Building Blocks Child Care Center, Inc.

10A NCAC 09 .0604 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 7/28/2025 Number Present: 10 Completed Date: 7/28/2025 Age: From 0 To 12 Total Minutes: 210 Time In: 10:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six percent (86%) as of 7/22/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc., is current/active as of 7/22/25. Permit type – Three (3) star license issued 11/12/2019. Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 8/7/24. The last fire drill was practiced on 7/21/25. The last shelter-in-place or lockdown drill has not been conducted since reopening on 6/16/25. The last playground inspection was documented on 7/14/25. The last fire inspection was approved on 6/10/25. The last sanitation inspection was conducted on 9/12/24 with eighteen (18) demerits for an Approved classification. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 10/17/23 without hazards. Lead paint testing was completed on 1/14/25. Asbestos testing was completed on 2/14/25. The program does not provide transportation. Upon arrival I was greeted by Ms. Bailey. In classroom space 5, children were sleeping. Chrissy Wolfe, Child Care Health Consultant was present and giving staff Technical Assistance on safe sleep practices. Children from classroom space 2 were outside playing on the infant/toddler playground. Children were listening to music and being soothed by caregivers. Children from classroom spaces 4 and 3 were combined into one group and were observed playing outside on the playground for preschool and school aged children. Children built small structures with wooden blocks and drew pictures with chalk and paper. Interactions were age appropriate, supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 812 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. Two (2) outlets in classroom space 4 and one (1) outlet in classroom space 5 was uncovered. 10A NCAC 09 .0604(c) 849 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. The permission for one (1) over the counter medication in classroom space 1 was dated 6/17/24 and expired 7/17/25. One (1) topical medication in classroom space 4 expired 4/2024 .0803(12) 871 Center staff did not comply with the safe sleep policy. A blanket was given to a ten (10) month old child to sleep in classroom space 1. 10A NCAC 09 .0606(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. The file for one (1) child, enrollment date 6/16/25 was missing a medical exam or health assessment. GS110-91(1) 1323 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. The file for one (1) child, enrollment date 6/16/25, was missing an immunization record. 10A NCAC 09 .0302(d)(2) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. The file for one (1) child, enrollment date 6/16/25, was missing a signed statement acknowledging receipt of the discipline policies. .1804(c) 1908 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. The file for one (1) child, enrollment date 6/16/25 was missing a signed statement acknowledging receipt of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. .0608(b)(1-6) Technical assistance was provided as follows: The following items were cited as violations today. Compliance is due by 8/11/25. Item #812 The outlets were covered during the visit. This is corrected. Plan to scan the classroom before children arrive in the morning to ensure safety standards are met. Item #849 The medications were removed from the classroom and will be given back to the parents. In your letter of compliance, please include a statement that indicates this has been completed. We discussed over the counter medication permission forms must be updated every 30 days for staff to administer the medication. We also discussed, if staff administer over the counter medication this must be recorded on a log. We discussed having the parent staff member administer the over the counter medication instead. Item #871 The blanket was removed from the child during the visit. This is corrected. Ms. Wolfe and I discussed with staff that blankets can only be given to children older than 12 months, according to the facility’s safe sleep policy. We also discussed editing the statement in the policy regarding blankets to clarify that children under 12 months old who sleep on cots also cannot have blankets. Item #1320, #1321, #1323, #1324, #1908: We discussed the facility recently moved children’s files to Brightwheel. We discussed the one (1) child did not have any digital files or signed acknowledgements. Plan to reach out to the parent and ensure they understand how to upload these files. Alternatively, you can maintain paper files while parents get accustomed to the new platform. In your letter of compliance, please include a statement that indicates the following items are on file for the one (1) child: Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy acknowledgement, Discipline policy acknowledgement, immunization record, medical exam, and parent handbook acknowledgement. The following items were not cited as violations during the visit today. Due to Tropical Storm Helene, the facility was closed from 9/26/24- 6/16/25. The facility sustained flooding damage that required extensive repairs. Additionally, a leak in the roof caused the ceiling to collapse in the office on 2/14/25, destroying various documents and records for program, staff and children. Additional time and guidance is given to reach compliance with the following items. Please note, violations may be cited for these items during future visits if compliance is not met: Staff Medical Reports: Two (2) staff members received medical reports after their date of hire. Moving forward, the medical report must be on file prior to employment. I recommend staff do not start until the medical report is received. ABCMS Provider Portal: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Alternatively, you can log into your Moodle and search for "ABCMS" and it will pull the course up. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 8/11/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: Kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Additionally, please copy my Supervisor, Bonnie Mathis, as I will be out on leave when the letter of compliance is due. Ms. Mathis’s email is bonnie.mathis@dhhs.nc.gov. Please call me at 828-713-8192, or email Kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Alternatively, if you have questions regarding compliance, you can contact Ms. Mathis at 828-782-0854. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed children under 15 months must have an Infant Feeding Plan posted in their classroom. Plan to obtain this feeding plan from the parents of the one (1) child when they begin attending. Plan to conduct a shelter-in-place or lockdown drill by the end of this week. Plan to brief new staff on procedures prior to the drill. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at Kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0302 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 7/28/2025 Number Present: 10 Completed Date: 7/28/2025 Age: From 0 To 12 Total Minutes: 210 Time In: 10:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six percent (86%) as of 7/22/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc., is current/active as of 7/22/25. Permit type – Three (3) star license issued 11/12/2019. Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 8/7/24. The last fire drill was practiced on 7/21/25. The last shelter-in-place or lockdown drill has not been conducted since reopening on 6/16/25. The last playground inspection was documented on 7/14/25. The last fire inspection was approved on 6/10/25. The last sanitation inspection was conducted on 9/12/24 with eighteen (18) demerits for an Approved classification. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 10/17/23 without hazards. Lead paint testing was completed on 1/14/25. Asbestos testing was completed on 2/14/25. The program does not provide transportation. Upon arrival I was greeted by Ms. Bailey. In classroom space 5, children were sleeping. Chrissy Wolfe, Child Care Health Consultant was present and giving staff Technical Assistance on safe sleep practices. Children from classroom space 2 were outside playing on the infant/toddler playground. Children were listening to music and being soothed by caregivers. Children from classroom spaces 4 and 3 were combined into one group and were observed playing outside on the playground for preschool and school aged children. Children built small structures with wooden blocks and drew pictures with chalk and paper. Interactions were age appropriate, supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 812 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. Two (2) outlets in classroom space 4 and one (1) outlet in classroom space 5 was uncovered. 10A NCAC 09 .0604(c) 849 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. The permission for one (1) over the counter medication in classroom space 1 was dated 6/17/24 and expired 7/17/25. One (1) topical medication in classroom space 4 expired 4/2024 .0803(12) 871 Center staff did not comply with the safe sleep policy. A blanket was given to a ten (10) month old child to sleep in classroom space 1. 10A NCAC 09 .0606(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. The file for one (1) child, enrollment date 6/16/25 was missing a medical exam or health assessment. GS110-91(1) 1323 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. The file for one (1) child, enrollment date 6/16/25, was missing an immunization record. 10A NCAC 09 .0302(d)(2) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. The file for one (1) child, enrollment date 6/16/25, was missing a signed statement acknowledging receipt of the discipline policies. .1804(c) 1908 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. The file for one (1) child, enrollment date 6/16/25 was missing a signed statement acknowledging receipt of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. .0608(b)(1-6) Technical assistance was provided as follows: The following items were cited as violations today. Compliance is due by 8/11/25. Item #812 The outlets were covered during the visit. This is corrected. Plan to scan the classroom before children arrive in the morning to ensure safety standards are met. Item #849 The medications were removed from the classroom and will be given back to the parents. In your letter of compliance, please include a statement that indicates this has been completed. We discussed over the counter medication permission forms must be updated every 30 days for staff to administer the medication. We also discussed, if staff administer over the counter medication this must be recorded on a log. We discussed having the parent staff member administer the over the counter medication instead. Item #871 The blanket was removed from the child during the visit. This is corrected. Ms. Wolfe and I discussed with staff that blankets can only be given to children older than 12 months, according to the facility’s safe sleep policy. We also discussed editing the statement in the policy regarding blankets to clarify that children under 12 months old who sleep on cots also cannot have blankets. Item #1320, #1321, #1323, #1324, #1908: We discussed the facility recently moved children’s files to Brightwheel. We discussed the one (1) child did not have any digital files or signed acknowledgements. Plan to reach out to the parent and ensure they understand how to upload these files. Alternatively, you can maintain paper files while parents get accustomed to the new platform. In your letter of compliance, please include a statement that indicates the following items are on file for the one (1) child: Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy acknowledgement, Discipline policy acknowledgement, immunization record, medical exam, and parent handbook acknowledgement. The following items were not cited as violations during the visit today. Due to Tropical Storm Helene, the facility was closed from 9/26/24- 6/16/25. The facility sustained flooding damage that required extensive repairs. Additionally, a leak in the roof caused the ceiling to collapse in the office on 2/14/25, destroying various documents and records for program, staff and children. Additional time and guidance is given to reach compliance with the following items. Please note, violations may be cited for these items during future visits if compliance is not met: Staff Medical Reports: Two (2) staff members received medical reports after their date of hire. Moving forward, the medical report must be on file prior to employment. I recommend staff do not start until the medical report is received. ABCMS Provider Portal: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Alternatively, you can log into your Moodle and search for "ABCMS" and it will pull the course up. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 8/11/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: Kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Additionally, please copy my Supervisor, Bonnie Mathis, as I will be out on leave when the letter of compliance is due. Ms. Mathis’s email is bonnie.mathis@dhhs.nc.gov. Please call me at 828-713-8192, or email Kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Alternatively, if you have questions regarding compliance, you can contact Ms. Mathis at 828-782-0854. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed children under 15 months must have an Infant Feeding Plan posted in their classroom. Plan to obtain this feeding plan from the parents of the one (1) child when they begin attending. Plan to conduct a shelter-in-place or lockdown drill by the end of this week. Plan to brief new staff on procedures prior to the drill. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at Kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 7/28/2025 Number Present: 10 Completed Date: 7/28/2025 Age: From 0 To 12 Total Minutes: 210 Time In: 10:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six percent (86%) as of 7/22/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc., is current/active as of 7/22/25. Permit type – Three (3) star license issued 11/12/2019. Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 8/7/24. The last fire drill was practiced on 7/21/25. The last shelter-in-place or lockdown drill has not been conducted since reopening on 6/16/25. The last playground inspection was documented on 7/14/25. The last fire inspection was approved on 6/10/25. The last sanitation inspection was conducted on 9/12/24 with eighteen (18) demerits for an Approved classification. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 10/17/23 without hazards. Lead paint testing was completed on 1/14/25. Asbestos testing was completed on 2/14/25. The program does not provide transportation. Upon arrival I was greeted by Ms. Bailey. In classroom space 5, children were sleeping. Chrissy Wolfe, Child Care Health Consultant was present and giving staff Technical Assistance on safe sleep practices. Children from classroom space 2 were outside playing on the infant/toddler playground. Children were listening to music and being soothed by caregivers. Children from classroom spaces 4 and 3 were combined into one group and were observed playing outside on the playground for preschool and school aged children. Children built small structures with wooden blocks and drew pictures with chalk and paper. Interactions were age appropriate, supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 812 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. Two (2) outlets in classroom space 4 and one (1) outlet in classroom space 5 was uncovered. 10A NCAC 09 .0604(c) 849 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. The permission for one (1) over the counter medication in classroom space 1 was dated 6/17/24 and expired 7/17/25. One (1) topical medication in classroom space 4 expired 4/2024 .0803(12) 871 Center staff did not comply with the safe sleep policy. A blanket was given to a ten (10) month old child to sleep in classroom space 1. 10A NCAC 09 .0606(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. The file for one (1) child, enrollment date 6/16/25 was missing a medical exam or health assessment. GS110-91(1) 1323 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. The file for one (1) child, enrollment date 6/16/25, was missing an immunization record. 10A NCAC 09 .0302(d)(2) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. The file for one (1) child, enrollment date 6/16/25, was missing a signed statement acknowledging receipt of the discipline policies. .1804(c) 1908 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. The file for one (1) child, enrollment date 6/16/25 was missing a signed statement acknowledging receipt of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. .0608(b)(1-6) Technical assistance was provided as follows: The following items were cited as violations today. Compliance is due by 8/11/25. Item #812 The outlets were covered during the visit. This is corrected. Plan to scan the classroom before children arrive in the morning to ensure safety standards are met. Item #849 The medications were removed from the classroom and will be given back to the parents. In your letter of compliance, please include a statement that indicates this has been completed. We discussed over the counter medication permission forms must be updated every 30 days for staff to administer the medication. We also discussed, if staff administer over the counter medication this must be recorded on a log. We discussed having the parent staff member administer the over the counter medication instead. Item #871 The blanket was removed from the child during the visit. This is corrected. Ms. Wolfe and I discussed with staff that blankets can only be given to children older than 12 months, according to the facility’s safe sleep policy. We also discussed editing the statement in the policy regarding blankets to clarify that children under 12 months old who sleep on cots also cannot have blankets. Item #1320, #1321, #1323, #1324, #1908: We discussed the facility recently moved children’s files to Brightwheel. We discussed the one (1) child did not have any digital files or signed acknowledgements. Plan to reach out to the parent and ensure they understand how to upload these files. Alternatively, you can maintain paper files while parents get accustomed to the new platform. In your letter of compliance, please include a statement that indicates the following items are on file for the one (1) child: Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy acknowledgement, Discipline policy acknowledgement, immunization record, medical exam, and parent handbook acknowledgement. The following items were not cited as violations during the visit today. Due to Tropical Storm Helene, the facility was closed from 9/26/24- 6/16/25. The facility sustained flooding damage that required extensive repairs. Additionally, a leak in the roof caused the ceiling to collapse in the office on 2/14/25, destroying various documents and records for program, staff and children. Additional time and guidance is given to reach compliance with the following items. Please note, violations may be cited for these items during future visits if compliance is not met: Staff Medical Reports: Two (2) staff members received medical reports after their date of hire. Moving forward, the medical report must be on file prior to employment. I recommend staff do not start until the medical report is received. ABCMS Provider Portal: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Alternatively, you can log into your Moodle and search for "ABCMS" and it will pull the course up. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 8/11/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: Kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Additionally, please copy my Supervisor, Bonnie Mathis, as I will be out on leave when the letter of compliance is due. Ms. Mathis’s email is bonnie.mathis@dhhs.nc.gov. Please call me at 828-713-8192, or email Kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Alternatively, if you have questions regarding compliance, you can contact Ms. Mathis at 828-782-0854. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed children under 15 months must have an Infant Feeding Plan posted in their classroom. Plan to obtain this feeding plan from the parents of the one (1) child when they begin attending. Plan to conduct a shelter-in-place or lockdown drill by the end of this week. Plan to brief new staff on procedures prior to the drill. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at Kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0606 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 7/28/2025 Number Present: 10 Completed Date: 7/28/2025 Age: From 0 To 12 Total Minutes: 210 Time In: 10:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six percent (86%) as of 7/22/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc., is current/active as of 7/22/25. Permit type – Three (3) star license issued 11/12/2019. Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 8/7/24. The last fire drill was practiced on 7/21/25. The last shelter-in-place or lockdown drill has not been conducted since reopening on 6/16/25. The last playground inspection was documented on 7/14/25. The last fire inspection was approved on 6/10/25. The last sanitation inspection was conducted on 9/12/24 with eighteen (18) demerits for an Approved classification. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 10/17/23 without hazards. Lead paint testing was completed on 1/14/25. Asbestos testing was completed on 2/14/25. The program does not provide transportation. Upon arrival I was greeted by Ms. Bailey. In classroom space 5, children were sleeping. Chrissy Wolfe, Child Care Health Consultant was present and giving staff Technical Assistance on safe sleep practices. Children from classroom space 2 were outside playing on the infant/toddler playground. Children were listening to music and being soothed by caregivers. Children from classroom spaces 4 and 3 were combined into one group and were observed playing outside on the playground for preschool and school aged children. Children built small structures with wooden blocks and drew pictures with chalk and paper. Interactions were age appropriate, supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 812 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. Two (2) outlets in classroom space 4 and one (1) outlet in classroom space 5 was uncovered. 10A NCAC 09 .0604(c) 849 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. The permission for one (1) over the counter medication in classroom space 1 was dated 6/17/24 and expired 7/17/25. One (1) topical medication in classroom space 4 expired 4/2024 .0803(12) 871 Center staff did not comply with the safe sleep policy. A blanket was given to a ten (10) month old child to sleep in classroom space 1. 10A NCAC 09 .0606(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. The file for one (1) child, enrollment date 6/16/25 was missing a medical exam or health assessment. GS110-91(1) 1323 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. The file for one (1) child, enrollment date 6/16/25, was missing an immunization record. 10A NCAC 09 .0302(d)(2) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. The file for one (1) child, enrollment date 6/16/25, was missing a signed statement acknowledging receipt of the discipline policies. .1804(c) 1908 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. The file for one (1) child, enrollment date 6/16/25 was missing a signed statement acknowledging receipt of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. .0608(b)(1-6) Technical assistance was provided as follows: The following items were cited as violations today. Compliance is due by 8/11/25. Item #812 The outlets were covered during the visit. This is corrected. Plan to scan the classroom before children arrive in the morning to ensure safety standards are met. Item #849 The medications were removed from the classroom and will be given back to the parents. In your letter of compliance, please include a statement that indicates this has been completed. We discussed over the counter medication permission forms must be updated every 30 days for staff to administer the medication. We also discussed, if staff administer over the counter medication this must be recorded on a log. We discussed having the parent staff member administer the over the counter medication instead. Item #871 The blanket was removed from the child during the visit. This is corrected. Ms. Wolfe and I discussed with staff that blankets can only be given to children older than 12 months, according to the facility’s safe sleep policy. We also discussed editing the statement in the policy regarding blankets to clarify that children under 12 months old who sleep on cots also cannot have blankets. Item #1320, #1321, #1323, #1324, #1908: We discussed the facility recently moved children’s files to Brightwheel. We discussed the one (1) child did not have any digital files or signed acknowledgements. Plan to reach out to the parent and ensure they understand how to upload these files. Alternatively, you can maintain paper files while parents get accustomed to the new platform. In your letter of compliance, please include a statement that indicates the following items are on file for the one (1) child: Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy acknowledgement, Discipline policy acknowledgement, immunization record, medical exam, and parent handbook acknowledgement. The following items were not cited as violations during the visit today. Due to Tropical Storm Helene, the facility was closed from 9/26/24- 6/16/25. The facility sustained flooding damage that required extensive repairs. Additionally, a leak in the roof caused the ceiling to collapse in the office on 2/14/25, destroying various documents and records for program, staff and children. Additional time and guidance is given to reach compliance with the following items. Please note, violations may be cited for these items during future visits if compliance is not met: Staff Medical Reports: Two (2) staff members received medical reports after their date of hire. Moving forward, the medical report must be on file prior to employment. I recommend staff do not start until the medical report is received. ABCMS Provider Portal: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Alternatively, you can log into your Moodle and search for "ABCMS" and it will pull the course up. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 8/11/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: Kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Additionally, please copy my Supervisor, Bonnie Mathis, as I will be out on leave when the letter of compliance is due. Ms. Mathis’s email is bonnie.mathis@dhhs.nc.gov. Please call me at 828-713-8192, or email Kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Alternatively, if you have questions regarding compliance, you can contact Ms. Mathis at 828-782-0854. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed children under 15 months must have an Infant Feeding Plan posted in their classroom. Plan to obtain this feeding plan from the parents of the one (1) child when they begin attending. Plan to conduct a shelter-in-place or lockdown drill by the end of this week. Plan to brief new staff on procedures prior to the drill. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at Kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 7/28/2025 Number Present: 10 Completed Date: 7/28/2025 Age: From 0 To 12 Total Minutes: 210 Time In: 10:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six percent (86%) as of 7/22/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc., is current/active as of 7/22/25. Permit type – Three (3) star license issued 11/12/2019. Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 8/7/24. The last fire drill was practiced on 7/21/25. The last shelter-in-place or lockdown drill has not been conducted since reopening on 6/16/25. The last playground inspection was documented on 7/14/25. The last fire inspection was approved on 6/10/25. The last sanitation inspection was conducted on 9/12/24 with eighteen (18) demerits for an Approved classification. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 10/17/23 without hazards. Lead paint testing was completed on 1/14/25. Asbestos testing was completed on 2/14/25. The program does not provide transportation. Upon arrival I was greeted by Ms. Bailey. In classroom space 5, children were sleeping. Chrissy Wolfe, Child Care Health Consultant was present and giving staff Technical Assistance on safe sleep practices. Children from classroom space 2 were outside playing on the infant/toddler playground. Children were listening to music and being soothed by caregivers. Children from classroom spaces 4 and 3 were combined into one group and were observed playing outside on the playground for preschool and school aged children. Children built small structures with wooden blocks and drew pictures with chalk and paper. Interactions were age appropriate, supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 812 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. Two (2) outlets in classroom space 4 and one (1) outlet in classroom space 5 was uncovered. 10A NCAC 09 .0604(c) 849 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. The permission for one (1) over the counter medication in classroom space 1 was dated 6/17/24 and expired 7/17/25. One (1) topical medication in classroom space 4 expired 4/2024 .0803(12) 871 Center staff did not comply with the safe sleep policy. A blanket was given to a ten (10) month old child to sleep in classroom space 1. 