Tiny Hearts Child Care Center

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

“Written authorization was not on file for two Ventolin HFA inhalers located in space #2.”

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: May 18, 2026. Correction verified: by a letter from the provider.

A drug or medicine was administered after its expiration date.

“One Ventolin HFA inhaler, located in space #2, expired January 2026.”

Rule A drug or medicine was administered after its expiration date.. 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.

“One bottle of 50% Isopropyl Alcohol was stored on a shelf, above five feet in space #4.”

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.

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

“Seven staff files reviewed had health questionnaires that expired in April 2026.”

Rule All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: May 18, 2026. Correction verified: by a letter from the provider.

Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services.

“An asthma action plan was not on file for two Ventolin HFA inhalers located in space #2.”

Rule Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: May 18, 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.

“Seven staff files reviewed contained emergency information that expired in April 2026.”

Rule Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: May 18, 2026. Correction verified: by a letter from the provider.

Children’s records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care was not on file for each child.

“A child enrolled on 8/27/24 did not have a medical report on file.”

Rule Children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care was not on file for each child.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: May 18, 2026. Correction verified: by a letter from the provider.

Diaper changing surfaces were not kept free of storage.

“There were two meal plates located on the changing table in space #3.”

Rule Diaper changing surfaces were not kept free of storage.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: May 18, 2026. Correction verified: by a letter from the provider.

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.

“A child enrolled on 1/5/26 had an immunization report on file dated 4/9/26.”

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: May 18, 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.

“Signed acknowledgment of personnel and operational policies was not on file for three staff.”

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.. Corrected during the inspection.

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

“A child enrolled on 1/5/26 had a medical report on file dated 4/9/26.”

Rule Medical exam or health assessment record was not on file before or within 30 days after admission.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: May 18, 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 menu posted in the lobby and in the kitchen were dated 4/27/26-5/1/26.”

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: May 18, 2026. Correction verified: by a letter from the provider.

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

“The thermometer in the refrigerator in space #5 read 50 degrees F.”

Rule Refrigerator(s) did not maintain a temperature of 45 degrees F. or below.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: May 18, 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.

“Three of ten staff files reviewed did not contain signed acknowledgement of review of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy.”

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.

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

“The EPR Plan on file was last reviewed/revised on February 13, 2025.”

Rule The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: May 18, 2026. 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.

“One bottle of Murphy’s Multi-Use Wood Cleaner was stored on a shelf, above five feet, and one bottle of Family Guard Disinfectant Cleaner was stored in the cabinet below the sink in the bathroom of space #1.”

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, 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.

“Emergency Information was not on file for staff employed on 9/4/25.”

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.

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

“Documentation of orientation was not on file for staff that was employed on 9/4/25.”

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 13, 2025. Correction verified: by a letter from the provider.

Menus for all meals and snacks were not planned at least 1 week ahead and dated.

“A current menu was not posted in the kitchen and the parent information board.”

Rule Menus for all meals and snacks were not planned at least 1 week ahead and dated.. Corrected during the inspection.

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

“The mulch under the stationary structures of outdoor space #2 was compacted and did not meet the required depth of loose surfacing, measuring less than one inch in the fall zone.”

Rule The depth of the loose surfacing was not based on critical height of the equipment.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Oct 13, 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.

“A medication authorization form was not on file for one tube of Parent Choice Diaper Rash Ointment, located in space #3.”

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: May 30, 2025. 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. Recertification for staff employed on 9/3/24, did not include infant and child 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: May 30, 2025. Correction verified: at a follow-up visit by DCDEE.

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.

“Documentation of safe sleep checks were not available for the week of May 12, 2025-May 16, 2025, and May 19th-May 21, 2025.”

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: May 30, 2025. Correction verified: at a follow-up visit by DCDEE.

Children were not adequately supervised at all times.

“One staff stood in the doorway between spaces #1 and #2, observing two group of children. Nine children, two to five years of age were present in space #1. Eight children, two years of age were present in space #2.”

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: May 30, 2025. Correction verified: at a follow-up visit by DCDEE.

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

“Staff employed on 6/12/23, 6/12/23, 7/13/23, 8/2/23, 10/20/23, 10/16/23, 10/26/23, and 12/8/23 did not complete the health and safety training within one 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: Jun 3, 2025. 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.

“One canister of Wet Ones wipes was on the sink of the hall bathroom used by school aged children. There was one spray bottle of Lysol Multi-Purpose cleaner under the bathroom sink and one spray bottle of Clorox Sentiva Multi-Surface Cleaner on the bathroom sink in space #3.”

