Baby policy on file.”

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.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Sep 20, 2024. Correction verified: by a letter from the provider.

All children were not held or placed in feeding chairs or other appropriate apparatus to be fed.

“Upon arrival in the infant classroom (classroom space #1), one infant was lying on his back on the floor, drinking his bottle of milk.”

Rule All children were not held or placed in feeding chairs or other appropriate apparatus to be fed.. Corrected during the inspection.

An individual written feeding plan was not provided by child’s parent or health care provider or was not followed and posted.

“One child (under the age of 15 months) in classroom space #2 did not have a feeding schedule.”

Rule An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Aug 19, 2024. Correction verified: by a letter from the provider.

Fire drills were not practiced monthly and/or the drill record was incomplete.

“The last documented fire drill was conducted on 3/20/24.”

Rule Fire drills were not practiced monthly and/or the drill record was incomplete.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Aug 19, 2024. Correction verified: by a letter from the provider.

Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements.

“The last documented playground inspection was conducted on 5/20/24.”

Rule Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Aug 19, 2024. Correction verified: by a letter from the provider.

Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete.

“The last documented shelter-in-place drill was conducted on 3/14/24.”

Rule Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Aug 19, 2024. Correction verified: by a letter from the provider.

The materials and equipment indoors and outdoors were not sufficient to provide a variety of play experiences to promote the children’s emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development.

“Several shelving units in classroom space #5 were empty. Additional materials and equipment was needed for the 9 children present today.”

Rule The materials and equipment indoors and outdoors were not sufficient to provide a variety of play experiences to promote the children's emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Aug 19, 2024. Correction verified: by a letter from the provider.

Following the issuance of any administrative action the operator did not post the administrative action, cover letter, and/or corrective action plan, if applicable, in a location visible to parents and visitors near the entrance of the child care facility during the pendency of an appeal and/or throughout the effective time period of the administrative action.

“(Applicable to administrative actions after 2/1/19). The Administrative Action recently issued in June 2024 was not posted nor available for the Division Representative review.”

Rule Following the issuance of any administrative action the operator did not post the administrative action, cover letter, and/or corrective action plan, if applicable, in a location visible to parents and visitors near the entrance of the child care facility during the pendency of an appeal and/or throughout the effective time period of the administrative action.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jul 18, 2024. Correction verified: by a letter from the provider.

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

“A staff member on more than one occasion raised their tone at children. In June 2024, a staff member pulled a 5-year-old child by their hands off the floor instead of underneath their arms.”

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 18, 2024. Correction verified: at a follow-up visit by DCDEE.

An individual written feeding plan was not provided by child’s parent or health care provider or was not followed and posted.

“(omit posting for centers located in a residence). One child, under the age of 15 months, did not have a feeding schedule. He had been attending the center for approximately 2 weeks.”

Rule An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: May 20, 2024. Correction verified: by a letter from the provider.

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

“A teacher, who began employment on 2/20/24, used harsh language when a child (age 2) was trying to see his image in a selfie video the teacher was taking.”

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: May 20, 2024. Correction verified: by a letter from the provider.

Facility did not follow written operational policies.

“A staff person took pictures of children on her personal phone and forwarded them over the internet, which was against the center’s written policy.”

Rule Facility did not follow written operational policies.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: May 20, 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.

“The staff person, who began employment on 2/20/24, had not completed her new staff orientation.”

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: May 20, 2024. Correction verified: by a letter from the provider.

All staff records, except financial records, were not made available for review.

“There was no key on the premises to unlock staff records today.”

Rule All staff records, except financial records, were not made available for review.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Mar 19, 2024. Correction verified: by a letter from the provider.

An individual responsible for both administering the program and planning and ensuring the implementation of the daily activities did not meet requirements for an administrator and/or complete BSAC training.

“The director had not completed the BSAC training. This was a repeat violation from the 2/15/23 visit.”

Rule An individual responsible for both administering the program and planning and ensuring the implementation of the daily activities did not meet requirements for an administrator and/or complete BSAC training.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Mar 25, 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.

“New staff orientation had not been completed for the staff person, who began employment on 2/13/23. This was a repeat violation from the 2/15/23 visit.”

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: Mar 19, 2024. Correction verified: by a letter from the provider.

A child’s file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information.

“Three children needed the signed form on file.”

Rule A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Feb 28, 2024. Correction verified: by a letter from the provider.

A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center.

“One child did not have signed verification of receipt of the summary on file.”

Rule A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Feb 28, 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. There was no verification that staff person, who began employment on 4/4/23, had not completed CPR training.”

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: Mar 5, 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. There was no verification that staff person, who began employment on 4/4/23, had not completed First Aid training.”

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: Mar 5, 2024. Correction verified: at a follow-up visit by DCDEE.

All stationary equipment, more than 18 inches high, was not installed over protective surfacing.

“All three climbing structures needed additional surfacing to meet the requirements.”

Rule All stationary equipment, more than 18 inches high, was not installed over protective surfacing.. 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.

An individual responsible for both administering the program and planning and ensuring the implementation of the daily activities did not meet requirements for an administrator and/or complete BSAC training.

“The administrator had not completed the BSAC training.”

Rule An individual responsible for both administering the program and planning and ensuring the implementation of the daily activities did not meet requirements for an administrator and/or complete BSAC training.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Mar 25, 2024. Correction verified: by a letter from the provider.

Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application.

“One child needed emergency contact information on file.”

Rule Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Feb 28, 2024. Correction verified: by a letter from the provider.

Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month.

“The safe sleep monitoring charts in classroom space #1 reflected that visually monitoring of sleeping infants was last documented on 2/2/24.”

Rule Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Feb 28, 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 needed updated emergency information on file. The emergency information for two staff was not dated.”

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: Feb 28, 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.

“The completion of annual evaluations could not be verified during the visit.”

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: Feb 28, 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.

“There was no verificatin that staff, who began employment on 1/8/24, 1/13/24 had received the orientation.”

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: Feb 28, 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.

“There was no verification that five staff, who began employment at the center in 2023, has received new staff orientation.”

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: Feb 28, 2024. Correction verified: by a letter from the provider.

Parents were not given the changed Shaken Baby Syndrome and Abusive Head Trauma policy 14 days prior to implementation and did not sign a statement which attests that the new policy was given to and discussed with him or her.

“Two children needed a signed Shaken Baby policy on file.”

Rule Parents were not given the changed Shaken Baby Syndrome and Abusive Head Trauma policy 14 days prior to implementation and did not sign a statement which attests that the new policy was given to and discussed with him or her.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Feb 28, 2024. Correction verified: by a letter from the provider.

Prior to employment a Criminal Background Check was not completed.

“The staff person, who began employment on 4/4/23, had not completed the Criminal Record Check process to have a CRC clearance letter on file.”

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: Mar 5, 2024. Correction verified: at a follow-up visit by DCDEE.

Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child’s file.

“One child did not have a signed discipline policy on file.”

Rule Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Feb 28, 2024. Correction verified: by a letter from the provider.

Staff did not complete the health and safety training within one year of employment.

“Two staff did not take the Health and safety trainings within their first year of employment.”

Rule Staff did not complete the health and safety training within one year of employment.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Apr 12, 2024. 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.

“Two staff needed additional training hours to meet their yearly in-service training requirement.”

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: Feb 28, 2024. Correction verified: by a letter from the provider.

The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction.

“One child did not have notification on file.”

Rule The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Feb 28, 2024. Correction verified: by a letter from the provider.