10A NCAC 09 .0606(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. The file for one (1) child, enrollment date 6/16/25 was missing a medical exam or health assessment. GS110-91(1) 1323 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. The file for one (1) child, enrollment date 6/16/25, was missing an immunization record. 10A NCAC 09 .0302(d)(2) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. The file for one (1) child, enrollment date 6/16/25, was missing a signed statement acknowledging receipt of the discipline policies. .1804(c) 1908 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. The file for one (1) child, enrollment date 6/16/25 was missing a signed statement acknowledging receipt of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. .0608(b)(1-6) Technical assistance was provided as follows: The following items were cited as violations today. Compliance is due by 8/11/25. Item #812 The outlets were covered during the visit. This is corrected. Plan to scan the classroom before children arrive in the morning to ensure safety standards are met. Item #849 The medications were removed from the classroom and will be given back to the parents. In your letter of compliance, please include a statement that indicates this has been completed. We discussed over the counter medication permission forms must be updated every 30 days for staff to administer the medication. We also discussed, if staff administer over the counter medication this must be recorded on a log. We discussed having the parent staff member administer the over the counter medication instead. Item #871 The blanket was removed from the child during the visit. This is corrected. Ms. Wolfe and I discussed with staff that blankets can only be given to children older than 12 months, according to the facility’s safe sleep policy. We also discussed editing the statement in the policy regarding blankets to clarify that children under 12 months old who sleep on cots also cannot have blankets. Item #1320, #1321, #1323, #1324, #1908: We discussed the facility recently moved children’s files to Brightwheel. We discussed the one (1) child did not have any digital files or signed acknowledgements. Plan to reach out to the parent and ensure they understand how to upload these files. Alternatively, you can maintain paper files while parents get accustomed to the new platform. In your letter of compliance, please include a statement that indicates the following items are on file for the one (1) child: Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy acknowledgement, Discipline policy acknowledgement, immunization record, medical exam, and parent handbook acknowledgement. The following items were not cited as violations during the visit today. Due to Tropical Storm Helene, the facility was closed from 9/26/24- 6/16/25. The facility sustained flooding damage that required extensive repairs. Additionally, a leak in the roof caused the ceiling to collapse in the office on 2/14/25, destroying various documents and records for program, staff and children. Additional time and guidance is given to reach compliance with the following items. Please note, violations may be cited for these items during future visits if compliance is not met: Staff Medical Reports: Two (2) staff members received medical reports after their date of hire. Moving forward, the medical report must be on file prior to employment. I recommend staff do not start until the medical report is received. ABCMS Provider Portal: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Alternatively, you can log into your Moodle and search for "ABCMS" and it will pull the course up. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 8/11/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: Kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Additionally, please copy my Supervisor, Bonnie Mathis, as I will be out on leave when the letter of compliance is due. Ms. Mathis’s email is bonnie.mathis@dhhs.nc.gov. Please call me at 828-713-8192, or email Kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Alternatively, if you have questions regarding compliance, you can contact Ms. Mathis at 828-782-0854. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed children under 15 months must have an Infant Feeding Plan posted in their classroom. Plan to obtain this feeding plan from the parents of the one (1) child when they begin attending. Plan to conduct a shelter-in-place or lockdown drill by the end of this week. Plan to brief new staff on procedures prior to the drill. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at Kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 7/28/2025 Number Present: 10 Completed Date: 7/28/2025 Age: From 0 To 12 Total Minutes: 210 Time In: 10:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six percent (86%) as of 7/22/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc., is current/active as of 7/22/25. Permit type – Three (3) star license issued 11/12/2019. Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 8/7/24. The last fire drill was practiced on 7/21/25. The last shelter-in-place or lockdown drill has not been conducted since reopening on 6/16/25. The last playground inspection was documented on 7/14/25. The last fire inspection was approved on 6/10/25. The last sanitation inspection was conducted on 9/12/24 with eighteen (18) demerits for an Approved classification. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 10/17/23 without hazards. Lead paint testing was completed on 1/14/25. Asbestos testing was completed on 2/14/25. The program does not provide transportation. Upon arrival I was greeted by Ms. Bailey. In classroom space 5, children were sleeping. Chrissy Wolfe, Child Care Health Consultant was present and giving staff Technical Assistance on safe sleep practices. Children from classroom space 2 were outside playing on the infant/toddler playground. Children were listening to music and being soothed by caregivers. Children from classroom spaces 4 and 3 were combined into one group and were observed playing outside on the playground for preschool and school aged children. Children built small structures with wooden blocks and drew pictures with chalk and paper. Interactions were age appropriate, supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 812 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. Two (2) outlets in classroom space 4 and one (1) outlet in classroom space 5 was uncovered. 10A NCAC 09 .0604(c) 849 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. The permission for one (1) over the counter medication in classroom space 1 was dated 6/17/24 and expired 7/17/25. One (1) topical medication in classroom space 4 expired 4/2024 .0803(12) 871 Center staff did not comply with the safe sleep policy. A blanket was given to a ten (10) month old child to sleep in classroom space 1. 10A NCAC 09 .0606(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. The file for one (1) child, enrollment date 6/16/25 was missing a medical exam or health assessment. GS110-91(1) 1323 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. The file for one (1) child, enrollment date 6/16/25, was missing an immunization record. 10A NCAC 09 .0302(d)(2) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. The file for one (1) child, enrollment date 6/16/25, was missing a signed statement acknowledging receipt of the discipline policies. .1804(c) 1908 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. The file for one (1) child, enrollment date 6/16/25 was missing a signed statement acknowledging receipt of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. .0608(b)(1-6) Technical assistance was provided as follows: The following items were cited as violations today. Compliance is due by 8/11/25. Item #812 The outlets were covered during the visit. This is corrected. Plan to scan the classroom before children arrive in the morning to ensure safety standards are met. Item #849 The medications were removed from the classroom and will be given back to the parents. In your letter of compliance, please include a statement that indicates this has been completed. We discussed over the counter medication permission forms must be updated every 30 days for staff to administer the medication. We also discussed, if staff administer over the counter medication this must be recorded on a log. We discussed having the parent staff member administer the over the counter medication instead. Item #871 The blanket was removed from the child during the visit. This is corrected. Ms. Wolfe and I discussed with staff that blankets can only be given to children older than 12 months, according to the facility’s safe sleep policy. We also discussed editing the statement in the policy regarding blankets to clarify that children under 12 months old who sleep on cots also cannot have blankets. Item #1320, #1321, #1323, #1324, #1908: We discussed the facility recently moved children’s files to Brightwheel. We discussed the one (1) child did not have any digital files or signed acknowledgements. Plan to reach out to the parent and ensure they understand how to upload these files. Alternatively, you can maintain paper files while parents get accustomed to the new platform. In your letter of compliance, please include a statement that indicates the following items are on file for the one (1) child: Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy acknowledgement, Discipline policy acknowledgement, immunization record, medical exam, and parent handbook acknowledgement. The following items were not cited as violations during the visit today. Due to Tropical Storm Helene, the facility was closed from 9/26/24- 6/16/25. The facility sustained flooding damage that required extensive repairs. Additionally, a leak in the roof caused the ceiling to collapse in the office on 2/14/25, destroying various documents and records for program, staff and children. Additional time and guidance is given to reach compliance with the following items. Please note, violations may be cited for these items during future visits if compliance is not met: Staff Medical Reports: Two (2) staff members received medical reports after their date of hire. Moving forward, the medical report must be on file prior to employment. I recommend staff do not start until the medical report is received. ABCMS Provider Portal: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Alternatively, you can log into your Moodle and search for "ABCMS" and it will pull the course up. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 8/11/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: Kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Additionally, please copy my Supervisor, Bonnie Mathis, as I will be out on leave when the letter of compliance is due. Ms. Mathis’s email is bonnie.mathis@dhhs.nc.gov. Please call me at 828-713-8192, or email Kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Alternatively, if you have questions regarding compliance, you can contact Ms. Mathis at 828-782-0854. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed children under 15 months must have an Infant Feeding Plan posted in their classroom. Plan to obtain this feeding plan from the parents of the one (1) child when they begin attending. Plan to conduct a shelter-in-place or lockdown drill by the end of this week. Plan to brief new staff on procedures prior to the drill. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at Kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 7/28/2025 Number Present: 10 Completed Date: 7/28/2025 Age: From 0 To 12 Total Minutes: 210 Time In: 10:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six percent (86%) as of 7/22/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc., is current/active as of 7/22/25. Permit type – Three (3) star license issued 11/12/2019. Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 8/7/24. The last fire drill was practiced on 7/21/25. The last shelter-in-place or lockdown drill has not been conducted since reopening on 6/16/25. The last playground inspection was documented on 7/14/25. The last fire inspection was approved on 6/10/25. The last sanitation inspection was conducted on 9/12/24 with eighteen (18) demerits for an Approved classification. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 10/17/23 without hazards. Lead paint testing was completed on 1/14/25. Asbestos testing was completed on 2/14/25. The program does not provide transportation. Upon arrival I was greeted by Ms. Bailey. In classroom space 5, children were sleeping. Chrissy Wolfe, Child Care Health Consultant was present and giving staff Technical Assistance on safe sleep practices. Children from classroom space 2 were outside playing on the infant/toddler playground. Children were listening to music and being soothed by caregivers. Children from classroom spaces 4 and 3 were combined into one group and were observed playing outside on the playground for preschool and school aged children. Children built small structures with wooden blocks and drew pictures with chalk and paper. Interactions were age appropriate, supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 812 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. Two (2) outlets in classroom space 4 and one (1) outlet in classroom space 5 was uncovered. 10A NCAC 09 .0604(c) 849 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. The permission for one (1) over the counter medication in classroom space 1 was dated 6/17/24 and expired 7/17/25. One (1) topical medication in classroom space 4 expired 4/2024 .0803(12) 871 Center staff did not comply with the safe sleep policy. A blanket was given to a ten (10) month old child to sleep in classroom space 1. 10A NCAC 09 .0606(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. The file for one (1) child, enrollment date 6/16/25 was missing a medical exam or health assessment. GS110-91(1) 1323 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. The file for one (1) child, enrollment date 6/16/25, was missing an immunization record. 10A NCAC 09 .0302(d)(2) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. The file for one (1) child, enrollment date 6/16/25, was missing a signed statement acknowledging receipt of the discipline policies. .1804(c) 1908 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. The file for one (1) child, enrollment date 6/16/25 was missing a signed statement acknowledging receipt of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. .0608(b)(1-6) Technical assistance was provided as follows: The following items were cited as violations today. Compliance is due by 8/11/25. Item #812 The outlets were covered during the visit. This is corrected. Plan to scan the classroom before children arrive in the morning to ensure safety standards are met. Item #849 The medications were removed from the classroom and will be given back to the parents. In your letter of compliance, please include a statement that indicates this has been completed. We discussed over the counter medication permission forms must be updated every 30 days for staff to administer the medication. We also discussed, if staff administer over the counter medication this must be recorded on a log. We discussed having the parent staff member administer the over the counter medication instead. Item #871 The blanket was removed from the child during the visit. This is corrected. Ms. Wolfe and I discussed with staff that blankets can only be given to children older than 12 months, according to the facility’s safe sleep policy. We also discussed editing the statement in the policy regarding blankets to clarify that children under 12 months old who sleep on cots also cannot have blankets. Item #1320, #1321, #1323, #1324, #1908: We discussed the facility recently moved children’s files to Brightwheel. We discussed the one (1) child did not have any digital files or signed acknowledgements. Plan to reach out to the parent and ensure they understand how to upload these files. Alternatively, you can maintain paper files while parents get accustomed to the new platform. In your letter of compliance, please include a statement that indicates the following items are on file for the one (1) child: Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy acknowledgement, Discipline policy acknowledgement, immunization record, medical exam, and parent handbook acknowledgement. The following items were not cited as violations during the visit today. Due to Tropical Storm Helene, the facility was closed from 9/26/24- 6/16/25. The facility sustained flooding damage that required extensive repairs. Additionally, a leak in the roof caused the ceiling to collapse in the office on 2/14/25, destroying various documents and records for program, staff and children. Additional time and guidance is given to reach compliance with the following items. Please note, violations may be cited for these items during future visits if compliance is not met: Staff Medical Reports: Two (2) staff members received medical reports after their date of hire. Moving forward, the medical report must be on file prior to employment. I recommend staff do not start until the medical report is received. ABCMS Provider Portal: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Alternatively, you can log into your Moodle and search for "ABCMS" and it will pull the course up. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 8/11/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: Kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Additionally, please copy my Supervisor, Bonnie Mathis, as I will be out on leave when the letter of compliance is due. Ms. Mathis’s email is bonnie.mathis@dhhs.nc.gov. Please call me at 828-713-8192, or email Kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Alternatively, if you have questions regarding compliance, you can contact Ms. Mathis at 828-782-0854. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed children under 15 months must have an Infant Feeding Plan posted in their classroom. Plan to obtain this feeding plan from the parents of the one (1) child when they begin attending. Plan to conduct a shelter-in-place or lockdown drill by the end of this week. Plan to brief new staff on procedures prior to the drill. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at Kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 7/28/2025 Number Present: 10 Completed Date: 7/28/2025 Age: From 0 To 12 Total Minutes: 210 Time In: 10:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six percent (86%) as of 7/22/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc., is current/active as of 7/22/25. Permit type – Three (3) star license issued 11/12/2019. Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 8/7/24. The last fire drill was practiced on 7/21/25. The last shelter-in-place or lockdown drill has not been conducted since reopening on 6/16/25. The last playground inspection was documented on 7/14/25. The last fire inspection was approved on 6/10/25. The last sanitation inspection was conducted on 9/12/24 with eighteen (18) demerits for an Approved classification. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 10/17/23 without hazards. Lead paint testing was completed on 1/14/25. Asbestos testing was completed on 2/14/25. The program does not provide transportation. Upon arrival I was greeted by Ms. Bailey. In classroom space 5, children were sleeping. Chrissy Wolfe, Child Care Health Consultant was present and giving staff Technical Assistance on safe sleep practices. Children from classroom space 2 were outside playing on the infant/toddler playground. Children were listening to music and being soothed by caregivers. Children from classroom spaces 4 and 3 were combined into one group and were observed playing outside on the playground for preschool and school aged children. Children built small structures with wooden blocks and drew pictures with chalk and paper. Interactions were age appropriate, supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 812 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. Two (2) outlets in classroom space 4 and one (1) outlet in classroom space 5 was uncovered. 10A NCAC 09 .0604(c) 849 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. The permission for one (1) over the counter medication in classroom space 1 was dated 6/17/24 and expired 7/17/25. One (1) topical medication in classroom space 4 expired 4/2024 .0803(12) 871 Center staff did not comply with the safe sleep policy. A blanket was given to a ten (10) month old child to sleep in classroom space 1. 10A NCAC 09 .0606(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. The file for one (1) child, enrollment date 6/16/25 was missing a medical exam or health assessment. GS110-91(1) 1323 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. The file for one (1) child, enrollment date 6/16/25, was missing an immunization record. 10A NCAC 09 .0302(d)(2) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. The file for one (1) child, enrollment date 6/16/25, was missing a signed statement acknowledging receipt of the discipline policies. .1804(c) 1908 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. The file for one (1) child, enrollment date 6/16/25 was missing a signed statement acknowledging receipt of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. .0608(b)(1-6) Technical assistance was provided as follows: The following items were cited as violations today. Compliance is due by 8/11/25. Item #812 The outlets were covered during the visit. This is corrected. Plan to scan the classroom before children arrive in the morning to ensure safety standards are met. Item #849 The medications were removed from the classroom and will be given back to the parents. In your letter of compliance, please include a statement that indicates this has been completed. We discussed over the counter medication permission forms must be updated every 30 days for staff to administer the medication. We also discussed, if staff administer over the counter medication this must be recorded on a log. We discussed having the parent staff member administer the over the counter medication instead. Item #871 The blanket was removed from the child during the visit. This is corrected. Ms. Wolfe and I discussed with staff that blankets can only be given to children older than 12 months, according to the facility’s safe sleep policy. We also discussed editing the statement in the policy regarding blankets to clarify that children under 12 months old who sleep on cots also cannot have blankets. Item #1320, #1321, #1323, #1324, #1908: We discussed the facility recently moved children’s files to Brightwheel. We discussed the one (1) child did not have any digital files or signed acknowledgements. Plan to reach out to the parent and ensure they understand how to upload these files. Alternatively, you can maintain paper files while parents get accustomed to the new platform. In your letter of compliance, please include a statement that indicates the following items are on file for the one (1) child: Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy acknowledgement, Discipline policy acknowledgement, immunization record, medical exam, and parent handbook acknowledgement. The following items were not cited as violations during the visit today. Due to Tropical Storm Helene, the facility was closed from 9/26/24- 6/16/25. The facility sustained flooding damage that required extensive repairs. Additionally, a leak in the roof caused the ceiling to collapse in the office on 2/14/25, destroying various documents and records for program, staff and children. Additional time and guidance is given to reach compliance with the following items. Please note, violations may be cited for these items during future visits if compliance is not met: Staff Medical Reports: Two (2) staff members received medical reports after their date of hire. Moving forward, the medical report must be on file prior to employment. I recommend staff do not start until the medical report is received. ABCMS Provider Portal: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Alternatively, you can log into your Moodle and search for "ABCMS" and it will pull the course up. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 8/11/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: Kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Additionally, please copy my Supervisor, Bonnie Mathis, as I will be out on leave when the letter of compliance is due. Ms. Mathis’s email is bonnie.mathis@dhhs.nc.gov. Please call me at 828-713-8192, or email Kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Alternatively, if you have questions regarding compliance, you can contact Ms. Mathis at 828-782-0854. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed children under 15 months must have an Infant Feeding Plan posted in their classroom. Plan to obtain this feeding plan from the parents of the one (1) child when they begin attending. Plan to conduct a shelter-in-place or lockdown drill by the end of this week. Plan to brief new staff on procedures prior to the drill. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at Kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS110-91 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 7/28/2025 Number Present: 10 Completed Date: 7/28/2025 Age: From 0 To 12 Total Minutes: 210 Time In: 10:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six percent (86%) as of 7/22/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc., is current/active as of 7/22/25. Permit type – Three (3) star license issued 11/12/2019. Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 8/7/24. The last fire drill was practiced on 7/21/25. The last shelter-in-place or lockdown drill has not been conducted since reopening on 6/16/25. The last playground inspection was documented on 7/14/25. The last fire inspection was approved on 6/10/25. The last sanitation inspection was conducted on 9/12/24 with eighteen (18) demerits for an Approved classification. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 10/17/23 without hazards. Lead paint testing was completed on 1/14/25. Asbestos testing was completed on 2/14/25. The program does not provide transportation. Upon arrival I was greeted by Ms. Bailey. In classroom space 5, children were sleeping. Chrissy Wolfe, Child Care Health Consultant was present and giving staff Technical Assistance on safe sleep practices. Children from classroom space 2 were outside playing on the infant/toddler playground. Children were listening to music and being soothed by caregivers. Children from classroom spaces 4 and 3 were combined into one group and were observed playing outside on the playground for preschool and school aged children. Children built small structures with wooden blocks and drew pictures with chalk and paper. Interactions were age appropriate, supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 812 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. Two (2) outlets in classroom space 4 and one (1) outlet in classroom space 5 was uncovered. 10A NCAC 09 .0604(c) 849 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. The permission for one (1) over the counter medication in classroom space 1 was dated 6/17/24 and expired 7/17/25. One (1) topical medication in classroom space 4 expired 4/2024 .0803(12) 871 Center staff did not comply with the safe sleep policy. A blanket was given to a ten (10) month old child to sleep in classroom space 1. 10A NCAC 09 .0606(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. The file for one (1) child, enrollment date 6/16/25 was missing a medical exam or health assessment. GS110-91(1) 1323 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. The file for one (1) child, enrollment date 6/16/25, was missing an immunization record. 10A NCAC 09 .0302(d)(2) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. The file for one (1) child, enrollment date 6/16/25, was missing a signed statement acknowledging receipt of the discipline policies. .1804(c) 1908 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. The file for one (1) child, enrollment date 6/16/25 was missing a signed statement acknowledging receipt of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. .0608(b)(1-6) Technical assistance was provided as follows: The following items were cited as violations today. Compliance is due by 8/11/25. Item #812 The outlets were covered during the visit. This is corrected. Plan to scan the classroom before children arrive in the morning to ensure safety standards are met. Item #849 The medications were removed from the classroom and will be given back to the parents. In your letter of compliance, please include a statement that indicates this has been completed. We discussed over the counter medication permission forms must be updated every 30 days for staff to administer the medication. We also discussed, if staff administer over the counter medication this must be recorded on a log. We discussed having the parent staff member administer the over the counter medication instead. Item #871 The blanket was removed from the child during the visit. This is corrected. Ms. Wolfe and I discussed with staff that blankets can only be given to children older than 12 months, according to the facility’s safe sleep policy. We also discussed editing the statement in the policy regarding blankets to clarify that children under 12 months old who sleep on cots also cannot have blankets. Item #1320, #1321, #1323, #1324, #1908: We discussed the facility recently moved children’s files to Brightwheel. We discussed the one (1) child did not have any digital files or signed acknowledgements. Plan to reach out to the parent and ensure they understand how to upload these files. Alternatively, you can maintain paper files while parents get accustomed to the new platform. In your letter of compliance, please include a statement that indicates the following items are on file for the one (1) child: Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy acknowledgement, Discipline policy acknowledgement, immunization record, medical exam, and parent handbook acknowledgement. The following items were not cited as violations during the visit today. Due to Tropical Storm Helene, the facility was closed from 9/26/24- 6/16/25. The facility sustained flooding damage that required extensive repairs. Additionally, a leak in the roof caused the ceiling to collapse in the office on 2/14/25, destroying various documents and records for program, staff and children. Additional time and guidance is given to reach compliance with the following items. Please note, violations may be cited for these items during future visits if compliance is not met: Staff Medical Reports: Two (2) staff members received medical reports after their date of hire. Moving forward, the medical report must be on file prior to employment. I recommend staff do not start until the medical report is received. ABCMS Provider Portal: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Alternatively, you can log into your Moodle and search for "ABCMS" and it will pull the course up. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 8/11/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: Kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Additionally, please copy my Supervisor, Bonnie Mathis, as I will be out on leave when the letter of compliance is due. Ms. Mathis’s email is bonnie.mathis@dhhs.nc.gov. Please call me at 828-713-8192, or email Kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Alternatively, if you have questions regarding compliance, you can contact Ms. Mathis at 828-782-0854. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed children under 15 months must have an Infant Feeding Plan posted in their classroom. Plan to obtain this feeding plan from the parents of the one (1) child when they begin attending. Plan to conduct a shelter-in-place or lockdown drill by the end of this week. Plan to brief new staff on procedures prior to the drill. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at Kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 7/28/2025 Number Present: 10 Completed Date: 7/28/2025 Age: From 0 To 12 Total Minutes: 210 Time In: 10:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six percent (86%) as of 7/22/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc., is current/active as of 7/22/25. Permit type – Three (3) star license issued 11/12/2019. Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 8/7/24. The last fire drill was practiced on 7/21/25. The last shelter-in-place or lockdown drill has not been conducted since reopening on 6/16/25. The last playground inspection was documented on 7/14/25. The last fire inspection was approved on 6/10/25. The last sanitation inspection was conducted on 9/12/24 with eighteen (18) demerits for an Approved classification. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 10/17/23 without hazards. Lead paint testing was completed on 1/14/25. Asbestos testing was completed on 2/14/25. The program does not provide transportation. Upon arrival I was greeted by Ms. Bailey. In classroom space 5, children were sleeping. Chrissy Wolfe, Child Care Health Consultant was present and giving staff Technical Assistance on safe sleep practices. Children from classroom space 2 were outside playing on the infant/toddler playground. Children were listening to music and being soothed by caregivers. Children from classroom spaces 4 and 3 were combined into one group and were observed playing outside on the playground for preschool and school aged children. Children built small structures with wooden blocks and drew pictures with chalk and paper. Interactions were age appropriate, supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 812 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. Two (2) outlets in classroom space 4 and one (1) outlet in classroom space 5 was uncovered. 10A NCAC 09 .0604(c) 849 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. The permission for one (1) over the counter medication in classroom space 1 was dated 6/17/24 and expired 7/17/25. One (1) topical medication in classroom space 4 expired 4/2024 .0803(12) 871 Center staff did not comply with the safe sleep policy. A blanket was given to a ten (10) month old child to sleep in classroom space 1. 10A NCAC 09 .0606(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. The file for one (1) child, enrollment date 6/16/25 was missing a medical exam or health assessment. GS110-91(1) 1323 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. The file for one (1) child, enrollment date 6/16/25, was missing an immunization record. 10A NCAC 09 .0302(d)(2) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. The file for one (1) child, enrollment date 6/16/25, was missing a signed statement acknowledging receipt of the discipline policies. .1804(c) 1908 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. The file for one (1) child, enrollment date 6/16/25 was missing a signed statement acknowledging receipt of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. .0608(b)(1-6) Technical assistance was provided as follows: The following items were cited as violations today. Compliance is due by 8/11/25. Item #812 The outlets were covered during the visit. This is corrected. Plan to scan the classroom before children arrive in the morning to ensure safety standards are met. Item #849 The medications were removed from the classroom and will be given back to the parents. In your letter of compliance, please include a statement that indicates this has been completed. We discussed over the counter medication permission forms must be updated every 30 days for staff to administer the medication. We also discussed, if staff administer over the counter medication this must be recorded on a log. We discussed having the parent staff member administer the over the counter medication instead. Item #871 The blanket was removed from the child during the visit. This is corrected. Ms. Wolfe and I discussed with staff that blankets can only be given to children older than 12 months, according to the facility’s safe sleep policy. We also discussed editing the statement in the policy regarding blankets to clarify that children under 12 months old who sleep on cots also cannot have blankets. Item #1320, #1321, #1323, #1324, #1908: We discussed the facility recently moved children’s files to Brightwheel. We discussed the one (1) child did not have any digital files or signed acknowledgements. Plan to reach out to the parent and ensure they understand how to upload these files. Alternatively, you can maintain paper files while parents get accustomed to the new platform. In your letter of compliance, please include a statement that indicates the following items are on file for the one (1) child: Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy acknowledgement, Discipline policy acknowledgement, immunization record, medical exam, and parent handbook acknowledgement. The following items were not cited as violations during the visit today. Due to Tropical Storm Helene, the facility was closed from 9/26/24- 6/16/25. The facility sustained flooding damage that required extensive repairs. Additionally, a leak in the roof caused the ceiling to collapse in the office on 2/14/25, destroying various documents and records for program, staff and children. Additional time and guidance is given to reach compliance with the following items. Please note, violations may be cited for these items during future visits if compliance is not met: Staff Medical Reports: Two (2) staff members received medical reports after their date of hire. Moving forward, the medical report must be on file prior to employment. I recommend staff do not start until the medical report is received. ABCMS Provider Portal: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Alternatively, you can log into your Moodle and search for "ABCMS" and it will pull the course up. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 8/11/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: Kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Additionally, please copy my Supervisor, Bonnie Mathis, as I will be out on leave when the letter of compliance is due. Ms. Mathis’s email is bonnie.mathis@dhhs.nc.gov. Please call me at 828-713-8192, or email Kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Alternatively, if you have questions regarding compliance, you can contact Ms. Mathis at 828-782-0854. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed children under 15 months must have an Infant Feeding Plan posted in their classroom. Plan to obtain this feeding plan from the parents of the one (1) child when they begin attending. Plan to conduct a shelter-in-place or lockdown drill by the end of this week. Plan to brief new staff on procedures prior to the drill. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at Kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0302 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 8/7/2024 Number Present: 23 Completed Date: 8/7/2024 Age: From 1 To 9 Total Minutes: 390 Time In: 09:30 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 8/5/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc., is current/active as of 8/5/24. Permit type – Three (3) star license, issued 11/12/19. Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 9/27/23. The last fire drill was practiced on 8/2/24. The last shelter-in-place drill was practiced on 5/16/24. The last playground inspection was documented on 7/27/24. The last fire inspection was approved on 3/18/24. The last sanitation inspection was conducted on 9/29/23 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. There are thirty-seven (37) children enrolled. Four (4) children’s files were monitored today. There are seven (7) staff. One (1) new staff file was monitored today. One (1) existing staff files were monitored today. The facility does not provide transportation. Upon arrival I was greeted by Ms. Bailey. In classroom space 2, children were being soothed by caregivers and preparing to go outside. Once outside on the playground for infants and toddlers, children were observed throwing and kicking balls. Children from classroom spaces 3 and 4 were playing outside on the large playground. Children were observed dancing to music with caregivers, pretending cook and serve food, riding scooters and toy cars, and building small structures with interlocking blocks at a table in the shade. Interactions were positive, children’s needs were met immediately and appropriately for the age of the child. Children were actively supervised at all times. Lunch today consisted of beef tacos with cheese, corn, beans, milk and fish sticks as an alternative protein. The facility is currently under an Administrative Action- Written Warning. The Action issued 6/14/24 and was received on 6/20/24. The Administrative Action and cover letter was posted on the bulletin board near the entrance for parent reference. We reviewed the stipulations in the Action. Ms. Bailey reached out to Sharon Fitzgerald, Health Social Behaviors Specialist, to schedule the required training on 6/20/24. The training is scheduled for 8/8/24. Ms. Bailey sent the revised discipline policy to me via email, on 6/25/24. We discussed that the revised discipline policy is due one (1) week after the required training in CAP item #2. Plan to resend the revised discipline policy to me after the training has been received to allow for any techniques or strategies learned during the training to be included in the revised policy. The revised discipline policy will be due to me by 8/15/24. Ms. Bailey sent the fire inspection policy to me, via email on 6/25/24. We discussed the following edits are needed for approval: -Identify, specifically, who the fire safety coordinator will be. We discussed you can use titles instead of names, in case there are staffing changes in the future. For example, you can state “Administrator” instead of “Kim Bailey”. - We discussed resources for fire safety training. Plan to reach out to your local fire marshal or fire inspector before paying for training to ensure it will be acceptable. -Include a plan to ensure the approved annual fire inspection is submitted to the Division within one (1) week of the inspection, on the form provided by the Division. Please note that, if hand-written, the inspection must be submitted via mail. As a reminder, you are required to keep the Administrative Action posted until you receive a Closure Letter from me. Unannounced visits will continue to occur every 4-6 weeks, per procedures. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. The activity plan in classroom space 3 was dated for 7/23/24-7/26/24. GS 110-91(12); .0508(a) 508 Special diet or food allergy information was not posted where they can be seen in food preparation and eating areas. Food allergy, sensitivity and preferences were not posted in the classrooms or kitchen .0901(g) 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. On the large playground, mulch measured less than one (1) inch under the swings in both structures. Mulch measured three (3) inches deep at the base of the slide on the climber on the left side of the playground. Mulch measured two (2) inches deep at the base of the slide on the climber in the center of the playground. .0605(j) 721 All equipment and furnishings were not in good repair. The wooden climber on the left side of the large playground swayed when children used the swings. The wooden climber in the center of the playground swayed when moderate pressure was applied to the side by an adult. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. A fire drill was not conducted during July 2024. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. Twelve (12) incident reports were not documented on the incident log. .0802(g)(1-6) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In classroom space 4, medication administration permission expired on 7/19/24 for one topical medication and on 3/28/24 for two additional topical medications. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: Item #428 The activity plan was updated during the visit today. This was corrected. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item #508 The food allergy, sensitivity and preferences lists were posted during the visit. This is corrected. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. Item #716 Add mulch so that it reaches a depth of six (6) inches within the fall zone of the two (2) climbing structures on the large playground. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (j) All stationary outdoor equipment more than 18 inches high shall be installed over protective surfacing. Footings which anchor equipment shall not be exposed. Protective surfacing shall be either: (1) loose surfacing material, including wood mulch, double shredded bark mulch, uniform wood chips, fine sand, coarse sand, and pea gravel, except that pea gravel shall not be used if the area will be used by children under three years of age. Loose surfacing material shall not be installed over concrete; or (2) other materials that have been certified by the manufacturer to be shock-absorbing protective material in accordance with the American Society for Testing and Materials (ASTM) Standard F 1292, may be used if installed, maintained, and replaced according to the manufacturer's instructions. This standard is incorporated by reference and does include subsequent editions. This standard may be found online at https://www.astm.org/Standards/F1292.htm for a cost of sixty-five dollars ($65.00). (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. (l) Protective surfacing shall cover the area under and around equipment where a child may fall, referred to as the fall zone. The area for fall zones is as follows: (1) for stationary outdoor equipment used by children under two years of age, the protective surfacing shall extend beyond the external limits of the equipment for a minimum of three feet, except that protective surfacing shall be required at all points of entrance and exit for any structure that has a protective barrier; and (2) for stationary outdoor equipment used by children two years of age or older, the protective surfacing shall extend beyond the external limits of the equipment for six feet; (2) Swings shall have protective surfacing that extends two times the length of the pivot point to the surface below. The surfacing shall be to the front and rear of the swing. Item #721 Plan to reach out to ownership and maintenance to attempt to tighten the bolts on the climbers and to make the structure more steady. We discussed that children should not use the structures until they have been repaired. You stated that the facility is closed for children on Thursday and Fridy this week for staff training and that you would contact ownership and maintenance to address the issue. In your letter of compliance, state your plan to ensure children do not use the structures until they are repaired. 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Item #805 In your letter of compliance, include a statement that indicates how you will ensure fire drills are conducted monthly. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item #853 The incident reports were documented on the incident log during the visit. This was corrected. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/I/incident_log_i.pdf?ver=2017-05-16-105723-723. Item #1882 The medication administration permission form was updated for the one (1) medication that had expired on 7/19/24. The medication associated with the permission forms that expired on 3/28/24 was removed from the classroom to return to the parent. This is corrected. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/21/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that all incident reports must be maintained in the child’s file. Plan to work with ownership to develop an updated job description, specific to each role. Currently, staff are given a job description for “Child Care Worker”. Job descriptions should be specific to each role/title. Plan to conduct a shelter-in-place or lockdown drill by 8/31/24. We discussed that safe sleep rules apply for children who are twelve (12) months old. Continue to conduct sleep checks for children who are twelve (12) months old in the classroom for one year old children. 10A NCAC 09 .1724 SAFE SLEEP PRACTICES (a) Each operator licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (3) specifies no pillows, wedges or other positioners, pillow-like toys, blankets, toys, bumper pads, quilts, sheepskins, loose bedding, towels and washcloths, or other objects may be placed in a crib with a sleeping infant aged 12 months or younger; (7) specifies the operator shall visually check sleeping infants aged 12 months or younger at least every 15 minutes; If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 8/7/2024 Number Present: 23 Completed Date: 8/7/2024 Age: From 1 To 9 Total Minutes: 390 Time In: 09:30 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 8/5/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc., is current/active as of 8/5/24. Permit type – Three (3) star license, issued 11/12/19. Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 9/27/23. The last fire drill was practiced on 8/2/24. The last shelter-in-place drill was practiced on 5/16/24. The last playground inspection was documented on 7/27/24. The last fire inspection was approved on 3/18/24. The last sanitation inspection was conducted on 9/29/23 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. There are thirty-seven (37) children enrolled. Four (4) children’s files were monitored today. There are seven (7) staff. One (1) new staff file was monitored today. One (1) existing staff files were monitored today. The facility does not provide transportation. Upon arrival I was greeted by Ms. Bailey. In classroom space 2, children were being soothed by caregivers and preparing to go outside. Once outside on the playground for infants and toddlers, children were observed throwing and kicking balls. Children from classroom spaces 3 and 4 were playing outside on the large playground. Children were observed dancing to music with caregivers, pretending cook and serve food, riding scooters and toy cars, and building small structures with interlocking blocks at a table in the shade. Interactions were positive, children’s needs were met immediately and appropriately for the age of the child. Children were actively supervised at all times. Lunch today consisted of beef tacos with cheese, corn, beans, milk and fish sticks as an alternative protein. The facility is currently under an Administrative Action- Written Warning. The Action issued 6/14/24 and was received on 6/20/24. The Administrative Action and cover letter was posted on the bulletin board near the entrance for parent reference. We reviewed the stipulations in the Action. Ms. Bailey reached out to Sharon Fitzgerald, Health Social Behaviors Specialist, to schedule the required training on 6/20/24. The training is scheduled for 8/8/24. Ms. Bailey sent the revised discipline policy to me via email, on 6/25/24. We discussed that the revised discipline policy is due one (1) week after the required training in CAP item #2. Plan to resend the revised discipline policy to me after the training has been received to allow for any techniques or strategies learned during the training to be included in the revised policy. The revised discipline policy will be due to me by 8/15/24. Ms. Bailey sent the fire inspection policy to me, via email on 6/25/24. We discussed the following edits are needed for approval: -Identify, specifically, who the fire safety coordinator will be. We discussed you can use titles instead of names, in case there are staffing changes in the future. For example, you can state “Administrator” instead of “Kim Bailey”. - We discussed resources for fire safety training. Plan to reach out to your local fire marshal or fire inspector before paying for training to ensure it will be acceptable. -Include a plan to ensure the approved annual fire inspection is submitted to the Division within one (1) week of the inspection, on the form provided by the Division. Please note that, if hand-written, the inspection must be submitted via mail. As a reminder, you are required to keep the Administrative Action posted until you receive a Closure Letter from me. Unannounced visits will continue to occur every 4-6 weeks, per procedures. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. The activity plan in classroom space 3 was dated for 7/23/24-7/26/24. GS 110-91(12); .0508(a) 508 Special diet or food allergy information was not posted where they can be seen in food preparation and eating areas. Food allergy, sensitivity and preferences were not posted in the classrooms or kitchen .0901(g) 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. On the large playground, mulch measured less than one (1) inch under the swings in both structures. Mulch measured three (3) inches deep at the base of the slide on the climber on the left side of the playground. Mulch measured two (2) inches deep at the base of the slide on the climber in the center of the playground. .0605(j) 721 All equipment and furnishings were not in good repair. The wooden climber on the left side of the large playground swayed when children used the swings. The wooden climber in the center of the playground swayed when moderate pressure was applied to the side by an adult. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. A fire drill was not conducted during July 2024. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. Twelve (12) incident reports were not documented on the incident log. .0802(g)(1-6) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In classroom space 4, medication administration permission expired on 7/19/24 for one topical medication and on 3/28/24 for two additional topical medications. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: Item #428 The activity plan was updated during the visit today. This was corrected. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item #508 The food allergy, sensitivity and preferences lists were posted during the visit. This is corrected. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. Item #716 Add mulch so that it reaches a depth of six (6) inches within the fall zone of the two (2) climbing structures on the large playground. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (j) All stationary outdoor equipment more than 18 inches high shall be installed over protective surfacing. Footings which anchor equipment shall not be exposed. Protective surfacing shall be either: (1) loose surfacing material, including wood mulch, double shredded bark mulch, uniform wood chips, fine sand, coarse sand, and pea gravel, except that pea gravel shall not be used if the area will be used by children under three years of age. Loose surfacing material shall not be installed over concrete; or (2) other materials that have been certified by the manufacturer to be shock-absorbing protective material in accordance with the American Society for Testing and Materials (ASTM) Standard F 1292, may be used if installed, maintained, and replaced according to the manufacturer's instructions. This standard is incorporated by reference and does include subsequent editions. This standard may be found online at https://www.astm.org/Standards/F1292.htm for a cost of sixty-five dollars ($65.00). (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. (l) Protective surfacing shall cover the area under and around equipment where a child may fall, referred to as the fall zone. The area for fall zones is as follows: (1) for stationary outdoor equipment used by children under two years of age, the protective surfacing shall extend beyond the external limits of the equipment for a minimum of three feet, except that protective surfacing shall be required at all points of entrance and exit for any structure that has a protective barrier; and (2) for stationary outdoor equipment used by children two years of age or older, the protective surfacing shall extend beyond the external limits of the equipment for six feet; (2) Swings shall have protective surfacing that extends two times the length of the pivot point to the surface below. The surfacing shall be to the front and rear of the swing. Item #721 Plan to reach out to ownership and maintenance to attempt to tighten the bolts on the climbers and to make the structure more steady. We discussed that children should not use the structures until they have been repaired. You stated that the facility is closed for children on Thursday and Fridy this week for staff training and that you would contact ownership and maintenance to address the issue. In your letter of compliance, state your plan to ensure children do not use the structures until they are repaired. 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Item #805 In your letter of compliance, include a statement that indicates how you will ensure fire drills are conducted monthly. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item #853 The incident reports were documented on the incident log during the visit. This was corrected. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/I/incident_log_i.pdf?ver=2017-05-16-105723-723. Item #1882 The medication administration permission form was updated for the one (1) medication that had expired on 7/19/24. The medication associated with the permission forms that expired on 3/28/24 was removed from the classroom to return to the parent. This is corrected. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/21/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that all incident reports must be maintained in the child’s file. Plan to work with ownership to develop an updated job description, specific to each role. Currently, staff are given a job description for “Child Care Worker”. Job descriptions should be specific to each role/title. Plan to conduct a shelter-in-place or lockdown drill by 8/31/24. We discussed that safe sleep rules apply for children who are twelve (12) months old. Continue to conduct sleep checks for children who are twelve (12) months old in the classroom for one year old children. 10A NCAC 09 .1724 SAFE SLEEP PRACTICES (a) Each operator licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (3) specifies no pillows, wedges or other positioners, pillow-like toys, blankets, toys, bumper pads, quilts, sheepskins, loose bedding, towels and washcloths, or other objects may be placed in a crib with a sleeping infant aged 12 months or younger; (7) specifies the operator shall visually check sleeping infants aged 12 months or younger at least every 15 minutes; If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0508 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 8/7/2024 Number Present: 23 Completed Date: 8/7/2024 Age: From 1 To 9 Total Minutes: 390 Time In: 09:30 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 8/5/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc., is current/active as of 8/5/24. Permit type – Three (3) star license, issued 11/12/19. Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 9/27/23. The last fire drill was practiced on 8/2/24. The last shelter-in-place drill was practiced on 5/16/24. The last playground inspection was documented on 7/27/24. The last fire inspection was approved on 3/18/24. The last sanitation inspection was conducted on 9/29/23 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. There are thirty-seven (37) children enrolled. Four (4) children’s files were monitored today. There are seven (7) staff. One (1) new staff file was monitored today. One (1) existing staff files were monitored today. The facility does not provide transportation. Upon arrival I was greeted by Ms. Bailey. In classroom space 2, children were being soothed by caregivers and preparing to go outside. Once outside on the playground for infants and toddlers, children were observed throwing and kicking balls. Children from classroom spaces 3 and 4 were playing outside on the large playground. Children were observed dancing to music with caregivers, pretending cook and serve food, riding scooters and toy cars, and building small structures with interlocking blocks at a table in the shade. Interactions were positive, children’s needs were met immediately and appropriately for the age of the child. Children were actively supervised at all times. Lunch today consisted of beef tacos with cheese, corn, beans, milk and fish sticks as an alternative protein. The facility is currently under an Administrative Action- Written Warning. The Action issued 6/14/24 and was received on 6/20/24. The Administrative Action and cover letter was posted on the bulletin board near the entrance for parent reference. We reviewed the stipulations in the Action. Ms. Bailey reached out to Sharon Fitzgerald, Health Social Behaviors Specialist, to schedule the required training on 6/20/24. The training is scheduled for 8/8/24. Ms. Bailey sent the revised discipline policy to me via email, on 6/25/24. We discussed that the revised discipline policy is due one (1) week after the required training in CAP item #2. Plan to resend the revised discipline policy to me after the training has been received to allow for any techniques or strategies learned during the training to be included in the revised policy. The revised discipline policy will be due to me by 8/15/24. Ms. Bailey sent the fire inspection policy to me, via email on 6/25/24. We discussed the following edits are needed for approval: -Identify, specifically, who the fire safety coordinator will be. We discussed you can use titles instead of names, in case there are staffing changes in the future. For example, you can state “Administrator” instead of “Kim Bailey”. - We discussed resources for fire safety training. Plan to reach out to your local fire marshal or fire inspector before paying for training to ensure it will be acceptable. -Include a plan to ensure the approved annual fire inspection is submitted to the Division within one (1) week of the inspection, on the form provided by the Division. Please note that, if hand-written, the inspection must be submitted via mail. As a reminder, you are required to keep the Administrative Action posted until you receive a Closure Letter from me. Unannounced visits will continue to occur every 4-6 weeks, per procedures. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. The activity plan in classroom space 3 was dated for 7/23/24-7/26/24. GS 110-91(12); .0508(a) 508 Special diet or food allergy information was not posted where they can be seen in food preparation and eating areas. Food allergy, sensitivity and preferences were not posted in the classrooms or kitchen .0901(g) 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. On the large playground, mulch measured less than one (1) inch under the swings in both structures. Mulch measured three (3) inches deep at the base of the slide on the climber on the left side of the playground. Mulch measured two (2) inches deep at the base of the slide on the climber in the center of the playground. .0605(j) 721 All equipment and furnishings were not in good repair. The wooden climber on the left side of the large playground swayed when children used the swings. The wooden climber in the center of the playground swayed when moderate pressure was applied to the side by an adult. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. A fire drill was not conducted during July 2024. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. Twelve (12) incident reports were not documented on the incident log. .0802(g)(1-6) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In classroom space 4, medication administration permission expired on 7/19/24 for one topical medication and on 3/28/24 for two additional topical medications. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: Item #428 The activity plan was updated during the visit today. This was corrected. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item #508 The food allergy, sensitivity and preferences lists were posted during the visit. This is corrected. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. Item #716 Add mulch so that it reaches a depth of six (6) inches within the fall zone of the two (2) climbing structures on the large playground. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (j) All stationary outdoor equipment more than 18 inches high shall be installed over protective surfacing. Footings which anchor equipment shall not be exposed. Protective surfacing shall be either: (1) loose surfacing material, including wood mulch, double shredded bark mulch, uniform wood chips, fine sand, coarse sand, and pea gravel, except that pea gravel shall not be used if the area will be used by children under three years of age. Loose surfacing material shall not be installed over concrete; or (2) other materials that have been certified by the manufacturer to be shock-absorbing protective material in accordance with the American Society for Testing and Materials (ASTM) Standard F 1292, may be used if installed, maintained, and replaced according to the manufacturer's instructions. This standard is incorporated by reference and does include subsequent editions. This standard may be found online at https://www.astm.org/Standards/F1292.htm for a cost of sixty-five dollars ($65.00). (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. (l) Protective surfacing shall cover the area under and around equipment where a child may fall, referred to as the fall zone. The area for fall zones is as follows: (1) for stationary outdoor equipment used by children under two years of age, the protective surfacing shall extend beyond the external limits of the equipment for a minimum of three feet, except that protective surfacing shall be required at all points of entrance and exit for any structure that has a protective barrier; and (2) for stationary outdoor equipment used by children two years of age or older, the protective surfacing shall extend beyond the external limits of the equipment for six feet; (2) Swings shall have protective surfacing that extends two times the length of the pivot point to the surface below. The surfacing shall be to the front and rear of the swing. Item #721 Plan to reach out to ownership and maintenance to attempt to tighten the bolts on the climbers and to make the structure more steady. We discussed that children should not use the structures until they have been repaired. You stated that the facility is closed for children on Thursday and Fridy this week for staff training and that you would contact ownership and maintenance to address the issue. In your letter of compliance, state your plan to ensure children do not use the structures until they are repaired. 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Item #805 In your letter of compliance, include a statement that indicates how you will ensure fire drills are conducted monthly. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item #853 The incident reports were documented on the incident log during the visit. This was corrected. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/I/incident_log_i.pdf?ver=2017-05-16-105723-723. Item #1882 The medication administration permission form was updated for the one (1) medication that had expired on 7/19/24. The medication associated with the permission forms that expired on 3/28/24 was removed from the classroom to return to the parent. This is corrected. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/21/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that all incident reports must be maintained in the child’s file. Plan to work with ownership to develop an updated job description, specific to each role. Currently, staff are given a job description for “Child Care Worker”. Job descriptions should be specific to each role/title. Plan to conduct a shelter-in-place or lockdown drill by 8/31/24. We discussed that safe sleep rules apply for children who are twelve (12) months old. Continue to conduct sleep checks for children who are twelve (12) months old in the classroom for one year old children. 10A NCAC 09 .1724 SAFE SLEEP PRACTICES (a) Each operator licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (3) specifies no pillows, wedges or other positioners, pillow-like toys, blankets, toys, bumper pads, quilts, sheepskins, loose bedding, towels and washcloths, or other objects may be placed in a crib with a sleeping infant aged 12 months or younger; (7) specifies the operator shall visually check sleeping infants aged 12 months or younger at least every 15 minutes; If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0601 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 8/7/2024 Number Present: 23 Completed Date: 8/7/2024 Age: From 1 To 9 Total Minutes: 390 Time In: 09:30 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 8/5/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc., is current/active as of 8/5/24. Permit type – Three (3) star license, issued 11/12/19. Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 9/27/23. The last fire drill was practiced on 8/2/24. The last shelter-in-place drill was practiced on 5/16/24. The last playground inspection was documented on 7/27/24. The last fire inspection was approved on 3/18/24. The last sanitation inspection was conducted on 9/29/23 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. There are thirty-seven (37) children enrolled. Four (4) children’s files were monitored today. There are seven (7) staff. One (1) new staff file was monitored today. One (1) existing staff files were monitored today. The facility does not provide transportation. Upon arrival I was greeted by Ms. Bailey. In classroom space 2, children were being soothed by caregivers and preparing to go outside. Once outside on the playground for infants and toddlers, children were observed throwing and kicking balls. Children from classroom spaces 3 and 4 were playing outside on the large playground. Children were observed dancing to music with caregivers, pretending cook and serve food, riding scooters and toy cars, and building small structures with interlocking blocks at a table in the shade. Interactions were positive, children’s needs were met immediately and appropriately for the age of the child. Children were actively supervised at all times. Lunch today consisted of beef tacos with cheese, corn, beans, milk and fish sticks as an alternative protein. The facility is currently under an Administrative Action- Written Warning. The Action issued 6/14/24 and was received on 6/20/24. The Administrative Action and cover letter was posted on the bulletin board near the entrance for parent reference. We reviewed the stipulations in the Action. Ms. Bailey reached out to Sharon Fitzgerald, Health Social Behaviors Specialist, to schedule the required training on 6/20/24. The training is scheduled for 8/8/24. Ms. Bailey sent the revised discipline policy to me via email, on 6/25/24. We discussed that the revised discipline policy is due one (1) week after the required training in CAP item #2. Plan to resend the revised discipline policy to me after the training has been received to allow for any techniques or strategies learned during the training to be included in the revised policy. The revised discipline policy will be due to me by 8/15/24. Ms. Bailey sent the fire inspection policy to me, via email on 6/25/24. We discussed the following edits are needed for approval: -Identify, specifically, who the fire safety coordinator will be. We discussed you can use titles instead of names, in case there are staffing changes in the future. For example, you can state “Administrator” instead of “Kim Bailey”. - We discussed resources for fire safety training. Plan to reach out to your local fire marshal or fire inspector before paying for training to ensure it will be acceptable. -Include a plan to ensure the approved annual fire inspection is submitted to the Division within one (1) week of the inspection, on the form provided by the Division. Please note that, if hand-written, the inspection must be submitted via mail. As a reminder, you are required to keep the Administrative Action posted until you receive a Closure Letter from me. Unannounced visits will continue to occur every 4-6 weeks, per procedures. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. The activity plan in classroom space 3 was dated for 7/23/24-7/26/24. GS 110-91(12); .0508(a) 508 Special diet or food allergy information was not posted where they can be seen in food preparation and eating areas. Food allergy, sensitivity and preferences were not posted in the classrooms or kitchen .0901(g) 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. On the large playground, mulch measured less than one (1) inch under the swings in both structures. Mulch measured three (3) inches deep at the base of the slide on the climber on the left side of the playground. Mulch measured two (2) inches deep at the base of the slide on the climber in the center of the playground. .0605(j) 721 All equipment and furnishings were not in good repair. The wooden climber on the left side of the large playground swayed when children used the swings. The wooden climber in the center of the playground swayed when moderate pressure was applied to the side by an adult. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. A fire drill was not conducted during July 2024. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. Twelve (12) incident reports were not documented on the incident log. .0802(g)(1-6) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In classroom space 4, medication administration permission expired on 7/19/24 for one topical medication and on 3/28/24 for two additional topical medications. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: Item #428 The activity plan was updated during the visit today. This was corrected. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item #508 The food allergy, sensitivity and preferences lists were posted during the visit. This is corrected. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. Item #716 Add mulch so that it reaches a depth of six (6) inches within the fall zone of the two (2) climbing structures on the large playground. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (j) All stationary outdoor equipment more than 18 inches high shall be installed over protective surfacing. Footings which anchor equipment shall not be exposed. Protective surfacing shall be either: (1) loose surfacing material, including wood mulch, double shredded bark mulch, uniform wood chips, fine sand, coarse sand, and pea gravel, except that pea gravel shall not be used if the area will be used by children under three years of age. Loose surfacing material shall not be installed over concrete; or (2) other materials that have been certified by the manufacturer to be shock-absorbing protective material in accordance with the American Society for Testing and Materials (ASTM) Standard F 1292, may be used if installed, maintained, and replaced according to the manufacturer's instructions. This standard is incorporated by reference and does include subsequent editions. This standard may be found online at https://www.astm.org/Standards/F1292.htm for a cost of sixty-five dollars ($65.00). (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. (l) Protective surfacing shall cover the area under and around equipment where a child may fall, referred to as the fall zone. The area for fall zones is as follows: (1) for stationary outdoor equipment used by children under two years of age, the protective surfacing shall extend beyond the external limits of the equipment for a minimum of three feet, except that protective surfacing shall be required at all points of entrance and exit for any structure that has a protective barrier; and (2) for stationary outdoor equipment used by children two years of age or older, the protective surfacing shall extend beyond the external limits of the equipment for six feet; (2) Swings shall have protective surfacing that extends two times the length of the pivot point to the surface below. The surfacing shall be to the front and rear of the swing. Item #721 Plan to reach out to ownership and maintenance to attempt to tighten the bolts on the climbers and to make the structure more steady. We discussed that children should not use the structures until they have been repaired. You stated that the facility is closed for children on Thursday and Fridy this week for staff training and that you would contact ownership and maintenance to address the issue. In your letter of compliance, state your plan to ensure children do not use the structures until they are repaired. 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Item #805 In your letter of compliance, include a statement that indicates how you will ensure fire drills are conducted monthly. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item #853 The incident reports were documented on the incident log during the visit. This was corrected. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/I/incident_log_i.pdf?ver=2017-05-16-105723-723. Item #1882 The medication administration permission form was updated for the one (1) medication that had expired on 7/19/24. The medication associated with the permission forms that expired on 3/28/24 was removed from the classroom to return to the parent. This is corrected. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/21/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that all incident reports must be maintained in the child’s file. Plan to work with ownership to develop an updated job description, specific to each role. Currently, staff are given a job description for “Child Care Worker”. Job descriptions should be specific to each role/title. Plan to conduct a shelter-in-place or lockdown drill by 8/31/24. We discussed that safe sleep rules apply for children who are twelve (12) months old. Continue to conduct sleep checks for children who are twelve (12) months old in the classroom for one year old children. 10A NCAC 09 .1724 SAFE SLEEP PRACTICES (a) Each operator licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (3) specifies no pillows, wedges or other positioners, pillow-like toys, blankets, toys, bumper pads, quilts, sheepskins, loose bedding, towels and washcloths, or other objects may be placed in a crib with a sleeping infant aged 12 months or younger; (7) specifies the operator shall visually check sleeping infants aged 12 months or younger at least every 15 minutes; If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0604 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 8/7/2024 Number Present: 23 Completed Date: 8/7/2024 Age: From 1 To 9 Total Minutes: 390 Time In: 09:30 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 8/5/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc., is current/active as of 8/5/24. Permit type – Three (3) star license, issued 11/12/19. Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 9/27/23. The last fire drill was practiced on 8/2/24. The last shelter-in-place drill was practiced on 5/16/24. The last playground inspection was documented on 7/27/24. The last fire inspection was approved on 3/18/24. The last sanitation inspection was conducted on 9/29/23 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. There are thirty-seven (37) children enrolled. Four (4) children’s files were monitored today. There are seven (7) staff. One (1) new staff file was monitored today. One (1) existing staff files were monitored today. The facility does not provide transportation. Upon arrival I was greeted by Ms. Bailey. In classroom space 2, children were being soothed by caregivers and preparing to go outside. Once outside on the playground for infants and toddlers, children were observed throwing and kicking balls. Children from classroom spaces 3 and 4 were playing outside on the large playground. Children were observed dancing to music with caregivers, pretending cook and serve food, riding scooters and toy cars, and building small structures with interlocking blocks at a table in the shade. Interactions were positive, children’s needs were met immediately and appropriately for the age of the child. Children were actively supervised at all times. Lunch today consisted of beef tacos with cheese, corn, beans, milk and fish sticks as an alternative protein. The facility is currently under an Administrative Action- Written Warning. The Action issued 6/14/24 and was received on 6/20/24. The Administrative Action and cover letter was posted on the bulletin board near the entrance for parent reference. We reviewed the stipulations in the Action. Ms. Bailey reached out to Sharon Fitzgerald, Health Social Behaviors Specialist, to schedule the required training on 6/20/24. The training is scheduled for 8/8/24. Ms. Bailey sent the revised discipline policy to me via email, on 6/25/24. We discussed that the revised discipline policy is due one (1) week after the required training in CAP item #2. Plan to resend the revised discipline policy to me after the training has been received to allow for any techniques or strategies learned during the training to be included in the revised policy. The revised discipline policy will be due to me by 8/15/24. Ms. Bailey sent the fire inspection policy to me, via email on 6/25/24. We discussed the following edits are needed for approval: -Identify, specifically, who the fire safety coordinator will be. We discussed you can use titles instead of names, in case there are staffing changes in the future. For example, you can state “Administrator” instead of “Kim Bailey”. - We discussed resources for fire safety training. Plan to reach out to your local fire marshal or fire inspector before paying for training to ensure it will be acceptable. -Include a plan to ensure the approved annual fire inspection is submitted to the Division within one (1) week of the inspection, on the form provided by the Division. Please note that, if hand-written, the inspection must be submitted via mail. As a reminder, you are required to keep the Administrative Action posted until you receive a Closure Letter from me. Unannounced visits will continue to occur every 4-6 weeks, per procedures. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. The activity plan in classroom space 3 was dated for 7/23/24-7/26/24. GS 110-91(12); .0508(a) 508 Special diet or food allergy information was not posted where they can be seen in food preparation and eating areas. Food allergy, sensitivity and preferences were not posted in the classrooms or kitchen .0901(g) 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. On the large playground, mulch measured less than one (1) inch under the swings in both structures. Mulch measured three (3) inches deep at the base of the slide on the climber on the left side of the playground. Mulch measured two (2) inches deep at the base of the slide on the climber in the center of the playground. .0605(j) 721 All equipment and furnishings were not in good repair. The wooden climber on the left side of the large playground swayed when children used the swings. The wooden climber in the center of the playground swayed when moderate pressure was applied to the side by an adult. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. A fire drill was not conducted during July 2024. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. Twelve (12) incident reports were not documented on the incident log. .0802(g)(1-6) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In classroom space 4, medication administration permission expired on 7/19/24 for one topical medication and on 3/28/24 for two additional topical medications. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: Item #428 The activity plan was updated during the visit today. This was corrected. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item #508 The food allergy, sensitivity and preferences lists were posted during the visit. This is corrected. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. Item #716 Add mulch so that it reaches a depth of six (6) inches within the fall zone of the two (2) climbing structures on the large playground. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (j) All stationary outdoor equipment more than 18 inches high shall be installed over protective surfacing. Footings which anchor equipment shall not be exposed. Protective surfacing shall be either: (1) loose surfacing material, including wood mulch, double shredded bark mulch, uniform wood chips, fine sand, coarse sand, and pea gravel, except that pea gravel shall not be used if the area will be used by children under three years of age. Loose surfacing material shall not be installed over concrete; or (2) other materials that have been certified by the manufacturer to be shock-absorbing protective material in accordance with the American Society for Testing and Materials (ASTM) Standard F 1292, may be used if installed, maintained, and replaced according to the manufacturer's instructions. This standard is incorporated by reference and does include subsequent editions. This standard may be found online at https://www.astm.org/Standards/F1292.htm for a cost of sixty-five dollars ($65.00). (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. (l) Protective surfacing shall cover the area under and around equipment where a child may fall, referred to as the fall zone. The area for fall zones is as follows: (1) for stationary outdoor equipment used by children under two years of age, the protective surfacing shall extend beyond the external limits of the equipment for a minimum of three feet, except that protective surfacing shall be required at all points of entrance and exit for any structure that has a protective barrier; and (2) for stationary outdoor equipment used by children two years of age or older, the protective surfacing shall extend beyond the external limits of the equipment for six feet; (2) Swings shall have protective surfacing that extends two times the length of the pivot point to the surface below. The surfacing shall be to the front and rear of the swing. Item #721 Plan to reach out to ownership and maintenance to attempt to tighten the bolts on the climbers and to make the structure more steady. We discussed that children should not use the structures until they have been repaired. You stated that the facility is closed for children on Thursday and Fridy this week for staff training and that you would contact ownership and maintenance to address the issue. In your letter of compliance, state your plan to ensure children do not use the structures until they are repaired. 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Item #805 In your letter of compliance, include a statement that indicates how you will ensure fire drills are conducted monthly. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item #853 The incident reports were documented on the incident log during the visit. This was corrected. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/I/incident_log_i.pdf?ver=2017-05-16-105723-723. Item #1882 The medication administration permission form was updated for the one (1) medication that had expired on 7/19/24. The medication associated with the permission forms that expired on 3/28/24 was removed from the classroom to return to the parent. This is corrected. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/21/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that all incident reports must be maintained in the child’s file. Plan to work with ownership to develop an updated job description, specific to each role. Currently, staff are given a job description for “Child Care Worker”. Job descriptions should be specific to each role/title. Plan to conduct a shelter-in-place or lockdown drill by 8/31/24. We discussed that safe sleep rules apply for children who are twelve (12) months old. Continue to conduct sleep checks for children who are twelve (12) months old in the classroom for one year old children. 10A NCAC 09 .1724 SAFE SLEEP PRACTICES (a) Each operator licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (3) specifies no pillows, wedges or other positioners, pillow-like toys, blankets, toys, bumper pads, quilts, sheepskins, loose bedding, towels and washcloths, or other objects may be placed in a crib with a sleeping infant aged 12 months or younger; (7) specifies the operator shall visually check sleeping infants aged 12 months or younger at least every 15 minutes; If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0605 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 8/7/2024 Number Present: 23 Completed Date: 8/7/2024 Age: From 1 To 9 Total Minutes: 390 Time In: 09:30 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 8/5/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc., is current/active as of 8/5/24. Permit type – Three (3) star license, issued 11/12/19. Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 9/27/23. The last fire drill was practiced on 8/2/24. The last shelter-in-place drill was practiced on 5/16/24. The last playground inspection was documented on 7/27/24. The last fire inspection was approved on 3/18/24. The last sanitation inspection was conducted on 9/29/23 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. There are thirty-seven (37) children enrolled. Four (4) children’s files were monitored today. There are seven (7) staff. One (1) new staff file was monitored today. One (1) existing staff files were monitored today. The facility does not provide transportation. Upon arrival I was greeted by Ms. Bailey. In classroom space 2, children were being soothed by caregivers and preparing to go outside. Once outside on the playground for infants and toddlers, children were observed throwing and kicking balls. Children from classroom spaces 3 and 4 were playing outside on the large playground. Children were observed dancing to music with caregivers, pretending cook and serve food, riding scooters and toy cars, and building small structures with interlocking blocks at a table in the shade. Interactions were positive, children’s needs were met immediately and appropriately for the age of the child. Children were actively supervised at all times. Lunch today consisted of beef tacos with cheese, corn, beans, milk and fish sticks as an alternative protein. The facility is currently under an Administrative Action- Written Warning. The Action issued 6/14/24 and was received on 6/20/24. The Administrative Action and cover letter was posted on the bulletin board near the entrance for parent reference. We reviewed the stipulations in the Action. Ms. Bailey reached out to Sharon Fitzgerald, Health Social Behaviors Specialist, to schedule the required training on 6/20/24. The training is scheduled for 8/8/24. Ms. Bailey sent the revised discipline policy to me via email, on 6/25/24. We discussed that the revised discipline policy is due one (1) week after the required training in CAP item #2. Plan to resend the revised discipline policy to me after the training has been received to allow for any techniques or strategies learned during the training to be included in the revised policy. The revised discipline policy will be due to me by 8/15/24. Ms. Bailey sent the fire inspection policy to me, via email on 6/25/24. We discussed the following edits are needed for approval: -Identify, specifically, who the fire safety coordinator will be. We discussed you can use titles instead of names, in case there are staffing changes in the future. For example, you can state “Administrator” instead of “Kim Bailey”. - We discussed resources for fire safety training. Plan to reach out to your local fire marshal or fire inspector before paying for training to ensure it will be acceptable. -Include a plan to ensure the approved annual fire inspection is submitted to the Division within one (1) week of the inspection, on the form provided by the Division. Please note that, if hand-written, the inspection must be submitted via mail. As a reminder, you are required to keep the Administrative Action posted until you receive a Closure Letter from me. Unannounced visits will continue to occur every 4-6 weeks, per procedures. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. The activity plan in classroom space 3 was dated for 7/23/24-7/26/24. GS 110-91(12); .0508(a) 508 Special diet or food allergy information was not posted where they can be seen in food preparation and eating areas. Food allergy, sensitivity and preferences were not posted in the classrooms or kitchen .0901(g) 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. On the large playground, mulch measured less than one (1) inch under the swings in both structures. Mulch measured three (3) inches deep at the base of the slide on the climber on the left side of the playground. Mulch measured two (2) inches deep at the base of the slide on the climber in the center of the playground. .0605(j) 721 All equipment and furnishings were not in good repair. The wooden climber on the left side of the large playground swayed when children used the swings. The wooden climber in the center of the playground swayed when moderate pressure was applied to the side by an adult. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. A fire drill was not conducted during July 2024. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. Twelve (12) incident reports were not documented on the incident log. .0802(g)(1-6) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In classroom space 4, medication administration permission expired on 7/19/24 for one topical medication and on 3/28/24 for two additional topical medications. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: Item #428 The activity plan was updated during the visit today. This was corrected. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item #508 The food allergy, sensitivity and preferences lists were posted during the visit. This is corrected. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. Item #716 Add mulch so that it reaches a depth of six (6) inches within the fall zone of the two (2) climbing structures on the large playground. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (j) All stationary outdoor equipment more than 18 inches high shall be installed over protective surfacing. Footings which anchor equipment shall not be exposed. Protective surfacing shall be either: (1) loose surfacing material, including wood mulch, double shredded bark mulch, uniform wood chips, fine sand, coarse sand, and pea gravel, except that pea gravel shall not be used if the area will be used by children under three years of age. Loose surfacing material shall not be installed over concrete; or (2) other materials that have been certified by the manufacturer to be shock-absorbing protective material in accordance with the American Society for Testing and Materials (ASTM) Standard F 1292, may be used if installed, maintained, and replaced according to the manufacturer's instructions. This standard is incorporated by reference and does include subsequent editions. This standard may be found online at https://www.astm.org/Standards/F1292.htm for a cost of sixty-five dollars ($65.00). (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. (l) Protective surfacing shall cover the area under and around equipment where a child may fall, referred to as the fall zone. The area for fall zones is as follows: (1) for stationary outdoor equipment used by children under two years of age, the protective surfacing shall extend beyond the external limits of the equipment for a minimum of three feet, except that protective surfacing shall be required at all points of entrance and exit for any structure that has a protective barrier; and (2) for stationary outdoor equipment used by children two years of age or older, the protective surfacing shall extend beyond the external limits of the equipment for six feet; (2) Swings shall have protective surfacing that extends two times the length of the pivot point to the surface below. The surfacing shall be to the front and rear of the swing. Item #721 Plan to reach out to ownership and maintenance to attempt to tighten the bolts on the climbers and to make the structure more steady. We discussed that children should not use the structures until they have been repaired. You stated that the facility is closed for children on Thursday and Fridy this week for staff training and that you would contact ownership and maintenance to address the issue. In your letter of compliance, state your plan to ensure children do not use the structures until they are repaired. 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Item #805 In your letter of compliance, include a statement that indicates how you will ensure fire drills are conducted monthly. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item #853 The incident reports were documented on the incident log during the visit. This was corrected. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/I/incident_log_i.pdf?ver=2017-05-16-105723-723. Item #1882 The medication administration permission form was updated for the one (1) medication that had expired on 7/19/24. The medication associated with the permission forms that expired on 3/28/24 was removed from the classroom to return to the parent. This is corrected. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/21/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that all incident reports must be maintained in the child’s file. Plan to work with ownership to develop an updated job description, specific to each role. Currently, staff are given a job description for “Child Care Worker”. Job descriptions should be specific to each role/title. Plan to conduct a shelter-in-place or lockdown drill by 8/31/24. We discussed that safe sleep rules apply for children who are twelve (12) months old. Continue to conduct sleep checks for children who are twelve (12) months old in the classroom for one year old children. 10A NCAC 09 .1724 SAFE SLEEP PRACTICES (a) Each operator licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (3) specifies no pillows, wedges or other positioners, pillow-like toys, blankets, toys, bumper pads, quilts, sheepskins, loose bedding, towels and washcloths, or other objects may be placed in a crib with a sleeping infant aged 12 months or younger; (7) specifies the operator shall visually check sleeping infants aged 12 months or younger at least every 15 minutes; If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0802 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 8/7/2024 Number Present: 23 Completed Date: 8/7/2024 Age: From 1 To 9 Total Minutes: 390 Time In: 09:30 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 8/5/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc., is current/active as of 8/5/24. Permit type – Three (3) star license, issued 11/12/19. Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 9/27/23. The last fire drill was practiced on 8/2/24. The last shelter-in-place drill was practiced on 5/16/24. The last playground inspection was documented on 7/27/24. The last fire inspection was approved on 3/18/24. The last sanitation inspection was conducted on 9/29/23 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. There are thirty-seven (37) children enrolled. Four (4) children’s files were monitored today. There are seven (7) staff. One (1) new staff file was monitored today. One (1) existing staff files were monitored today. The facility does not provide transportation. Upon arrival I was greeted by Ms. Bailey. In classroom space 2, children were being soothed by caregivers and preparing to go outside. Once outside on the playground for infants and toddlers, children were observed throwing and kicking balls. Children from classroom spaces 3 and 4 were playing outside on the large playground. Children were observed dancing to music with caregivers, pretending cook and serve food, riding scooters and toy cars, and building small structures with interlocking blocks at a table in the shade. Interactions were positive, children’s needs were met immediately and appropriately for the age of the child. Children were actively supervised at all times. Lunch today consisted of beef tacos with cheese, corn, beans, milk and fish sticks as an alternative protein. The facility is currently under an Administrative Action- Written Warning. The Action issued 6/14/24 and was received on 6/20/24. The Administrative Action and cover letter was posted on the bulletin board near the entrance for parent reference. We reviewed the stipulations in the Action. Ms. Bailey reached out to Sharon Fitzgerald, Health Social Behaviors Specialist, to schedule the required training on 6/20/24. The training is scheduled for 8/8/24. Ms. Bailey sent the revised discipline policy to me via email, on 6/25/24. We discussed that the revised discipline policy is due one (1) week after the required training in CAP item #2. Plan to resend the revised discipline policy to me after the training has been received to allow for any techniques or strategies learned during the training to be included in the revised policy. The revised discipline policy will be due to me by 8/15/24. Ms. Bailey sent the fire inspection policy to me, via email on 6/25/24. We discussed the following edits are needed for approval: -Identify, specifically, who the fire safety coordinator will be. We discussed you can use titles instead of names, in case there are staffing changes in the future. For example, you can state “Administrator” instead of “Kim Bailey”. - We discussed resources for fire safety training. Plan to reach out to your local fire marshal or fire inspector before paying for training to ensure it will be acceptable. -Include a plan to ensure the approved annual fire inspection is submitted to the Division within one (1) week of the inspection, on the form provided by the Division. Please note that, if hand-written, the inspection must be submitted via mail. As a reminder, you are required to keep the Administrative Action posted until you receive a Closure Letter from me. Unannounced visits will continue to occur every 4-6 weeks, per procedures. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. The activity plan in classroom space 3 was dated for 7/23/24-7/26/24. GS 110-91(12); .0508(a) 508 Special diet or food allergy information was not posted where they can be seen in food preparation and eating areas. Food allergy, sensitivity and preferences were not posted in the classrooms or kitchen .0901(g) 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. On the large playground, mulch measured less than one (1) inch under the swings in both structures. Mulch measured three (3) inches deep at the base of the slide on the climber on the left side of the playground. Mulch measured two (2) inches deep at the base of the slide on the climber in the center of the playground. .0605(j) 721 All equipment and furnishings were not in good repair. The wooden climber on the left side of the large playground swayed when children used the swings. The wooden climber in the center of the playground swayed when moderate pressure was applied to the side by an adult. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. A fire drill was not conducted during July 2024. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. Twelve (12) incident reports were not documented on the incident log. .0802(g)(1-6) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In classroom space 4, medication administration permission expired on 7/19/24 for one topical medication and on 3/28/24 for two additional topical medications. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: Item #428 The activity plan was updated during the visit today. This was corrected. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item #508 The food allergy, sensitivity and preferences lists were posted during the visit. This is corrected. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. Item #716 Add mulch so that it reaches a depth of six (6) inches within the fall zone of the two (2) climbing structures on the large playground. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (j) All stationary outdoor equipment more than 18 inches high shall be installed over protective surfacing. Footings which anchor equipment shall not be exposed. Protective surfacing shall be either: (1) loose surfacing material, including wood mulch, double shredded bark mulch, uniform wood chips, fine sand, coarse sand, and pea gravel, except that pea gravel shall not be used if the area will be used by children under three years of age. Loose surfacing material shall not be installed over concrete; or (2) other materials that have been certified by the manufacturer to be shock-absorbing protective material in accordance with the American Society for Testing and Materials (ASTM) Standard F 1292, may be used if installed, maintained, and replaced according to the manufacturer's instructions. This standard is incorporated by reference and does include subsequent editions. This standard may be found online at https://www.astm.org/Standards/F1292.htm for a cost of sixty-five dollars ($65.00). (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. (l) Protective surfacing shall cover the area under and around equipment where a child may fall, referred to as the fall zone. The area for fall zones is as follows: (1) for stationary outdoor equipment used by children under two years of age, the protective surfacing shall extend beyond the external limits of the equipment for a minimum of three feet, except that protective surfacing shall be required at all points of entrance and exit for any structure that has a protective barrier; and (2) for stationary outdoor equipment used by children two years of age or older, the protective surfacing shall extend beyond the external limits of the equipment for six feet; (2) Swings shall have protective surfacing that extends two times the length of the pivot point to the surface below. The surfacing shall be to the front and rear of the swing. Item #721 Plan to reach out to ownership and maintenance to attempt to tighten the bolts on the climbers and to make the structure more steady. We discussed that children should not use the structures until they have been repaired. You stated that the facility is closed for children on Thursday and Fridy this week for staff training and that you would contact ownership and maintenance to address the issue. In your letter of compliance, state your plan to ensure children do not use the structures until they are repaired. 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Item #805 In your letter of compliance, include a statement that indicates how you will ensure fire drills are conducted monthly. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item #853 The incident reports were documented on the incident log during the visit. This was corrected. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/I/incident_log_i.pdf?ver=2017-05-16-105723-723. Item #1882 The medication administration permission form was updated for the one (1) medication that had expired on 7/19/24. The medication associated with the permission forms that expired on 3/28/24 was removed from the classroom to return to the parent. This is corrected. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/21/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that all incident reports must be maintained in the child’s file. Plan to work with ownership to develop an updated job description, specific to each role. Currently, staff are given a job description for “Child Care Worker”. Job descriptions should be specific to each role/title. Plan to conduct a shelter-in-place or lockdown drill by 8/31/24. We discussed that safe sleep rules apply for children who are twelve (12) months old. Continue to conduct sleep checks for children who are twelve (12) months old in the classroom for one year old children. 10A NCAC 09 .1724 SAFE SLEEP PRACTICES (a) Each operator licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (3) specifies no pillows, wedges or other positioners, pillow-like toys, blankets, toys, bumper pads, quilts, sheepskins, loose bedding, towels and washcloths, or other objects may be placed in a crib with a sleeping infant aged 12 months or younger; (7) specifies the operator shall visually check sleeping infants aged 12 months or younger at least every 15 minutes; If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0803 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 8/7/2024 Number Present: 23 Completed Date: 8/7/2024 Age: From 1 To 9 Total Minutes: 390 Time In: 09:30 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 8/5/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc., is current/active as of 8/5/24. Permit type – Three (3) star license, issued 11/12/19. Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 9/27/23. The last fire drill was practiced on 8/2/24. The last shelter-in-place drill was practiced on 5/16/24. The last playground inspection was documented on 7/27/24. The last fire inspection was approved on 3/18/24. The last sanitation inspection was conducted on 9/29/23 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. There are thirty-seven (37) children enrolled. Four (4) children’s files were monitored today. There are seven (7) staff. One (1) new staff file was monitored today. One (1) existing staff files were monitored today. The facility does not provide transportation. Upon arrival I was greeted by Ms. Bailey. In classroom space 2, children were being soothed by caregivers and preparing to go outside. Once outside on the playground for infants and toddlers, children were observed throwing and kicking balls. Children from classroom spaces 3 and 4 were playing outside on the large playground. Children were observed dancing to music with caregivers, pretending cook and serve food, riding scooters and toy cars, and building small structures with interlocking blocks at a table in the shade. Interactions were positive, children’s needs were met immediately and appropriately for the age of the child. Children were actively supervised at all times. Lunch today consisted of beef tacos with cheese, corn, beans, milk and fish sticks as an alternative protein. The facility is currently under an Administrative Action- Written Warning. The Action issued 6/14/24 and was received on 6/20/24. The Administrative Action and cover letter was posted on the bulletin board near the entrance for parent reference. We reviewed the stipulations in the Action. Ms. Bailey reached out to Sharon Fitzgerald, Health Social Behaviors Specialist, to schedule the required training on 6/20/24. The training is scheduled for 8/8/24. Ms. Bailey sent the revised discipline policy to me via email, on 6/25/24. We discussed that the revised discipline policy is due one (1) week after the required training in CAP item #2. Plan to resend the revised discipline policy to me after the training has been received to allow for any techniques or strategies learned during the training to be included in the revised policy. The revised discipline policy will be due to me by 8/15/24. Ms. Bailey sent the fire inspection policy to me, via email on 6/25/24. We discussed the following edits are needed for approval: -Identify, specifically, who the fire safety coordinator will be. We discussed you can use titles instead of names, in case there are staffing changes in the future. For example, you can state “Administrator” instead of “Kim Bailey”. - We discussed resources for fire safety training. Plan to reach out to your local fire marshal or fire inspector before paying for training to ensure it will be acceptable. -Include a plan to ensure the approved annual fire inspection is submitted to the Division within one (1) week of the inspection, on the form provided by the Division. Please note that, if hand-written, the inspection must be submitted via mail. As a reminder, you are required to keep the Administrative Action posted until you receive a Closure Letter from me. Unannounced visits will continue to occur every 4-6 weeks, per procedures. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. The activity plan in classroom space 3 was dated for 7/23/24-7/26/24. GS 110-91(12); .0508(a) 508 Special diet or food allergy information was not posted where they can be seen in food preparation and eating areas. Food allergy, sensitivity and preferences were not posted in the classrooms or kitchen .0901(g) 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. On the large playground, mulch measured less than one (1) inch under the swings in both structures. Mulch measured three (3) inches deep at the base of the slide on the climber on the left side of the playground. Mulch measured two (2) inches deep at the base of the slide on the climber in the center of the playground. .0605(j) 721 All equipment and furnishings were not in good repair. The wooden climber on the left side of the large playground swayed when children used the swings. The wooden climber in the center of the playground swayed when moderate pressure was applied to the side by an adult. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. A fire drill was not conducted during July 2024. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. Twelve (12) incident reports were not documented on the incident log. .0802(g)(1-6) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In classroom space 4, medication administration permission expired on 7/19/24 for one topical medication and on 3/28/24 for two additional topical medications. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: Item #428 The activity plan was updated during the visit today. This was corrected. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item #508 The food allergy, sensitivity and preferences lists were posted during the visit. This is corrected. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. Item #716 Add mulch so that it reaches a depth of six (6) inches within the fall zone of the two (2) climbing structures on the large playground. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (j) All stationary outdoor equipment more than 18 inches high shall be installed over protective surfacing. Footings which anchor equipment shall not be exposed. Protective surfacing shall be either: (1) loose surfacing material, including wood mulch, double shredded bark mulch, uniform wood chips, fine sand, coarse sand, and pea gravel, except that pea gravel shall not be used if the area will be used by children under three years of age. Loose surfacing material shall not be installed over concrete; or (2) other materials that have been certified by the manufacturer to be shock-absorbing protective material in accordance with the American Society for Testing and Materials (ASTM) Standard F 1292, may be used if installed, maintained, and replaced according to the manufacturer's instructions. This standard is incorporated by reference and does include subsequent editions. This standard may be found online at https://www.astm.org/Standards/F1292.htm for a cost of sixty-five dollars ($65.00). (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. (l) Protective surfacing shall cover the area under and around equipment where a child may fall, referred to as the fall zone. The area for fall zones is as follows: (1) for stationary outdoor equipment used by children under two years of age, the protective surfacing shall extend beyond the external limits of the equipment for a minimum of three feet, except that protective surfacing shall be required at all points of entrance and exit for any structure that has a protective barrier; and (2) for stationary outdoor equipment used by children two years of age or older, the protective surfacing shall extend beyond the external limits of the equipment for six feet; (2) Swings shall have protective surfacing that extends two times the length of the pivot point to the surface below. The surfacing shall be to the front and rear of the swing. Item #721 Plan to reach out to ownership and maintenance to attempt to tighten the bolts on the climbers and to make the structure more steady. We discussed that children should not use the structures until they have been repaired. You stated that the facility is closed for children on Thursday and Fridy this week for staff training and that you would contact ownership and maintenance to address the issue. In your letter of compliance, state your plan to ensure children do not use the structures until they are repaired. 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Item #805 In your letter of compliance, include a statement that indicates how you will ensure fire drills are conducted monthly. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item #853 The incident reports were documented on the incident log during the visit. This was corrected. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/I/incident_log_i.pdf?ver=2017-05-16-105723-723. Item #1882 The medication administration permission form was updated for the one (1) medication that had expired on 7/19/24. The medication associated with the permission forms that expired on 3/28/24 was removed from the classroom to return to the parent. This is corrected. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/21/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that all incident reports must be maintained in the child’s file. Plan to work with ownership to develop an updated job description, specific to each role. Currently, staff are given a job description for “Child Care Worker”. Job descriptions should be specific to each role/title. Plan to conduct a shelter-in-place or lockdown drill by 8/31/24. We discussed that safe sleep rules apply for children who are twelve (12) months old. Continue to conduct sleep checks for children who are twelve (12) months old in the classroom for one year old children. 10A NCAC 09 .1724 SAFE SLEEP PRACTICES (a) Each operator licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (3) specifies no pillows, wedges or other positioners, pillow-like toys, blankets, toys, bumper pads, quilts, sheepskins, loose bedding, towels and washcloths, or other objects may be placed in a crib with a sleeping infant aged 12 months or younger; (7) specifies the operator shall visually check sleeping infants aged 12 months or younger at least every 15 minutes; If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0901 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 8/7/2024 Number Present: 23 Completed Date: 8/7/2024 Age: From 1 To 9 Total Minutes: 390 Time In: 09:30 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 8/5/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc., is current/active as of 8/5/24. Permit type – Three (3) star license, issued 11/12/19. Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 9/27/23. The last fire drill was practiced on 8/2/24. The last shelter-in-place drill was practiced on 5/16/24. The last playground inspection was documented on 7/27/24. The last fire inspection was approved on 3/18/24. The last sanitation inspection was conducted on 9/29/23 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. There are thirty-seven (37) children enrolled. Four (4) children’s files were monitored today. There are seven (7) staff. One (1) new staff file was monitored today. One (1) existing staff files were monitored today. The facility does not provide transportation. Upon arrival I was greeted by Ms. Bailey. In classroom space 2, children were being soothed by caregivers and preparing to go outside. Once outside on the playground for infants and toddlers, children were observed throwing and kicking balls. Children from classroom spaces 3 and 4 were playing outside on the large playground. Children were observed dancing to music with caregivers, pretending cook and serve food, riding scooters and toy cars, and building small structures with interlocking blocks at a table in the shade. Interactions were positive, children’s needs were met immediately and appropriately for the age of the child. Children were actively supervised at all times. Lunch today consisted of beef tacos with cheese, corn, beans, milk and fish sticks as an alternative protein. The facility is currently under an Administrative Action- Written Warning. The Action issued 6/14/24 and was received on 6/20/24. The Administrative Action and cover letter was posted on the bulletin board near the entrance for parent reference. We reviewed the stipulations in the Action. Ms. Bailey reached out to Sharon Fitzgerald, Health Social Behaviors Specialist, to schedule the required training on 6/20/24. The training is scheduled for 8/8/24. Ms. Bailey sent the revised discipline policy to me via email, on 6/25/24. We discussed that the revised discipline policy is due one (1) week after the required training in CAP item #2. Plan to resend the revised discipline policy to me after the training has been received to allow for any techniques or strategies learned during the training to be included in the revised policy. The revised discipline policy will be due to me by 8/15/24. Ms. Bailey sent the fire inspection policy to me, via email on 6/25/24. We discussed the following edits are needed for approval: -Identify, specifically, who the fire safety coordinator will be. We discussed you can use titles instead of names, in case there are staffing changes in the future. For example, you can state “Administrator” instead of “Kim Bailey”. - We discussed resources for fire safety training. Plan to reach out to your local fire marshal or fire inspector before paying for training to ensure it will be acceptable. -Include a plan to ensure the approved annual fire inspection is submitted to the Division within one (1) week of the inspection, on the form provided by the Division. Please note that, if hand-written, the inspection must be submitted via mail. As a reminder, you are required to keep the Administrative Action posted until you receive a Closure Letter from me. Unannounced visits will continue to occur every 4-6 weeks, per procedures. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. The activity plan in classroom space 3 was dated for 7/23/24-7/26/24. GS 110-91(12); .0508(a) 508 Special diet or food allergy information was not posted where they can be seen in food preparation and eating areas. Food allergy, sensitivity and preferences were not posted in the classrooms or kitchen .0901(g) 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. On the large playground, mulch measured less than one (1) inch under the swings in both structures. Mulch measured three (3) inches deep at the base of the slide on the climber on the left side of the playground. Mulch measured two (2) inches deep at the base of the slide on the climber in the center of the playground. .0605(j) 721 All equipment and furnishings were not in good repair. The wooden climber on the left side of the large playground swayed when children used the swings. The wooden climber in the center of the playground swayed when moderate pressure was applied to the side by an adult. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. A fire drill was not conducted during July 2024. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. Twelve (12) incident reports were not documented on the incident log. .0802(g)(1-6) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In classroom space 4, medication administration permission expired on 7/19/24 for one topical medication and on 3/28/24 for two additional topical medications. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: Item #428 The activity plan was updated during the visit today. This was corrected. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item #508 The food allergy, sensitivity and preferences lists were posted during the visit. This is corrected. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. Item #716 Add mulch so that it reaches a depth of six (6) inches within the fall zone of the two (2) climbing structures on the large playground. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (j) All stationary outdoor equipment more than 18 inches high shall be installed over protective surfacing. Footings which anchor equipment shall not be exposed. Protective surfacing shall be either: (1) loose surfacing material, including wood mulch, double shredded bark mulch, uniform wood chips, fine sand, coarse sand, and pea gravel, except that pea gravel shall not be used if the area will be used by children under three years of age. Loose surfacing material shall not be installed over concrete; or (2) other materials that have been certified by the manufacturer to be shock-absorbing protective material in accordance with the American Society for Testing and Materials (ASTM) Standard F 1292, may be used if installed, maintained, and replaced according to the manufacturer's instructions. This standard is incorporated by reference and does include subsequent editions. This standard may be found online at https://www.astm.org/Standards/F1292.htm for a cost of sixty-five dollars ($65.00). (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. (l) Protective surfacing shall cover the area under and around equipment where a child may fall, referred to as the fall zone. The area for fall zones is as follows: (1) for stationary outdoor equipment used by children under two years of age, the protective surfacing shall extend beyond the external limits of the equipment for a minimum of three feet, except that protective surfacing shall be required at all points of entrance and exit for any structure that has a protective barrier; and (2) for stationary outdoor equipment used by children two years of age or older, the protective surfacing shall extend beyond the external limits of the equipment for six feet; (2) Swings shall have protective surfacing that extends two times the length of the pivot point to the surface below. The surfacing shall be to the front and rear of the swing. Item #721 Plan to reach out to ownership and maintenance to attempt to tighten the bolts on the climbers and to make the structure more steady. We discussed that children should not use the structures until they have been repaired. You stated that the facility is closed for children on Thursday and Fridy this week for staff training and that you would contact ownership and maintenance to address the issue. In your letter of compliance, state your plan to ensure children do not use the structures until they are repaired. 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Item #805 In your letter of compliance, include a statement that indicates how you will ensure fire drills are conducted monthly. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item #853 The incident reports were documented on the incident log during the visit. This was corrected. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/I/incident_log_i.pdf?ver=2017-05-16-105723-723. Item #1882 The medication administration permission form was updated for the one (1) medication that had expired on 7/19/24. The medication associated with the permission forms that expired on 3/28/24 was removed from the classroom to return to the parent. This is corrected. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/21/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that all incident reports must be maintained in the child’s file. Plan to work with ownership to develop an updated job description, specific to each role. Currently, staff are given a job description for “Child Care Worker”. Job descriptions should be specific to each role/title. Plan to conduct a shelter-in-place or lockdown drill by 8/31/24. We discussed that safe sleep rules apply for children who are twelve (12) months old. Continue to conduct sleep checks for children who are twelve (12) months old in the classroom for one year old children. 10A NCAC 09 .1724 SAFE SLEEP PRACTICES (a) Each operator licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (3) specifies no pillows, wedges or other positioners, pillow-like toys, blankets, toys, bumper pads, quilts, sheepskins, loose bedding, towels and washcloths, or other objects may be placed in a crib with a sleeping infant aged 12 months or younger; (7) specifies the operator shall visually check sleeping infants aged 12 months or younger at least every 15 minutes; If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 8/7/2024 Number Present: 23 Completed Date: 8/7/2024 Age: From 1 To 9 Total Minutes: 390 Time In: 09:30 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 8/5/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc., is current/active as of 8/5/24. Permit type – Three (3) star license, issued 11/12/19. Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 9/27/23. The last fire drill was practiced on 8/2/24. The last shelter-in-place drill was practiced on 5/16/24. The last playground inspection was documented on 7/27/24. The last fire inspection was approved on 3/18/24. The last sanitation inspection was conducted on 9/29/23 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. There are thirty-seven (37) children enrolled. Four (4) children’s files were monitored today. There are seven (7) staff. One (1) new staff file was monitored today. One (1) existing staff files were monitored today. The facility does not provide transportation. Upon arrival I was greeted by Ms. Bailey. In classroom space 2, children were being soothed by caregivers and preparing to go outside. Once outside on the playground for infants and toddlers, children were observed throwing and kicking balls. Children from classroom spaces 3 and 4 were playing outside on the large playground. Children were observed dancing to music with caregivers, pretending cook and serve food, riding scooters and toy cars, and building small structures with interlocking blocks at a table in the shade. Interactions were positive, children’s needs were met immediately and appropriately for the age of the child. Children were actively supervised at all times. Lunch today consisted of beef tacos with cheese, corn, beans, milk and fish sticks as an alternative protein. The facility is currently under an Administrative Action- Written Warning. The Action issued 6/14/24 and was received on 6/20/24. The Administrative Action and cover letter was posted on the bulletin board near the entrance for parent reference. We reviewed the stipulations in the Action. Ms. Bailey reached out to Sharon Fitzgerald, Health Social Behaviors Specialist, to schedule the required training on 6/20/24. The training is scheduled for 8/8/24. Ms. Bailey sent the revised discipline policy to me via email, on 6/25/24. We discussed that the revised discipline policy is due one (1) week after the required training in CAP item #2. Plan to resend the revised discipline policy to me after the training has been received to allow for any techniques or strategies learned during the training to be included in the revised policy. The revised discipline policy will be due to me by 8/15/24. Ms. Bailey sent the fire inspection policy to me, via email on 6/25/24. We discussed the following edits are needed for approval: -Identify, specifically, who the fire safety coordinator will be. We discussed you can use titles instead of names, in case there are staffing changes in the future. For example, you can state “Administrator” instead of “Kim Bailey”. - We discussed resources for fire safety training. Plan to reach out to your local fire marshal or fire inspector before paying for training to ensure it will be acceptable. -Include a plan to ensure the approved annual fire inspection is submitted to the Division within one (1) week of the inspection, on the form provided by the Division. Please note that, if hand-written, the inspection must be submitted via mail. As a reminder, you are required to keep the Administrative Action posted until you receive a Closure Letter from me. Unannounced visits will continue to occur every 4-6 weeks, per procedures. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. The activity plan in classroom space 3 was dated for 7/23/24-7/26/24. GS 110-91(12); .0508(a) 508 Special diet or food allergy information was not posted where they can be seen in food preparation and eating areas. Food allergy, sensitivity and preferences were not posted in the classrooms or kitchen .0901(g) 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. On the large playground, mulch measured less than one (1) inch under the swings in both structures. Mulch measured three (3) inches deep at the base of the slide on the climber on the left side of the playground. Mulch measured two (2) inches deep at the base of the slide on the climber in the center of the playground. .0605(j) 721 All equipment and furnishings were not in good repair. The wooden climber on the left side of the large playground swayed when children used the swings. The wooden climber in the center of the playground swayed when moderate pressure was applied to the side by an adult. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. A fire drill was not conducted during July 2024. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. Twelve (12) incident reports were not documented on the incident log. .0802(g)(1-6) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In classroom space 4, medication administration permission expired on 7/19/24 for one topical medication and on 3/28/24 for two additional topical medications. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: Item #428 The activity plan was updated during the visit today. This was corrected. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item #508 The food allergy, sensitivity and preferences lists were posted during the visit. This is corrected. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. Item #716 Add mulch so that it reaches a depth of six (6) inches within the fall zone of the two (2) climbing structures on the large playground. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (j) All stationary outdoor equipment more than 18 inches high shall be installed over protective surfacing. Footings which anchor equipment shall not be exposed. Protective surfacing shall be either: (1) loose surfacing material, including wood mulch, double shredded bark mulch, uniform wood chips, fine sand, coarse sand, and pea gravel, except that pea gravel shall not be used if the area will be used by children under three years of age. Loose surfacing material shall not be installed over concrete; or (2) other materials that have been certified by the manufacturer to be shock-absorbing protective material in accordance with the American Society for Testing and Materials (ASTM) Standard F 1292, may be used if installed, maintained, and replaced according to the manufacturer's instructions. This standard is incorporated by reference and does include subsequent editions. This standard may be found online at https://www.astm.org/Standards/F1292.htm for a cost of sixty-five dollars ($65.00). (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. (l) Protective surfacing shall cover the area under and around equipment where a child may fall, referred to as the fall zone. The area for fall zones is as follows: (1) for stationary outdoor equipment used by children under two years of age, the protective surfacing shall extend beyond the external limits of the equipment for a minimum of three feet, except that protective surfacing shall be required at all points of entrance and exit for any structure that has a protective barrier; and (2) for stationary outdoor equipment used by children two years of age or older, the protective surfacing shall extend beyond the external limits of the equipment for six feet; (2) Swings shall have protective surfacing that extends two times the length of the pivot point to the surface below. The surfacing shall be to the front and rear of the swing. Item #721 Plan to reach out to ownership and maintenance to attempt to tighten the bolts on the climbers and to make the structure more steady. We discussed that children should not use the structures until they have been repaired. You stated that the facility is closed for children on Thursday and Fridy this week for staff training and that you would contact ownership and maintenance to address the issue. In your letter of compliance, state your plan to ensure children do not use the structures until they are repaired. 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Item #805 In your letter of compliance, include a statement that indicates how you will ensure fire drills are conducted monthly. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item #853 The incident reports were documented on the incident log during the visit. This was corrected. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/I/incident_log_i.pdf?ver=2017-05-16-105723-723. Item #1882 The medication administration permission form was updated for the one (1) medication that had expired on 7/19/24. The medication associated with the permission forms that expired on 3/28/24 was removed from the classroom to return to the parent. This is corrected. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/21/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that all incident reports must be maintained in the child’s file. Plan to work with ownership to develop an updated job description, specific to each role. Currently, staff are given a job description for “Child Care Worker”. Job descriptions should be specific to each role/title. Plan to conduct a shelter-in-place or lockdown drill by 8/31/24. We discussed that safe sleep rules apply for children who are twelve (12) months old. Continue to conduct sleep checks for children who are twelve (12) months old in the classroom for one year old children. 10A NCAC 09 .1724 SAFE SLEEP PRACTICES (a) Each operator licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (3) specifies no pillows, wedges or other positioners, pillow-like toys, blankets, toys, bumper pads, quilts, sheepskins, loose bedding, towels and washcloths, or other objects may be placed in a crib with a sleeping infant aged 12 months or younger; (7) specifies the operator shall visually check sleeping infants aged 12 months or younger at least every 15 minutes; If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 8/7/2024 Number Present: 23 Completed Date: 8/7/2024 Age: From 1 To 9 Total Minutes: 390 Time In: 09:30 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 8/5/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc., is current/active as of 8/5/24. Permit type – Three (3) star license, issued 11/12/19. Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 9/27/23. The last fire drill was practiced on 8/2/24. The last shelter-in-place drill was practiced on 5/16/24. The last playground inspection was documented on 7/27/24. The last fire inspection was approved on 3/18/24. The last sanitation inspection was conducted on 9/29/23 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. There are thirty-seven (37) children enrolled. Four (4) children’s files were monitored today. There are seven (7) staff. One (1) new staff file was monitored today. One (1) existing staff files were monitored today. The facility does not provide transportation. Upon arrival I was greeted by Ms. Bailey. In classroom space 2, children were being soothed by caregivers and preparing to go outside. Once outside on the playground for infants and toddlers, children were observed throwing and kicking balls. Children from classroom spaces 3 and 4 were playing outside on the large playground. Children were observed dancing to music with caregivers, pretending cook and serve food, riding scooters and toy cars, and building small structures with interlocking blocks at a table in the shade. Interactions were positive, children’s needs were met immediately and appropriately for the age of the child. Children were actively supervised at all times. Lunch today consisted of beef tacos with cheese, corn, beans, milk and fish sticks as an alternative protein. The facility is currently under an Administrative Action- Written Warning. The Action issued 6/14/24 and was received on 6/20/24. The Administrative Action and cover letter was posted on the bulletin board near the entrance for parent reference. We reviewed the stipulations in the Action. Ms. Bailey reached out to Sharon Fitzgerald, Health Social Behaviors Specialist, to schedule the required training on 6/20/24. The training is scheduled for 8/8/24. Ms. Bailey sent the revised discipline policy to me via email, on 6/25/24. We discussed that the revised discipline policy is due one (1) week after the required training in CAP item #2. Plan to resend the revised discipline policy to me after the training has been received to allow for any techniques or strategies learned during the training to be included in the revised policy. The revised discipline policy will be due to me by 8/15/24. Ms. Bailey sent the fire inspection policy to me, via email on 6/25/24. We discussed the following edits are needed for approval: -Identify, specifically, who the fire safety coordinator will be. We discussed you can use titles instead of names, in case there are staffing changes in the future. For example, you can state “Administrator” instead of “Kim Bailey”. - We discussed resources for fire safety training. Plan to reach out to your local fire marshal or fire inspector before paying for training to ensure it will be acceptable. -Include a plan to ensure the approved annual fire inspection is submitted to the Division within one (1) week of the inspection, on the form provided by the Division. Please note that, if hand-written, the inspection must be submitted via mail. As a reminder, you are required to keep the Administrative Action posted until you receive a Closure Letter from me. Unannounced visits will continue to occur every 4-6 weeks, per procedures. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. The activity plan in classroom space 3 was dated for 7/23/24-7/26/24. GS 110-91(12); .0508(a) 508 Special diet or food allergy information was not posted where they can be seen in food preparation and eating areas. Food allergy, sensitivity and preferences were not posted in the classrooms or kitchen .0901(g) 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. On the large playground, mulch measured less than one (1) inch under the swings in both structures. Mulch measured three (3) inches deep at the base of the slide on the climber on the left side of the playground. Mulch measured two (2) inches deep at the base of the slide on the climber in the center of the playground. .0605(j) 721 All equipment and furnishings were not in good repair. The wooden climber on the left side of the large playground swayed when children used the swings. The wooden climber in the center of the playground swayed when moderate pressure was applied to the side by an adult. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. A fire drill was not conducted during July 2024. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. Twelve (12) incident reports were not documented on the incident log. .0802(g)(1-6) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In classroom space 4, medication administration permission expired on 7/19/24 for one topical medication and on 3/28/24 for two additional topical medications. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: Item #428 The activity plan was updated during the visit today. This was corrected. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item #508 The food allergy, sensitivity and preferences lists were posted during the visit. This is corrected. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. Item #716 Add mulch so that it reaches a depth of six (6) inches within the fall zone of the two (2) climbing structures on the large playground. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (j) All stationary outdoor equipment more than 18 inches high shall be installed over protective surfacing. Footings which anchor equipment shall not be exposed. Protective surfacing shall be either: (1) loose surfacing material, including wood mulch, double shredded bark mulch, uniform wood chips, fine sand, coarse sand, and pea gravel, except that pea gravel shall not be used if the area will be used by children under three years of age. Loose surfacing material shall not be installed over concrete; or (2) other materials that have been certified by the manufacturer to be shock-absorbing protective material in accordance with the American Society for Testing and Materials (ASTM) Standard F 1292, may be used if installed, maintained, and replaced according to the manufacturer's instructions. This standard is incorporated by reference and does include subsequent editions. This standard may be found online at https://www.astm.org/Standards/F1292.htm for a cost of sixty-five dollars ($65.00). (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. (l) Protective surfacing shall cover the area under and around equipment where a child may fall, referred to as the fall zone. The area for fall zones is as follows: (1) for stationary outdoor equipment used by children under two years of age, the protective surfacing shall extend beyond the external limits of the equipment for a minimum of three feet, except that protective surfacing shall be required at all points of entrance and exit for any structure that has a protective barrier; and (2) for stationary outdoor equipment used by children two years of age or older, the protective surfacing shall extend beyond the external limits of the equipment for six feet; (2) Swings shall have protective surfacing that extends two times the length of the pivot point to the surface below. The surfacing shall be to the front and rear of the swing. Item #721 Plan to reach out to ownership and maintenance to attempt to tighten the bolts on the climbers and to make the structure more steady. We discussed that children should not use the structures until they have been repaired. You stated that the facility is closed for children on Thursday and Fridy this week for staff training and that you would contact ownership and maintenance to address the issue. In your letter of compliance, state your plan to ensure children do not use the structures until they are repaired. 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Item #805 In your letter of compliance, include a statement that indicates how you will ensure fire drills are conducted monthly. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item #853 The incident reports were documented on the incident log during the visit. This was corrected. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/I/incident_log_i.pdf?ver=2017-05-16-105723-723. Item #1882 The medication administration permission form was updated for the one (1) medication that had expired on 7/19/24. The medication associated with the permission forms that expired on 3/28/24 was removed from the classroom to return to the parent. This is corrected. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/21/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that all incident reports must be maintained in the child’s file. Plan to work with ownership to develop an updated job description, specific to each role. Currently, staff are given a job description for “Child Care Worker”. Job descriptions should be specific to each role/title. Plan to conduct a shelter-in-place or lockdown drill by 8/31/24. We discussed that safe sleep rules apply for children who are twelve (12) months old. Continue to conduct sleep checks for children who are twelve (12) months old in the classroom for one year old children. 10A NCAC 09 .1724 SAFE SLEEP PRACTICES (a) Each operator licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (3) specifies no pillows, wedges or other positioners, pillow-like toys, blankets, toys, bumper pads, quilts, sheepskins, loose bedding, towels and washcloths, or other objects may be placed in a crib with a sleeping infant aged 12 months or younger; (7) specifies the operator shall visually check sleeping infants aged 12 months or younger at least every 15 minutes; If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1724 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 8/7/2024 Number Present: 23 Completed Date: 8/7/2024 Age: From 1 To 9 Total Minutes: 390 Time In: 09:30 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 8/5/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc., is current/active as of 8/5/24. Permit type – Three (3) star license, issued 11/12/19. Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 9/27/23. The last fire drill was practiced on 8/2/24. The last shelter-in-place drill was practiced on 5/16/24. The last playground inspection was documented on 7/27/24. The last fire inspection was approved on 3/18/24. The last sanitation inspection was conducted on 9/29/23 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. There are thirty-seven (37) children enrolled. Four (4) children’s files were monitored today. There are seven (7) staff. One (1) new staff file was monitored today. One (1) existing staff files were monitored today. The facility does not provide transportation. Upon arrival I was greeted by Ms. Bailey. In classroom space 2, children were being soothed by caregivers and preparing to go outside. Once outside on the playground for infants and toddlers, children were observed throwing and kicking balls. Children from classroom spaces 3 and 4 were playing outside on the large playground. Children were observed dancing to music with caregivers, pretending cook and serve food, riding scooters and toy cars, and building small structures with interlocking blocks at a table in the shade. Interactions were positive, children’s needs were met immediately and appropriately for the age of the child. Children were actively supervised at all times. Lunch today consisted of beef tacos with cheese, corn, beans, milk and fish sticks as an alternative protein. The facility is currently under an Administrative Action- Written Warning. The Action issued 6/14/24 and was received on 6/20/24. The Administrative Action and cover letter was posted on the bulletin board near the entrance for parent reference. We reviewed the stipulations in the Action. Ms. Bailey reached out to Sharon Fitzgerald, Health Social Behaviors Specialist, to schedule the required training on 6/20/24. The training is scheduled for 8/8/24. Ms. Bailey sent the revised discipline policy to me via email, on 6/25/24. We discussed that the revised discipline policy is due one (1) week after the required training in CAP item #2. Plan to resend the revised discipline policy to me after the training has been received to allow for any techniques or strategies learned during the training to be included in the revised policy. The revised discipline policy will be due to me by 8/15/24. Ms. Bailey sent the fire inspection policy to me, via email on 6/25/24. We discussed the following edits are needed for approval: -Identify, specifically, who the fire safety coordinator will be. We discussed you can use titles instead of names, in case there are staffing changes in the future. For example, you can state “Administrator” instead of “Kim Bailey”. - We discussed resources for fire safety training. Plan to reach out to your local fire marshal or fire inspector before paying for training to ensure it will be acceptable. -Include a plan to ensure the approved annual fire inspection is submitted to the Division within one (1) week of the inspection, on the form provided by the Division. Please note that, if hand-written, the inspection must be submitted via mail. As a reminder, you are required to keep the Administrative Action posted until you receive a Closure Letter from me. Unannounced visits will continue to occur every 4-6 weeks, per procedures. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. The activity plan in classroom space 3 was dated for 7/23/24-7/26/24. GS 110-91(12); .0508(a) 508 Special diet or food allergy information was not posted where they can be seen in food preparation and eating areas. Food allergy, sensitivity and preferences were not posted in the classrooms or kitchen .0901(g) 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. On the large playground, mulch measured less than one (1) inch under the swings in both structures. Mulch measured three (3) inches deep at the base of the slide on the climber on the left side of the playground. Mulch measured two (2) inches deep at the base of the slide on the climber in the center of the playground. .0605(j) 721 All equipment and furnishings were not in good repair. The wooden climber on the left side of the large playground swayed when children used the swings. The wooden climber in the center of the playground swayed when moderate pressure was applied to the side by an adult. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. A fire drill was not conducted during July 2024. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. Twelve (12) incident reports were not documented on the incident log. .0802(g)(1-6) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In classroom space 4, medication administration permission expired on 7/19/24 for one topical medication and on 3/28/24 for two additional topical medications. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: Item #428 The activity plan was updated during the visit today. This was corrected. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item #508 The food allergy, sensitivity and preferences lists were posted during the visit. This is corrected. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. Item #716 Add mulch so that it reaches a depth of six (6) inches within the fall zone of the two (2) climbing structures on the large playground. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (j) All stationary outdoor equipment more than 18 inches high shall be installed over protective surfacing. Footings which anchor equipment shall not be exposed. Protective surfacing shall be either: (1) loose surfacing material, including wood mulch, double shredded bark mulch, uniform wood chips, fine sand, coarse sand, and pea gravel, except that pea gravel shall not be used if the area will be used by children under three years of age. Loose surfacing material shall not be installed over concrete; or (2) other materials that have been certified by the manufacturer to be shock-absorbing protective material in accordance with the American Society for Testing and Materials (ASTM) Standard F 1292, may be used if installed, maintained, and replaced according to the manufacturer's instructions. This standard is incorporated by reference and does include subsequent editions. This standard may be found online at https://www.astm.org/Standards/F1292.htm for a cost of sixty-five dollars ($65.00). (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. (l) Protective surfacing shall cover the area under and around equipment where a child may fall, referred to as the fall zone. The area for fall zones is as follows: (1) for stationary outdoor equipment used by children under two years of age, the protective surfacing shall extend beyond the external limits of the equipment for a minimum of three feet, except that protective surfacing shall be required at all points of entrance and exit for any structure that has a protective barrier; and (2) for stationary outdoor equipment used by children two years of age or older, the protective surfacing shall extend beyond the external limits of the equipment for six feet; (2) Swings shall have protective surfacing that extends two times the length of the pivot point to the surface below. The surfacing shall be to the front and rear of the swing. Item #721 Plan to reach out to ownership and maintenance to attempt to tighten the bolts on the climbers and to make the structure more steady. We discussed that children should not use the structures until they have been repaired. You stated that the facility is closed for children on Thursday and Fridy this week for staff training and that you would contact ownership and maintenance to address the issue. In your letter of compliance, state your plan to ensure children do not use the structures until they are repaired. 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Item #805 In your letter of compliance, include a statement that indicates how you will ensure fire drills are conducted monthly. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item #853 The incident reports were documented on the incident log during the visit. This was corrected. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/I/incident_log_i.pdf?ver=2017-05-16-105723-723. Item #1882 The medication administration permission form was updated for the one (1) medication that had expired on 7/19/24. The medication associated with the permission forms that expired on 3/28/24 was removed from the classroom to return to the parent. This is corrected. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/21/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that all incident reports must be maintained in the child’s file. Plan to work with ownership to develop an updated job description, specific to each role. Currently, staff are given a job description for “Child Care Worker”. Job descriptions should be specific to each role/title. Plan to conduct a shelter-in-place or lockdown drill by 8/31/24. We discussed that safe sleep rules apply for children who are twelve (12) months old. Continue to conduct sleep checks for children who are twelve (12) months old in the classroom for one year old children. 10A NCAC 09 .1724 SAFE SLEEP PRACTICES (a) Each operator licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (3) specifies no pillows, wedges or other positioners, pillow-like toys, blankets, toys, bumper pads, quilts, sheepskins, loose bedding, towels and washcloths, or other objects may be placed in a crib with a sleeping infant aged 12 months or younger; (7) specifies the operator shall visually check sleeping infants aged 12 months or younger at least every 15 minutes; If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-91 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 8/7/2024 Number Present: 23 Completed Date: 8/7/2024 Age: From 1 To 9 Total Minutes: 390 Time In: 09:30 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 8/5/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc., is current/active as of 8/5/24. Permit type – Three (3) star license, issued 11/12/19. Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 9/27/23. The last fire drill was practiced on 8/2/24. The last shelter-in-place drill was practiced on 5/16/24. The last playground inspection was documented on 7/27/24. The last fire inspection was approved on 3/18/24. The last sanitation inspection was conducted on 9/29/23 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. There are thirty-seven (37) children enrolled. Four (4) children’s files were monitored today. There are seven (7) staff. One (1) new staff file was monitored today. One (1) existing staff files were monitored today. The facility does not provide transportation. Upon arrival I was greeted by Ms. Bailey. In classroom space 2, children were being soothed by caregivers and preparing to go outside. Once outside on the playground for infants and toddlers, children were observed throwing and kicking balls. Children from classroom spaces 3 and 4 were playing outside on the large playground. Children were observed dancing to music with caregivers, pretending cook and serve food, riding scooters and toy cars, and building small structures with interlocking blocks at a table in the shade. Interactions were positive, children’s needs were met immediately and appropriately for the age of the child. Children were actively supervised at all times. Lunch today consisted of beef tacos with cheese, corn, beans, milk and fish sticks as an alternative protein. The facility is currently under an Administrative Action- Written Warning. The Action issued 6/14/24 and was received on 6/20/24. The Administrative Action and cover letter was posted on the bulletin board near the entrance for parent reference. We reviewed the stipulations in the Action. Ms. Bailey reached out to Sharon Fitzgerald, Health Social Behaviors Specialist, to schedule the required training on 6/20/24. The training is scheduled for 8/8/24. Ms. Bailey sent the revised discipline policy to me via email, on 6/25/24. We discussed that the revised discipline policy is due one (1) week after the required training in CAP item #2. Plan to resend the revised discipline policy to me after the training has been received to allow for any techniques or strategies learned during the training to be included in the revised policy. The revised discipline policy will be due to me by 8/15/24. Ms. Bailey sent the fire inspection policy to me, via email on 6/25/24. We discussed the following edits are needed for approval: -Identify, specifically, who the fire safety coordinator will be. We discussed you can use titles instead of names, in case there are staffing changes in the future. For example, you can state “Administrator” instead of “Kim Bailey”. - We discussed resources for fire safety training. Plan to reach out to your local fire marshal or fire inspector before paying for training to ensure it will be acceptable. -Include a plan to ensure the approved annual fire inspection is submitted to the Division within one (1) week of the inspection, on the form provided by the Division. Please note that, if hand-written, the inspection must be submitted via mail. As a reminder, you are required to keep the Administrative Action posted until you receive a Closure Letter from me. Unannounced visits will continue to occur every 4-6 weeks, per procedures. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. The activity plan in classroom space 3 was dated for 7/23/24-7/26/24. GS 110-91(12); .0508(a) 508 Special diet or food allergy information was not posted where they can be seen in food preparation and eating areas. Food allergy, sensitivity and preferences were not posted in the classrooms or kitchen .0901(g) 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. On the large playground, mulch measured less than one (1) inch under the swings in both structures. Mulch measured three (3) inches deep at the base of the slide on the climber on the left side of the playground. Mulch measured two (2) inches deep at the base of the slide on the climber in the center of the playground. .0605(j) 721 All equipment and furnishings were not in good repair. The wooden climber on the left side of the large playground swayed when children used the swings. The wooden climber in the center of the playground swayed when moderate pressure was applied to the side by an adult. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. A fire drill was not conducted during July 2024. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. Twelve (12) incident reports were not documented on the incident log. .0802(g)(1-6) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In classroom space 4, medication administration permission expired on 7/19/24 for one topical medication and on 3/28/24 for two additional topical medications. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: Item #428 The activity plan was updated during the visit today. This was corrected. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item #508 The food allergy, sensitivity and preferences lists were posted during the visit. This is corrected. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. Item #716 Add mulch so that it reaches a depth of six (6) inches within the fall zone of the two (2) climbing structures on the large playground. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (j) All stationary outdoor equipment more than 18 inches high shall be installed over protective surfacing. Footings which anchor equipment shall not be exposed. Protective surfacing shall be either: (1) loose surfacing material, including wood mulch, double shredded bark mulch, uniform wood chips, fine sand, coarse sand, and pea gravel, except that pea gravel shall not be used if the area will be used by children under three years of age. Loose surfacing material shall not be installed over concrete; or (2) other materials that have been certified by the manufacturer to be shock-absorbing protective material in accordance with the American Society for Testing and Materials (ASTM) Standard F 1292, may be used if installed, maintained, and replaced according to the manufacturer's instructions. This standard is incorporated by reference and does include subsequent editions. This standard may be found online at https://www.astm.org/Standards/F1292.htm for a cost of sixty-five dollars ($65.00). (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. (l) Protective surfacing shall cover the area under and around equipment where a child may fall, referred to as the fall zone. The area for fall zones is as follows: (1) for stationary outdoor equipment used by children under two years of age, the protective surfacing shall extend beyond the external limits of the equipment for a minimum of three feet, except that protective surfacing shall be required at all points of entrance and exit for any structure that has a protective barrier; and (2) for stationary outdoor equipment used by children two years of age or older, the protective surfacing shall extend beyond the external limits of the equipment for six feet; (2) Swings shall have protective surfacing that extends two times the length of the pivot point to the surface below. The surfacing shall be to the front and rear of the swing. Item #721 Plan to reach out to ownership and maintenance to attempt to tighten the bolts on the climbers and to make the structure more steady. We discussed that children should not use the structures until they have been repaired. You stated that the facility is closed for children on Thursday and Fridy this week for staff training and that you would contact ownership and maintenance to address the issue. In your letter of compliance, state your plan to ensure children do not use the structures until they are repaired. 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Item #805 In your letter of compliance, include a statement that indicates how you will ensure fire drills are conducted monthly. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item #853 The incident reports were documented on the incident log during the visit. This was corrected. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/I/incident_log_i.pdf?ver=2017-05-16-105723-723. Item #1882 The medication administration permission form was updated for the one (1) medication that had expired on 7/19/24. The medication associated with the permission forms that expired on 3/28/24 was removed from the classroom to return to the parent. This is corrected. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/21/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that all incident reports must be maintained in the child’s file. Plan to work with ownership to develop an updated job description, specific to each role. Currently, staff are given a job description for “Child Care Worker”. Job descriptions should be specific to each role/title. Plan to conduct a shelter-in-place or lockdown drill by 8/31/24. We discussed that safe sleep rules apply for children who are twelve (12) months old. Continue to conduct sleep checks for children who are twelve (12) months old in the classroom for one year old children. 10A NCAC 09 .1724 SAFE SLEEP PRACTICES (a) Each operator licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (3) specifies no pillows, wedges or other positioners, pillow-like toys, blankets, toys, bumper pads, quilts, sheepskins, loose bedding, towels and washcloths, or other objects may be placed in a crib with a sleeping infant aged 12 months or younger; (7) specifies the operator shall visually check sleeping infants aged 12 months or younger at least every 15 minutes; If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-91 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 8/7/2024 Number Present: 23 Completed Date: 8/7/2024 Age: From 1 To 9 Total Minutes: 390 Time In: 09:30 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 8/5/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc., is current/active as of 8/5/24. Permit type – Three (3) star license, issued 11/12/19. Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 9/27/23. The last fire drill was practiced on 8/2/24. The last shelter-in-place drill was practiced on 5/16/24. The last playground inspection was documented on 7/27/24. The last fire inspection was approved on 3/18/24. The last sanitation inspection was conducted on 9/29/23 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. There are thirty-seven (37) children enrolled. Four (4) children’s files were monitored today. There are seven (7) staff. One (1) new staff file was monitored today. One (1) existing staff files were monitored today. The facility does not provide transportation. Upon arrival I was greeted by Ms. Bailey. In classroom space 2, children were being soothed by caregivers and preparing to go outside. Once outside on the playground for infants and toddlers, children were observed throwing and kicking balls. Children from classroom spaces 3 and 4 were playing outside on the large playground. Children were observed dancing to music with caregivers, pretending cook and serve food, riding scooters and toy cars, and building small structures with interlocking blocks at a table in the shade. Interactions were positive, children’s needs were met immediately and appropriately for the age of the child. Children were actively supervised at all times. Lunch today consisted of beef tacos with cheese, corn, beans, milk and fish sticks as an alternative protein. The facility is currently under an Administrative Action- Written Warning. The Action issued 6/14/24 and was received on 6/20/24. The Administrative Action and cover letter was posted on the bulletin board near the entrance for parent reference. We reviewed the stipulations in the Action. Ms. Bailey reached out to Sharon Fitzgerald, Health Social Behaviors Specialist, to schedule the required training on 6/20/24. The training is scheduled for 8/8/24. Ms. Bailey sent the revised discipline policy to me via email, on 6/25/24. We discussed that the revised discipline policy is due one (1) week after the required training in CAP item #2. Plan to resend the revised discipline policy to me after the training has been received to allow for any techniques or strategies learned during the training to be included in the revised policy. The revised discipline policy will be due to me by 8/15/24. Ms. Bailey sent the fire inspection policy to me, via email on 6/25/24. We discussed the following edits are needed for approval: -Identify, specifically, who the fire safety coordinator will be. We discussed you can use titles instead of names, in case there are staffing changes in the future. For example, you can state “Administrator” instead of “Kim Bailey”. - We discussed resources for fire safety training. Plan to reach out to your local fire marshal or fire inspector before paying for training to ensure it will be acceptable. -Include a plan to ensure the approved annual fire inspection is submitted to the Division within one (1) week of the inspection, on the form provided by the Division. Please note that, if hand-written, the inspection must be submitted via mail. As a reminder, you are required to keep the Administrative Action posted until you receive a Closure Letter from me. Unannounced visits will continue to occur every 4-6 weeks, per procedures. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. The activity plan in classroom space 3 was dated for 7/23/24-7/26/24. GS 110-91(12); .0508(a) 508 Special diet or food allergy information was not posted where they can be seen in food preparation and eating areas. Food allergy, sensitivity and preferences were not posted in the classrooms or kitchen .0901(g) 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. On the large playground, mulch measured less than one (1) inch under the swings in both structures. Mulch measured three (3) inches deep at the base of the slide on the climber on the left side of the playground. Mulch measured two (2) inches deep at the base of the slide on the climber in the center of the playground. .0605(j) 721 All equipment and furnishings were not in good repair. The wooden climber on the left side of the large playground swayed when children used the swings. The wooden climber in the center of the playground swayed when moderate pressure was applied to the side by an adult. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. A fire drill was not conducted during July 2024. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. Twelve (12) incident reports were not documented on the incident log. .0802(g)(1-6) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In classroom space 4, medication administration permission expired on 7/19/24 for one topical medication and on 3/28/24 for two additional topical medications. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: Item #428 The activity plan was updated during the visit today. This was corrected. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item #508 The food allergy, sensitivity and preferences lists were posted during the visit. This is corrected. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. Item #716 Add mulch so that it reaches a depth of six (6) inches within the fall zone of the two (2) climbing structures on the large playground. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (j) All stationary outdoor equipment more than 18 inches high shall be installed over protective surfacing. Footings which anchor equipment shall not be exposed. Protective surfacing shall be either: (1) loose surfacing material, including wood mulch, double shredded bark mulch, uniform wood chips, fine sand, coarse sand, and pea gravel, except that pea gravel shall not be used if the area will be used by children under three years of age. Loose surfacing material shall not be installed over concrete; or (2) other materials that have been certified by the manufacturer to be shock-absorbing protective material in accordance with the American Society for Testing and Materials (ASTM) Standard F 1292, may be used if installed, maintained, and replaced according to the manufacturer's instructions. This standard is incorporated by reference and does include subsequent editions. This standard may be found online at https://www.astm.org/Standards/F1292.htm for a cost of sixty-five dollars ($65.00). (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. (l) Protective surfacing shall cover the area under and around equipment where a child may fall, referred to as the fall zone. The area for fall zones is as follows: (1) for stationary outdoor equipment used by children under two years of age, the protective surfacing shall extend beyond the external limits of the equipment for a minimum of three feet, except that protective surfacing shall be required at all points of entrance and exit for any structure that has a protective barrier; and (2) for stationary outdoor equipment used by children two years of age or older, the protective surfacing shall extend beyond the external limits of the equipment for six feet; (2) Swings shall have protective surfacing that extends two times the length of the pivot point to the surface below. The surfacing shall be to the front and rear of the swing. Item #721 Plan to reach out to ownership and maintenance to attempt to tighten the bolts on the climbers and to make the structure more steady. We discussed that children should not use the structures until they have been repaired. You stated that the facility is closed for children on Thursday and Fridy this week for staff training and that you would contact ownership and maintenance to address the issue. In your letter of compliance, state your plan to ensure children do not use the structures until they are repaired. 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Item #805 In your letter of compliance, include a statement that indicates how you will ensure fire drills are conducted monthly. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item #853 The incident reports were documented on the incident log during the visit. This was corrected. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/I/incident_log_i.pdf?ver=2017-05-16-105723-723. Item #1882 The medication administration permission form was updated for the one (1) medication that had expired on 7/19/24. The medication associated with the permission forms that expired on 3/28/24 was removed from the classroom to return to the parent. This is corrected. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/21/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that all incident reports must be maintained in the child’s file. Plan to work with ownership to develop an updated job description, specific to each role. Currently, staff are given a job description for “Child Care Worker”. Job descriptions should be specific to each role/title. Plan to conduct a shelter-in-place or lockdown drill by 8/31/24. We discussed that safe sleep rules apply for children who are twelve (12) months old. Continue to conduct sleep checks for children who are twelve (12) months old in the classroom for one year old children. 