First Presbyterian Day School

Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In Space #118, one (1) container of Triple Paste Skin Protectant, two (2) boxes of Camillia Teething Relief, one (1) bottle of Cerave Daily Moisturizing Lotion, two (2) tubes of Bordreaux’s Butt Paste, one (1) bottle of Babyganics Mineral Sunscreen, one (1) tube of Aquaphor Healing Cream, one (1) tube of Banana Boat Baby Mineral Sunscreen, two (2) tubes of Blue Lizard Baby Australian Sunscreen, one (1) tube of Tubby Todd Diaper Paste, one (1) tube Desitin Maximum Strength Paste, and one (1) tube of Little Journey Diaper Rash Ointment, were in an unlocked cabinet under the diaper changing table, accessible to children.

Violation corrected during visit

The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The most recent review of the facility’s emergency medical care plan by (1) staff member, employed on April 15, 2024, one (1) staff member, employed on July 6, 2024, one (1) staff member, employed on September 7, 2021, one (1) staff member, employed on September 30, 2002, one (1) staff member, employed on August 12, 2024, one (1) staff member, employed on January 29, 2024, one (1) staff member, employed on July 5, 2024, one (1) staff member, employed on May 13, 2019, one (1) staff member, employed on July 18, 2022, one (1) staff member, employed on December 16, 2024, one (1) staff member, employed on February 19, 2025, one (1) staff member, employed on September 26, 2023, one (1) staff member, employed on September 3, 2000, one (1) staff member, employed on November 15, 2023, one (1) staff member, employed on February 21, 2022, one (1) staff member, employed on July 6, 2021, one (1) staff member, employed on May 10, 2021, one (1) staff member, employed on October 30, 2024, one (1) staff member, employed on March 21, 2016, one (1) staff member, employed on April 12, 2022, one (1) staff member, employed on September 8, 2004, was conducted on April 1, 2025. The most recent review of the facility’s emergency medical care plan by one (1) staff member, employed on June 3, 2024, was conducted on May 5, 2025.

Violation confirmed corrected by letter received from provider on 6/2/2026

Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. The emergency information on file for one (1) child, enrolled on October 6, 2026, was most recently updated on May 21, 2025. The emergency information on file for one (1) child, enrolled on January 6, 2025, was most recently updated on December 9, 2024.

Violation confirmed corrected by letter received from provider on 6/2/2026

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. One (1) staff member, employed on April 15, 2024, one (1) staff member, employed on January 29, 2024, one (1) staff member, employed on May 13, 2019, one (1) staff member, employed on July 18, 2022, one (1) staff member, employed on September 26, 2023, one (1) staff member, employed on November 15, 2023, one (1) staff member, employed on April 12, 2022, one (1) staff member, employed on January 26, 2026, and one (1) staff member, employed on April 27, 2026, were not entered into the facility’s ABCMS Provider Portal.

Violation confirmed corrected by letter received from provider on 6/2/2026

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. The most recent review of the facility’s Emergency Preparedness and Response Plan by (1) staff member, employed on April 15, 2024, one (1) staff member, employed on July 6, 2024, one (1) staff member, employed on September 7, 2021, one (1) staff member, employed on September 30, 2002, one (1) staff member, employed on August 12, 2024, one (1) staff member, employed on January 29, 2024, one (1) staff member, employed on July 5, 2024, one (1) staff member, employed on May 13, 2019, one (1) staff member, employed on July 18, 2022, one (1) staff member, employed on December 16, 2024, one (1) staff member, employed on February 19, 2025, one (1) staff member, employed on September 26, 2023, one (1) staff member, employed on September 3, 2000, one (1) staff member, employed on November 15, 2023, one (1) staff member, employed on February 21, 2022, one (1) staff member, employed on July 6, 2021, one (1) staff member, employed on May 10, 2021, one (1) staff member, employed on October 30, 2024, one (1) staff member, employed on March 21, 2016, one (1) staff member, employed on April 12, 2022, one (1) staff member, employed on September 8, 2004, was conducted on April 1, 2025. The most recent review of the facility’s Emergency Preparedness and Response Plan by one (1) staff member, employed on June 3, 2024, was conducted on May 5, 2025.

Violation confirmed corrected by letter received from provider on 6/2/2026

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. A fire inspection was conducted on January 27, 2025, and not again until February 26, 2026. The fire inspection form for the inspection conducted on February 26, 2026, was not submitted to DCDEE until March 24, 2026.

