Presbyterian Hospital Child Development Center

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

“On March 30, 2026, at 2:47 pm, with two caregivers present and ten (10) infants present in space #3, (Butterflies) one infant was given the incorrect formula bottle. The center administrator self-reported the incident on the same day, March 30, 2026.”

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

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

“Round mini donuts were served for 100th days of school to toddlers. A glue gun was monitored stored on the classroom countertop, plugged in and accessible to children.”

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

All equipment and furnishings were not in good repair.

“A plastic hose bin was monitored cracked on the top. A few balls were monitored in poor condition.”

Rule All equipment and furnishings were not in good repair.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jan 30, 2026. 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). Two infant feeding schedules were not posted in space #2. Five infant feeding schedules were not posted in the eating area for space #4 and #5.”

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: Jan 30, 2026. Correction verified: at a follow-up visit by DCDEE.

Equipment and furnishings were not sturdy, stable and free of hazards.

“A book in poor condition was monitored in the bookshelf of space #4.”

Rule Equipment and furnishings were not sturdy, stable and free of hazards.. Corrected during the inspection.

Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule.

“An epi pen was maintained in space #14 without current written permission to administer.”

Rule Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule.. 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: at a follow-up visit by DCDEE.

The medical action plan was not updated on an annual basis or when changes to the plan were made by the child’s parent or health care professional.

“A medical action plan maintained in space #14 was not current.”

Rule The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or 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 30, 2026. Correction verified: at a follow-up visit by DCDEE.

Toys and other mouth-contact surfaces were not cleaned and sanitized daily when used or cleaned more frequently if visibly dirty.

“The dirty toy bin in space #4 was very small and no toys were monitored in the bin. Staff had placed no toys in the container that had been mouthed by children to be cleaned.”

Rule Toys and other mouth-contact surfaces were not cleaned and sanitized daily when used or cleaned more frequently if visibly dirty.. 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: at a follow-up visit by DCDEE.

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

“Push pins were used on bulletin boards in classrooms with children under the age of three.”

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: Jul 24, 2025. 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.

“A boppy pillow encased in a plastic bag was monitored in the Bears room, accessible to infants.”

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.

The center’s safe sleep policy was not posted in a prominent place in the infant room where parents and caregivers were able to view daily.

“The posted ITS-SIDS policy was not the most current revised policy dated 2025 in the Kangaroos.”

Rule The center's safe sleep policy was not posted in a prominent place in the infant room where parents and caregivers were able to view daily.. Corrected during the inspection.

All equipment and furnishings were not in good repair.

“The Owls/Lambs protective surfacing was monitored in poor condition with grass growing it in one section and another area covered by a cone. Underneath the cone the surfacing was cut, and a portion is now missing.”

Rule All equipment and furnishings were not in good repair.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Feb 13, 2025. 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.

“There were three classrooms with children under the age of three with materials accessible to them with small parts. Glue sticks with caps and glitter glue were identified and removed from the children’s art center’s during the visit.”

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.

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 infant was transferred from space #2 over to space #1 and the infant’s feeding schedule was not transferred with the infant. After staff lunch breaks, the infant was returned to space #2 where the original feeding schedule was posted.”

Rule An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted.. Corrected during the inspection.

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

“On March 5, 2024, the center administrator self-reported that an infant was given the incorrect formula bottle to another infant in space #1/Kanagoos.”

Rule Each infant was not served only bottles labeled with their individual name.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Apr 2, 2024. Correction verified: by a letter from the provider.

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

“On March 5, 2024, a staff left space #2/Buttlerflies leaving one staff member with six infants.”

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: Apr 2, 2024. Correction verified: at a follow-up visit by DCDEE.

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

“The posted staff/child ratio worksheet in space #1 was not completed with the required information.”

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

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

“In space KD, a child’s medical action plan signed by the doctor stated Epi Pen and Benadryl. There was not an Epi Pen on site for the identified child. There several exposed tree roots on the children’s outdoor learning environment. There was a partially collapsed wooden retaining wall with exposed hardware.”

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: Feb 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.

“Twenty-three staff members 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.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Feb 5, 2024. Correction verified: by a letter from the provider.

Each child’s bed, cot, or 2” mat was not individually assigned and identified.

“An infant in space#2/Butterflies was monitored in a crib that was not labeled or identified as assigned to the infant.”

Rule Each child's bed, cot, or 2" mat was not individually assigned and identified.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Feb 5, 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.

“A new employee did not have documentation that this orientation had been completed.”

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 6, 2024. Correction verified: by a letter from the provider.

Equipment and furnishings were not sturdy, stable and free of hazards.

“There were exposed tree roots that caused tripping hazards. Washed away borders around the edges of the foam surfacing surrounding outdoor stationary play equipment was monitored with large gaps from the edge to the ground, causing tripping hazards. There was a piece of the SA stationary equipment with a protruding edge.”

Rule Equipment and furnishings were not sturdy, stable and free of hazards.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Feb 16, 2024. Correction verified: by a letter from the provider.

For children under three years of age, materials were not offered in sufficient quantity to allow all children to use them at some time during the day and to allow for a range of choices.

“In space #7/Ducks there were not enough materials for three children to play with the same toy. Presented materials were not offered in an organized manner to the children.”

Rule For children under three years of age, materials were not offered in sufficient quantity to allow all children to use them at some time during the day and to allow for a range of choices.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Feb 5, 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 staff did not have documentation that orientation had been received.”

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 6, 2024. Correction verified: by a letter from the provider.

Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional.

“There was an inhaler without the medication labeled container.”

Rule Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Feb 5, 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 shelter in place/lock down drill was completed October 9.2023”

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: Feb 8, 2024. Correction verified: by a letter from the provider.

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

“On November 3, 2023, one infant caregiving staff failed to follow center procedure of verifying the name listed on the bottle and checking the child’s face prior to the bottle feeding. An infant was given the incorrect formula bottle.”

Rule Each infant was not served only bottles labeled with their individual name.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Nov 21, 2023. Correction verified: by a letter from the provider.