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.

Children were not adequately supervised at all times.

“There was a lapse in supervision when the staff in spaces #1 stood in the doorway of spaces #1 and #2 while the staff assigned to space #2 opened the lobby door. There was a lapse of supervision when the staff assigned to space #2 stood in the doorway of spaces #1 and #2, while the staff assigned to space #1 left the classroom.”

Rule Children were not adequately supervised at all times.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Feb 17, 2025. Correction verified: at a follow-up visit by DCDEE.

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.

“There were five children signed in on paper and five children signed in on the Brightwheel App, however, there were twenty-five (25) children present at the facility.”

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.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Feb 17, 2025. Correction verified: at a follow-up visit by DCDEE.

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

“The last documented lockdown drill on 7/16/24.”

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: Feb 18, 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.

“Documentation of the completion of Recognizing and Responding to Suspicions of Child Maltreatment training for staff employed on 9/3/24 was not on file for review.”

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 17, 2025. Correction verified: at a follow-up visit by DCDEE.

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.

“Acknowledgement of the review of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not on file for staff employed on 9/3/24.”

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: Feb 17, 2025. Correction verified: at a follow-up visit by DCDEE.

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

“Activity plans in spaces #1 and #2 were dated June 3-7, 2024. Activity plan in space #3 was dated May 13-17, 2024. No activity plan was posted in space #4.”

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

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

“The wooden fence on outdoor space #1 had one missing slat and two slats that have become detached at the top. There were vines with thorns growing along the chain linked fence of outdoor space #2.”

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

A violation was found for which there is no item number.

“A staff’s purse was located on the floor of space #2. This is a violation of sanitation rule 15A NCAC 18A .2820(g) Storage.”

Rule A violation was found for which there is no item number.. Corrected during the inspection.

A violation was found for which there is no item number.

“There was toilet paper was in space #1 and the staff bathroom. This is a violation of sanitation rule 15A NCAC 18A .2817(a).”

Rule A violation was found for which there is no item number.. 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.

“One bottle of Clorox Scentevia Disinfectant spray and one bottle of Family Guard Disinfectant cleaner was located on top a cabinet in an unlocked staff bathroom outside of space #2. One Airwick automatic air freshener spray was stored on the sign-in counter of the lobby.”

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.

All equipment and furnishings were not in good repair.

“The laminate edging of the cubby in space #4, is detached and protruding from the shelf causing a shape edge to be exposed.”

Rule All equipment and furnishings were not in good repair.. 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.

“Documentation of orientation was not available for review for staff, S. Staton.”

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

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

“Documentation of a playground inspection was only available for August 2023 and May 2024.”

Rule Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements.. Corrected during the inspection.

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

“In space #5 there were two white trash bags and 3 grocery bags stored in a cabinet under the diaper changing table with a latching lock.”

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.

Running water, soap and individual sanitary towels, or other approved hand-drying devices were not supplied at each lavatory.

“Paper towels were not supplied in the staff and school age bathrooms.”

Rule Running water, soap and individual sanitary towels, or other approved hand-drying devices were not supplied at each lavatory.. 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, T. Garrett, D. Shackleford, and J. Cox completed Recognizing and Responding to Suspicions of Child Maltreatment training beyond 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.

The indoor and/or outdoor premises was not checked once a day, prior to initial use, ensuring debris, and broken equipment was removed and disposed of.

“In outdoor space #2 there were two broken sifting toys, one torn hammock, a bike with a missing wheel, and a tricycle with a broken seat.”

Rule The indoor and/or outdoor premises was not checked once a day, prior to initial use, ensuring debris, and broken equipment was removed and disposed of.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jun 20, 2024. 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.

“Signed acknowledgement of review of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was dated after providing care for staff Y. Moore, D. Shackelford, J. Cox, and T. Garrett.”

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.

The written feeding plan was not modified as the child’s needs changed.

“Feeding plans for one of three children enrolled in space #5 was last updated to reflect the child eating table food.”

Rule The written feeding plan was not modified as the child's needs changed.. Correction date, as North Carolina Department of Health and Human Services, Division of Child Development and Early Education (DCDEE) recorded it: Jun 20, 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 bottle of Family Guard Disinfectant Cleaner and Stink Bowl Spray was observed on the counter of an unlocked bathroom in the hallway of the facility.”

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.