Violation confirmed corrected by letter received from provider on 3/25/2026

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. In Space #117, the permission to administer medication form for one (1) tube of CVS Health Maximum Strength Cortisone Hydrocortisone Cream expired on March 1, 2026.

Violation confirmed corrected by letter received from provider on 3/25/2026

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. In Space #118, two (2) bottles containing formula were not labeled with the child’s name or the date they were brought into the facility, and four (4) bottles containing human milk were not labeled with the date they were brought into the facility.

Violation confirmed corrected by letter received from provider on 10/8/2025

An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. In Space #117, there was no infant feeding plan posted or on file for one infant, fourteen (14) months of age.

Violation confirmed corrected by letter received from provider on 10/8/2025

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. In Space #114, one (1) aerosol can of Glade Clean Linen Spray Refill, with multiple warnings, was on a shelf to the right of the restroom used by children, accessible to children.

Violation corrected during visit

All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. The most recent update of the health questionnaire on file for one (1) staff member, employed on October 2, 2023, was completed on April 23, 2024.

Violation confirmed corrected by letter received from provider on 10/8/2025

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. The most recent update of the emergency information form on file for one (1) staff member, employed on October 2, 2023, was completed on April 23, 2024.

Violation confirmed corrected by letter received from provider on 10/8/2025

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. One (1) staff member, employed on September 16, 2025, did not have a signed acknowledgment of receipt and review of the facility’s Prevention of Shaken Baby and Abusive Head Trauma Policy on file.

Violation confirmed corrected by letter received from provider on 10/8/2025

Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In Space #118, there was no permission to administer medication form for one (1) tube of Think Baby SPF 50 Zinc Oxide 23.4% Sunscreen.

Violation confirmed corrected by letter received from provider on 10/8/2025

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 (1) staff member, employed on March 24, 2025, did not complete Recognizing and Responding to Suspicions of Child Maltreatment Training.

Violation confirmed corrected by letter received from provider on 10/8/2025

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. In Space #112, one (1) aerosol can or Mod Podge Matte Clear Acrylic Sealer, with multiple warnings, was on top of the cabinet to the left of the cot storage area, accessible to children.

Violation corrected during visit

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. The First Aid Certification for one (1) staff member, employed on July 18, 2022, expired November 2024. The First Aid Certification for one (1) staff member, employed on November 2, 2022, expired November 2024.

Violation confirmed corrected by letter received from provider on 4/4/2025

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. The CPR Certification for one (1) staff member, employed on July 18, 2022, expired November 2024. The CPR Certification for one (1) staff member, employed on November 2, 2022, expired November 2024.

Violation confirmed corrected by letter received from provider on 4/4/2025

Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In Space#114, the permission to administer medication form for one (1) tube of Boudreauxs Butt Paste expired on November 27, 2024, and the permission to administer medication form for one (1) bottle of Children’s Benadryl Oral Suspension expired on March 10, 2025. In Space#115, two (2) different children were combined on the same permission to administer medication form for one (1) tube of Desitin Maximum Strength Paste. In Space 116, there was no permission to administer medication form for one (1) tube of Cerave Baby Healing Ointment.

Violation confirmed corrected by letter received from provider on 3/25/2025

Bottles were propped. Per staff report, approximately one (1) month ago, staff members assigned to Space #118 were propping bottles for infant feeding while infants were seated in bouncy seats.

Violation confirmed corrected by letter received from provider on 12/18/2024

A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. Per staff report, in Space #118, Jergens Ultra Healing Extra Dry Skin Moisturizer was administered to children for “dry patches” without permission from parents or health care professionals.

Violation confirmed corrected by letter received from provider on 12/18/2024

The written feeding plan was not modified as the child's needs changed. Per the infant feeding plan, one (1) child, fourteen (14) months of age enrolled in Space #117, is to consume formula at the facility. Per teacher report, and observation during the visit, the infant consumes table food while at the facility. Per the infant feeding plan, one (1) infant, seven (7) months of age enrolled in Space #118, is to consume formula at the facility. Per teacher report, the infant consumes baby food while at the facility. Per the infant feeding plan, one (1) infant, ten (10) months of age enrolled in Space #118, is to consume breast milk at the facility. Per teacher report, the infant consumes table food while at the facility. Per the infant feeding plan, one (1) infant, six (6) months of age enrolled in Space #118, is to consume breast milk at the facility. Per teacher report, the infant consumes table food while at the facility. Per the infant feeding plan, one (1) infant, ten (10) months of age enrolled in Space #118, is to consume formula at the facility. Per teacher report, the infant consumes table food while at the facility.

