Tree of Knowledge Daycare Center

Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization.

“Diaper cream and sunscreen for enrolled child L. J. was not discarded or given back to the parent within 72 hours after written authorization expired on August 2, 2026.”

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Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization..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: Sep 28, 2026. Correction verified: by a letter from the provider.

Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection.

“Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The last annual approved fire inspection expired on August 15, 2026.”

Rule Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Sep 29, 2026. 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.

“Two (2) staff members did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment.”

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.

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. The administrator failed to notify the division of a staff member that was hired on December 8, 2025, within five days of hire.”

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: Jul 30, 2026. Correction verified: by a letter from the provider.

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

“A staff member with a hire date of December 8, 2025, did not have a valid qualification letter on file.”

Rule A valid qualification letter was not on file and available to review at the facility.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jul 7, 2026. Correction verified: by a letter from the provider.

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

“A staff record for one (1) employee was not available for review.”

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: Jul 7, 2026. 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 menus posted were dated for the month of May 2026.”

Rule Menus for all meals and snacks were not current or posted where easily seen by parents and cook.. Corrected during the inspection.

Prior to employment a Criminal Background Check was not completed.

“A staff member with a hire date of December 8, 2025, did not complete a criminal background check prior to employment.”

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: Jul 7, 2026. Correction verified: by a letter from the provider.

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

“In space 1, an activity plan dated for the week of February 25-28, 2026, was posted, and in space 4, an activity plan dated for the week of March 23 -27, 2026, was posted.”

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

“Aerosol cans of Lysol, Clorox wipes, bulk sanitizer, and cleaning chemicals were stored in an unlocked storage closet.”

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.

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

“An activity plan dated for the week of February 16-20, 2026, was posted in the infant’s room.”

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.”

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: Mar 11, 2026. 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. Three (3) staff members did not successfully complete certification in CPR training and/or the verification of staff completion from an approved training organization was not on file.”

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 11, 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. Three (3) staff members, did not successfully complete certification in first aid training and/or the verification of staff completion from an approved training organization was not on file.”

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 11, 2026. Correction verified: by a letter from the provider.

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

“A staff member with a hire date of February 20, 2026, did not have an application for employment 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: Mar 11, 2026. Correction verified: by a letter from the provider.

Center did not maintain a record of daily attendance.

“In space 5 and 6, the daily attendance was not maintained for all eight (8) children that was present.”

Rule Center did not maintain a record of daily attendance.. Corrected during the inspection.

Center staff did not comply with the safe sleep policy.

“On February 23, 2026, an eight-month-old infant was observed sleeping in a swing.”

Rule Center staff did not comply with the safe sleep policy.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Mar 11, 2026. 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.

“A staff member with a hire date of February 20, 2026, did not have a medical report on file prior to employment.”

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: Mar 11, 2026. Correction verified: by a letter from the provider.

Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years.

“Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. A caregiver with a hire date of May 30, 2020, who was providing care in the classroom designated for infants, did not complete ITS-SIDS training on or before the expiration date of January 20, 2024.”

Rule Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Mar 11, 2026. 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.

“A staff member with a hire date of February 20, 2026, did not have the required 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: Mar 11, 2026. Correction verified: by a letter from the provider.

Each employee’s personnel file did not contain a signed and dated statement that they received a job description and that they have received personnel and operational policies.

“A staff member with a hire date of February 20, 2026, did not have a signed statement of receipt of job description, personnel, and operation policies on file.”

Rule Each employee's personnel file did not contain a signed and dated statement that they received a job description and that they have received personnel and operational policies.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Mar 11, 2026. 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.

“In space 2 and 4, electrical outlets that were accessible to children were not covered as required by the rule.”

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.. Corrected during the inspection.

Meals/snacks did not comply with the Meal Patterns for Children in Child Care Programs.

“During today’s visit, a fruit component was not served with the meal for lunch. The meal consisted of macaroni and cheese, sweet peas, and BBQ chicken.”

Rule Meals/snacks did not comply with the Meal Patterns for Children in Child Care Programs.. 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.

“Staff members, A.A. (hire date: September 2, 2025) and P.G. (hire date: September 15, 2025) did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment.”

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: Mar 11, 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.

“A staff member with a hire date of February 20, 2026, did not have documentation that the SBS/AHT policy was reviewed prior to the first day of caring for children.”

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: Mar 11, 2026. Correction verified: by a letter from the provider.

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

“In space 2, a current schedule was not posted as required by the rule.”

Rule A current schedule 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 10, 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. Three (3) staff members did not have documentation of the review of the center’s emergency preparedness and response plan during orientation 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: Oct 10, 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 (1) staff, D. H., did not renew a certification in first aid training prior to the expiration date of July 24, 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: Oct 14, 2025. 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.

“Two (2) staff members did not have a medical report on file prior to the first day of employment.”

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: Oct 10, 2025. 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.

“Two (2) staff members did not have an 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.. Corrected during the inspection.

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

“In space 1 & 4, daily records of arrival and departure times were not maintained as children arrived during the morning.”

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

Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission.

“One (1) enrolled child, M.R., did not have an immunization record on file within 30 days of enrollment.”

Rule Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Oct 10, 2025. Correction verified: by a letter from the provider.

Each employee’s personnel file did not contain a signed and dated statement that they received a job description and that they have received personnel and operational policies.

“Two (2) staff members did not have a signed statement of receipt of job description, personnel, and operation policies on file.”

Rule Each employee's personnel file did not contain a signed and dated statement that they received a job description and that they have received personnel and operational policies.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Oct 10, 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.

“Two (2) staff members did not complete six (6) clock hours of training 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: Oct 10, 2025. 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.

“A current menu was not posted as required by the rule.”

Rule Menus for all meals and snacks were not current or posted where easily seen by parents and cook.. Corrected during the inspection.

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

“A staff member with a hire date of February 24, 2025, did not receive 16 hours of orientation within the first six (6) weeks as required by the rule.”

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: Oct 10, 2025. Correction verified: by a letter from the provider.

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

“Documentation that the emergency care plan was reviewed with three (3) staff members as required was not 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: Oct 10, 2025. 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 (2) staff members did not complete a review of the SBS/AHT policy prior to the first day of providing care for children.”

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.

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.

“An open can of Pepsi was observed sitting on the staff member’s desk in space 3, and an open can of Mountain Dew was observed sitting on a shelf in space 5.”

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.. Corrected during the inspection.

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

“The staff/child ratios form posted in spaces 1, 2, and 4 was not applicable to the classroom.”

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

“A staff member with a hire date of 8-24-24 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment as required by the rule.”

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

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

“In Space #5, two (2) children were missing written authorization forms to apply topical ointments.”

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: Oct 22, 2024. Correction verified: by a letter from the provider.

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.

“A can of Lysol and WD-40, a bottle of Fabuloso and a bag of ice melt salt were all stored in an unlocked closet. In the bathroom, a can of air freshener was on top of the paper towel dispenser .”

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.

Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years.

“Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. The administrator did not renew ITS-SIDS training after it expired on 01-20-24”

Rule Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Nov 8, 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.

“In space #2 and #3, electrical outlets that were not in use were uncovered.”

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: Oct 22, 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 quarterly lockdown drill was conducted on 06-09-24.”

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: Oct 22, 2024. Correction verified: by a letter from the provider.

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.

“In space #5, an open can of Ginger Ale was observed sitting on the shelf.”

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: Oct 22, 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.

“In employee with a hire date of 05-20-24, did not complete the Recognizing and Responding to Suspicions of Child Maltreatment within 90 days of employment as required by the rule.”

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: Oct 22, 2024. Correction verified: by a letter from the provider.