Violation confirmed corrected by letter received from provider on 11/12/2024

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. In Space #115, the permission to administer medication form for one (1) tube of Aquaphor Healing Paste Fast Relief Diaper Rash Paste expired on October 27, 2024. In Space #115, the permission to administer medication form for one (1) tube of Aquaphor Healing Paste Fast Relief Diaper Rash Paste expired on October 10, 2024. In Space #115, the permission to administer medication form for one (1) aerosol container or Coppertone Kids Sunscreen Spray expired on October 31, 2024. In Space #115, the permission to administer medication form for one (1) container of Burts Bees Baby Multipurpose Healing Ointment expired on November 2, 2024. In Space #116, one (1) tube of Aquaphor Healing Ointment Advanced Therapy Baby expired October 2024.

Violation confirmed corrected by letter received from provider on 11/12/2024

Children were not adequately supervised at all times. Based on staff interviews, one (1) staff member, previously assigned to Space #118 where infants are enrolled, was observed, on multiple occasions, to fall asleep while holding an infant.

Violation confirmed corrected by follow-up visit made by consultant on 11/14/2024

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. An approved fire inspection was conducted on February 6, 2023, and not again until February 16, 2024.

Violation confirmed corrected by letter received from provider on 3/18/2024

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. In Space #114, two (2) bottles of Swiffer Wet Jet Floor Cleaner with Febreze, one (1) bottle of Swiffer Wet Jet Floor Cleaner with Dawn, and three (3) aerosol cans of Mod Podge Clear Acrylic Sealer, all with multiple warnings, were in the unlocked center cabinet above the cubbies.

Violation corrected during visit

Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In Space #114, one (1) Albuterol Sulfate HFA Inhalation Aerosol inhaler was not in the original pharmacy packaging and did not have a pharmacy label.

Violation confirmed corrected by letter received from provider on 3/18/2024

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. In Space #113, one (1) tube of Aquaphor Healing Ointment Baby Advanced Therapy expired February 2024. In Space #113, there was no Permission to Administer Medication Form on file for one (1) tube of Neosporin plus Pain Relief Ointment. In Space #114, the Permission to Administer Medication Form for one (1) bottle of Boogie Diaper Rash Spray expired on December 7, 2023. In Space #115, one (1) tube of Hello Baby Mineral Sunscreen plus Prebiotics expired February 2024, and one (1) tube of Boudrauxs Butt Paste with Natural Aloe Diaper Rash Ointment expired February 2024.

Violation confirmed corrected by letter received from provider on 3/18/2024

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. In Space #117, one (1) container of Harris Teeter Disinfecting Wipes with multiple warnings, was in an unlocked cabinet, on a shelf, three (3) feet, ten (1) inches from the ground. In Space #117, six (6) packets of insect sting relief and one (1) instant cold pack, all with multiple warnings, were in an unlocked Be Smart Get prepared First Aid Kit located in an unlocked cabinet.

Violation corrected during visit

Center staff did not comply with the safe sleep policy. In Space #118, six (6) battery operated sound machines were hanging on the rails in six (6) cribs used by infants.

Violation corrected during visit

Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. The emergency information on file for one (1) child, enrolled on June 27, 2022, was last updated on August 24, 2022. The emergency information on file for one (1) child, enrolled on August 8, 2022, was last updated on August 24, 2022. The emergency information on file for one (1) child, enrolled on February 8, 2022, was last updated on August 24, 2022. The emergency information on file for one (1) child, enrolled on February 22, 2021, was last updated on August 24, 2022. The emergency information on file for one (1) child, enrolled on August 30 2022, was last updated on August 23, 2022. The emergency information on file for one (1) child, enrolled on October 11, 2021, was last updated on September 13, 2022.

Violation confirmed corrected by letter received from provider on 11/8/2023

Medical exam or health assessment record was not on file before or within 30 days after admission. One (1) child, enrolled on February 22, 2021, had a medical exam on file dated July 26, 2021.

Violation confirmed corrected by letter received from provider on 11/2/2023

Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In Space #117, the Permission to Administer Medication form for one (1) tube of Boudreauxs Butt Paste Max Strength Diaper rash ointment, did not contain the dates the permission was valid. In Space #117, the Permission to Administer Medication form for one (1) tube of Triple Paste Zinc Oxide Medicated Diaper Rash Ointment All in One expired on October 10, 2023.

Violation confirmed corrected by letter received from provider on 11/2/2023