10A NCAC 09 .1724 SAFE SLEEP PRACTICES (a) Each operator licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (3) specifies no pillows, wedges or other positioners, pillow-like toys, blankets, toys, bumper pads, quilts, sheepskins, loose bedding, towels and washcloths, or other objects may be placed in a crib with a sleeping infant aged 12 months or younger; (7) specifies the operator shall visually check sleeping infants aged 12 months or younger at least every 15 minutes; If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 8/7/2024 Number Present: 23 Completed Date: 8/7/2024 Age: From 1 To 9 Total Minutes: 390 Time In: 09:30 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 8/5/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc., is current/active as of 8/5/24. Permit type – Three (3) star license, issued 11/12/19. Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 9/27/23. The last fire drill was practiced on 8/2/24. The last shelter-in-place drill was practiced on 5/16/24. The last playground inspection was documented on 7/27/24. The last fire inspection was approved on 3/18/24. The last sanitation inspection was conducted on 9/29/23 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. There are thirty-seven (37) children enrolled. Four (4) children’s files were monitored today. There are seven (7) staff. One (1) new staff file was monitored today. One (1) existing staff files were monitored today. The facility does not provide transportation. Upon arrival I was greeted by Ms. Bailey. In classroom space 2, children were being soothed by caregivers and preparing to go outside. Once outside on the playground for infants and toddlers, children were observed throwing and kicking balls. Children from classroom spaces 3 and 4 were playing outside on the large playground. Children were observed dancing to music with caregivers, pretending cook and serve food, riding scooters and toy cars, and building small structures with interlocking blocks at a table in the shade. Interactions were positive, children’s needs were met immediately and appropriately for the age of the child. Children were actively supervised at all times. Lunch today consisted of beef tacos with cheese, corn, beans, milk and fish sticks as an alternative protein. The facility is currently under an Administrative Action- Written Warning. The Action issued 6/14/24 and was received on 6/20/24. The Administrative Action and cover letter was posted on the bulletin board near the entrance for parent reference. We reviewed the stipulations in the Action. Ms. Bailey reached out to Sharon Fitzgerald, Health Social Behaviors Specialist, to schedule the required training on 6/20/24. The training is scheduled for 8/8/24. Ms. Bailey sent the revised discipline policy to me via email, on 6/25/24. We discussed that the revised discipline policy is due one (1) week after the required training in CAP item #2. Plan to resend the revised discipline policy to me after the training has been received to allow for any techniques or strategies learned during the training to be included in the revised policy. The revised discipline policy will be due to me by 8/15/24. Ms. Bailey sent the fire inspection policy to me, via email on 6/25/24. We discussed the following edits are needed for approval: -Identify, specifically, who the fire safety coordinator will be. We discussed you can use titles instead of names, in case there are staffing changes in the future. For example, you can state “Administrator” instead of “Kim Bailey”. - We discussed resources for fire safety training. Plan to reach out to your local fire marshal or fire inspector before paying for training to ensure it will be acceptable. -Include a plan to ensure the approved annual fire inspection is submitted to the Division within one (1) week of the inspection, on the form provided by the Division. Please note that, if hand-written, the inspection must be submitted via mail. As a reminder, you are required to keep the Administrative Action posted until you receive a Closure Letter from me. Unannounced visits will continue to occur every 4-6 weeks, per procedures. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. The activity plan in classroom space 3 was dated for 7/23/24-7/26/24. GS 110-91(12); .0508(a) 508 Special diet or food allergy information was not posted where they can be seen in food preparation and eating areas. Food allergy, sensitivity and preferences were not posted in the classrooms or kitchen .0901(g) 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. On the large playground, mulch measured less than one (1) inch under the swings in both structures. Mulch measured three (3) inches deep at the base of the slide on the climber on the left side of the playground. Mulch measured two (2) inches deep at the base of the slide on the climber in the center of the playground. .0605(j) 721 All equipment and furnishings were not in good repair. The wooden climber on the left side of the large playground swayed when children used the swings. The wooden climber in the center of the playground swayed when moderate pressure was applied to the side by an adult. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. A fire drill was not conducted during July 2024. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. Twelve (12) incident reports were not documented on the incident log. .0802(g)(1-6) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In classroom space 4, medication administration permission expired on 7/19/24 for one topical medication and on 3/28/24 for two additional topical medications. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: Item #428 The activity plan was updated during the visit today. This was corrected. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item #508 The food allergy, sensitivity and preferences lists were posted during the visit. This is corrected. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. Item #716 Add mulch so that it reaches a depth of six (6) inches within the fall zone of the two (2) climbing structures on the large playground. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (j) All stationary outdoor equipment more than 18 inches high shall be installed over protective surfacing. Footings which anchor equipment shall not be exposed. Protective surfacing shall be either: (1) loose surfacing material, including wood mulch, double shredded bark mulch, uniform wood chips, fine sand, coarse sand, and pea gravel, except that pea gravel shall not be used if the area will be used by children under three years of age. Loose surfacing material shall not be installed over concrete; or (2) other materials that have been certified by the manufacturer to be shock-absorbing protective material in accordance with the American Society for Testing and Materials (ASTM) Standard F 1292, may be used if installed, maintained, and replaced according to the manufacturer's instructions. This standard is incorporated by reference and does include subsequent editions. This standard may be found online at https://www.astm.org/Standards/F1292.htm for a cost of sixty-five dollars ($65.00). (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. (l) Protective surfacing shall cover the area under and around equipment where a child may fall, referred to as the fall zone. The area for fall zones is as follows: (1) for stationary outdoor equipment used by children under two years of age, the protective surfacing shall extend beyond the external limits of the equipment for a minimum of three feet, except that protective surfacing shall be required at all points of entrance and exit for any structure that has a protective barrier; and (2) for stationary outdoor equipment used by children two years of age or older, the protective surfacing shall extend beyond the external limits of the equipment for six feet; (2) Swings shall have protective surfacing that extends two times the length of the pivot point to the surface below. The surfacing shall be to the front and rear of the swing. Item #721 Plan to reach out to ownership and maintenance to attempt to tighten the bolts on the climbers and to make the structure more steady. We discussed that children should not use the structures until they have been repaired. You stated that the facility is closed for children on Thursday and Fridy this week for staff training and that you would contact ownership and maintenance to address the issue. In your letter of compliance, state your plan to ensure children do not use the structures until they are repaired. 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Item #805 In your letter of compliance, include a statement that indicates how you will ensure fire drills are conducted monthly. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item #853 The incident reports were documented on the incident log during the visit. This was corrected. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/I/incident_log_i.pdf?ver=2017-05-16-105723-723. Item #1882 The medication administration permission form was updated for the one (1) medication that had expired on 7/19/24. The medication associated with the permission forms that expired on 3/28/24 was removed from the classroom to return to the parent. This is corrected. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/21/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that all incident reports must be maintained in the child’s file. Plan to work with ownership to develop an updated job description, specific to each role. Currently, staff are given a job description for “Child Care Worker”. Job descriptions should be specific to each role/title. Plan to conduct a shelter-in-place or lockdown drill by 8/31/24. We discussed that safe sleep rules apply for children who are twelve (12) months old. Continue to conduct sleep checks for children who are twelve (12) months old in the classroom for one year old children. 10A NCAC 09 .1724 SAFE SLEEP PRACTICES (a) Each operator licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (3) specifies no pillows, wedges or other positioners, pillow-like toys, blankets, toys, bumper pads, quilts, sheepskins, loose bedding, towels and washcloths, or other objects may be placed in a crib with a sleeping infant aged 12 months or younger; (7) specifies the operator shall visually check sleeping infants aged 12 months or younger at least every 15 minutes; If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0604 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: 0524-228L Visit Date: 5/22/2024 Number Present: 27 Completed Date: 5/22/2024 Age: From 0 To 11 Total Minutes: 150 Time In: 09:30 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to investigate a complaint received by the Division of Child Development and Early Education (DCDEE) on 5/16/24 and sent to me, Kaitlyn Marshall, Child Care Consultant, on 5/16/24. The reported concern is regarding a safe environment. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present and available to ask and answer questions throughout the visit today. Applicable child care requirements were monitored today including supervision, safe environment, staff/child ratio, permit restrictions, approved space and capacity. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six percent (86%) as of 5/22/24. The facility operates on a three (3) star license issued 11/12/19. Restrictions include 1st shift (daytime care), meets enhanced space. Per report, the allegations state that one (1) staff member smells of marijuana and smokes from a marijuana vape pen while on break. Upon arrival, I observed one (1) staff member sitting in the grass across the street from the child care facility. I did not observe smoke. When I entered the facility I was greeted by Ms. Bailey and Tanisha Hemphill, Assistant Director. I announced the purpose for my visit. Children from classroom spaces 3 and 4 were playing on playground space 1 with twenty-three (23) children ages two (2) to eleven (11) years old three (3) caregivers present. Four (4) children were in classroom space 5 with one (1) caregiver and were freely exploring their environment through walking, cruising and crawling. I spoke with Ms. Bailey as well as the caregiver involved in the report. Ms. Bailey stated that there were no concerns of staff working at the facility under the influence of marijuana or other impairing substances. The caregiver’s file was reviewed today and the smoking and tobacco policy as well as the policy regarding controlled substances was reviewed with the staff member named in the report on 2/29/24. Staff are not required to submit to a drug test upon hire. Ms. Bailey stated that the staff member will not be required to submit to a drug test. The staff member stated that they do not use marijuana products. The staff member stated that they have not come to work under the influence of marijuana or other impairing substances. The staff member stated that a tobacco vape is maintained in their personal bag in locked storage. This was confirmed during the visit today. Due to the discussion with the caregiver and Administrator and lack of evidence that the caregiver uses marijuana products, the concerns regarding a safe environment are unsubstantiated. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 1850 Signage was not posted regarding the smoking and tobacco restriction at the entrance of the center and/or in vehicles used to transport children. Signage regarding smoking and tobacco was not present at the facility’s entrance .0604(i) Technical Assistance provided as follows: Item #1850 Signage regarding smoking and tobacco was not present at the facility’s entrance. A no smoking sign was posted during the visit today. Plan to periodically check that signage is posted as required, in the event it is removed or falls off. This was corrected. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (i) Signage regarding the smoking and tobacco restriction shall be posted at each entrance to the center and in vehicles used to transport children. Consultation is provided as follows: We reviewed the requirements around smoking for child care centers. Please see the rule references below for additional guidance: 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (g) All materials used for starting fires, such as matches, lighters, and accelerants shall be kept in locked storage. (h) Children shall be in a smoke free and tobacco free environment. Smoking and the use of any product containing, made or derived from tobacco, including e-cigarettes, cigars, little cigars, smokeless tobacco, and hookah, shall not be permitted on the premises of the child care center, in vehicles used to transport children, or during any off premise activities. All smoking materials shall be kept in locked storage. For child care centers in an occupied residence that are licensed for 3 to 12 children when any preschool-age children are in care, or for 3 to 15 children when only school-age children are in care, the premises shall be smoke free and tobacco free during operating hours. (i) Signage regarding the smoking and tobacco restriction shall be posted at each entrance to the center and in vehicles used to transport children. We discussed the requirement in General Statutes regarding the use of impairing drugs as child care providers. Please see the rule reference below for additional guidance: G.S. 110-90.2. Mandatory child care providers' criminal history checks. (b1) The Department may prevent an individual from being a child care provider if the Department determines that the individual is a habitually excessive user of alcohol, illegally uses narcotic or other impairing drugs, or is mentally or emotionally impaired to an extent that may be injurious to children. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: 0524-228L Visit Date: 5/22/2024 Number Present: 27 Completed Date: 5/22/2024 Age: From 0 To 11 Total Minutes: 150 Time In: 09:30 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to investigate a complaint received by the Division of Child Development and Early Education (DCDEE) on 5/16/24 and sent to me, Kaitlyn Marshall, Child Care Consultant, on 5/16/24. The reported concern is regarding a safe environment. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present and available to ask and answer questions throughout the visit today. Applicable child care requirements were monitored today including supervision, safe environment, staff/child ratio, permit restrictions, approved space and capacity. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six percent (86%) as of 5/22/24. The facility operates on a three (3) star license issued 11/12/19. Restrictions include 1st shift (daytime care), meets enhanced space. Per report, the allegations state that one (1) staff member smells of marijuana and smokes from a marijuana vape pen while on break. Upon arrival, I observed one (1) staff member sitting in the grass across the street from the child care facility. I did not observe smoke. When I entered the facility I was greeted by Ms. Bailey and Tanisha Hemphill, Assistant Director. I announced the purpose for my visit. Children from classroom spaces 3 and 4 were playing on playground space 1 with twenty-three (23) children ages two (2) to eleven (11) years old three (3) caregivers present. Four (4) children were in classroom space 5 with one (1) caregiver and were freely exploring their environment through walking, cruising and crawling. I spoke with Ms. Bailey as well as the caregiver involved in the report. Ms. Bailey stated that there were no concerns of staff working at the facility under the influence of marijuana or other impairing substances. The caregiver’s file was reviewed today and the smoking and tobacco policy as well as the policy regarding controlled substances was reviewed with the staff member named in the report on 2/29/24. Staff are not required to submit to a drug test upon hire. Ms. Bailey stated that the staff member will not be required to submit to a drug test. The staff member stated that they do not use marijuana products. The staff member stated that they have not come to work under the influence of marijuana or other impairing substances. The staff member stated that a tobacco vape is maintained in their personal bag in locked storage. This was confirmed during the visit today. Due to the discussion with the caregiver and Administrator and lack of evidence that the caregiver uses marijuana products, the concerns regarding a safe environment are unsubstantiated. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 1850 Signage was not posted regarding the smoking and tobacco restriction at the entrance of the center and/or in vehicles used to transport children. Signage regarding smoking and tobacco was not present at the facility’s entrance .0604(i) Technical Assistance provided as follows: Item #1850 Signage regarding smoking and tobacco was not present at the facility’s entrance. A no smoking sign was posted during the visit today. Plan to periodically check that signage is posted as required, in the event it is removed or falls off. This was corrected. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (i) Signage regarding the smoking and tobacco restriction shall be posted at each entrance to the center and in vehicles used to transport children. Consultation is provided as follows: We reviewed the requirements around smoking for child care centers. Please see the rule references below for additional guidance: 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (g) All materials used for starting fires, such as matches, lighters, and accelerants shall be kept in locked storage. (h) Children shall be in a smoke free and tobacco free environment. Smoking and the use of any product containing, made or derived from tobacco, including e-cigarettes, cigars, little cigars, smokeless tobacco, and hookah, shall not be permitted on the premises of the child care center, in vehicles used to transport children, or during any off premise activities. All smoking materials shall be kept in locked storage. For child care centers in an occupied residence that are licensed for 3 to 12 children when any preschool-age children are in care, or for 3 to 15 children when only school-age children are in care, the premises shall be smoke free and tobacco free during operating hours. (i) Signage regarding the smoking and tobacco restriction shall be posted at each entrance to the center and in vehicles used to transport children. We discussed the requirement in General Statutes regarding the use of impairing drugs as child care providers. Please see the rule reference below for additional guidance: G.S. 110-90.2. Mandatory child care providers' criminal history checks. (b1) The Department may prevent an individual from being a child care provider if the Department determines that the individual is a habitually excessive user of alcohol, illegally uses narcotic or other impairing drugs, or is mentally or emotionally impaired to an extent that may be injurious to children. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0902 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: 0424-331L Visit Date: 4/25/2024 Number Present: 17 Completed Date: 4/25/2024 Age: From 0 To 5 Total Minutes: 105 Time In: 11:45 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to investigate a complaint received by the Division of Child Development and Early Education (DCDEE) on 4/22/24 and sent to Kaitlyn Marshall, Child Care Consultant, on 4/22/24. The reported concern is regarding nutrition. A computerized generated report of today’s visit reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Heather McConnell, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. McConnell and Kim Bailey, Administrator were present and available to ask and answer questions throughout the visit today. Applicable child care requirements were monitored today including supervision, nutrition, staff/child ratio, permit restrictions, approved space and capacity. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-four percent (84%) as of 4/22/24. The facility operates on a three (3) star license issued 11/12/19. Restrictions include 1st shift (daytime care), meets enhanced space. Per report, there is a concern regarding nutrition. Video footage of the incident was available for review. At 2:56pm on 4/19/24, the child was given a bottle and puffs. Upon arrival I was greeted by Ms. McConnell and Ms. Bailey. A brief walk-through of classroom space 5 was conducted. There were four (4) children ages 0-1 with one (1) caregivers present. The feeding plan for the child was viewed today. The feeding plan was completed on 12/11/23 and states to give the child a bottle every three (3) hours. The feeding plan states to give the child a bottle and hold and rock the child thirty (30) minutes prior to pick-up if the child seems hungry or is crying. I spoke with the caregiver present with the child on the date of the incident. The caregivers stated that the child was not crying and did not seem hungry prior to the parent’s arrival. After further review of the allegations within the complaint report, it was determined the concerns regarding nutrition are substantiated. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. The feeding plan for one (1) nine month old child in classroom space 5 was not followed. The child was not given a bottle every three (3) hours. 10A NCAC 09 .0902(a) Technical Assistance provided as follows: Item #540 For compliance, have the parent update the feeding plan for the one (1) child. As children’s needs change or if parents report a change in eating habits, have the parents document this information on the feeding plan to ensure consistency and accuracy. 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center. This plan shall include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan shall be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant shall include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/9/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed nutrition and feeding procedures were reviewed with all staff to ensure consistency of care across the facility. Please see the nutrition guidelines for infants in the rule below: 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center. This plan shall include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan shall be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant shall include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers. (b) Each infant shall be held for bottle feeding until able to hold his or her own bottle. Bottles shall not be propped. Each child shall be held or placed in feeding chairs or other age-appropriate seating apparatus to be fed. The feeding chair or other seating apparatus shall be disassembled for cleaning purposes. (c) Infants shall not be served juice in a bottle without a prescription or written statement on file from a health care professional or licensed dietitian/nutritionist. (d) Each infant shall be served only bottles labeled with their individual name. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0902 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: 0424-331L Visit Date: 4/25/2024 Number Present: 17 Completed Date: 4/25/2024 Age: From 0 To 5 Total Minutes: 105 Time In: 11:45 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to investigate a complaint received by the Division of Child Development and Early Education (DCDEE) on 4/22/24 and sent to Kaitlyn Marshall, Child Care Consultant, on 4/22/24. The reported concern is regarding nutrition. A computerized generated report of today’s visit reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Heather McConnell, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. McConnell and Kim Bailey, Administrator were present and available to ask and answer questions throughout the visit today. Applicable child care requirements were monitored today including supervision, nutrition, staff/child ratio, permit restrictions, approved space and capacity. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-four percent (84%) as of 4/22/24. The facility operates on a three (3) star license issued 11/12/19. Restrictions include 1st shift (daytime care), meets enhanced space. Per report, there is a concern regarding nutrition. Video footage of the incident was available for review. At 2:56pm on 4/19/24, the child was given a bottle and puffs. Upon arrival I was greeted by Ms. McConnell and Ms. Bailey. A brief walk-through of classroom space 5 was conducted. There were four (4) children ages 0-1 with one (1) caregivers present. The feeding plan for the child was viewed today. The feeding plan was completed on 12/11/23 and states to give the child a bottle every three (3) hours. The feeding plan states to give the child a bottle and hold and rock the child thirty (30) minutes prior to pick-up if the child seems hungry or is crying. I spoke with the caregiver present with the child on the date of the incident. The caregivers stated that the child was not crying and did not seem hungry prior to the parent’s arrival. After further review of the allegations within the complaint report, it was determined the concerns regarding nutrition are substantiated. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. The feeding plan for one (1) nine month old child in classroom space 5 was not followed. The child was not given a bottle every three (3) hours. 10A NCAC 09 .0902(a) Technical Assistance provided as follows: Item #540 For compliance, have the parent update the feeding plan for the one (1) child. As children’s needs change or if parents report a change in eating habits, have the parents document this information on the feeding plan to ensure consistency and accuracy. 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center. This plan shall include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan shall be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant shall include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/9/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed nutrition and feeding procedures were reviewed with all staff to ensure consistency of care across the facility. Please see the nutrition guidelines for infants in the rule below: 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center. This plan shall include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan shall be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant shall include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers. (b) Each infant shall be held for bottle feeding until able to hold his or her own bottle. Bottles shall not be propped. Each child shall be held or placed in feeding chairs or other age-appropriate seating apparatus to be fed. The feeding chair or other seating apparatus shall be disassembled for cleaning purposes. (c) Infants shall not be served juice in a bottle without a prescription or written statement on file from a health care professional or licensed dietitian/nutritionist. (d) Each infant shall be served only bottles labeled with their individual name. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: 0424-331L Visit Date: 4/25/2024 Number Present: 17 Completed Date: 4/25/2024 Age: From 0 To 5 Total Minutes: 105 Time In: 11:45 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to investigate a complaint received by the Division of Child Development and Early Education (DCDEE) on 4/22/24 and sent to Kaitlyn Marshall, Child Care Consultant, on 4/22/24. The reported concern is regarding nutrition. A computerized generated report of today’s visit reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Heather McConnell, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. McConnell and Kim Bailey, Administrator were present and available to ask and answer questions throughout the visit today. Applicable child care requirements were monitored today including supervision, nutrition, staff/child ratio, permit restrictions, approved space and capacity. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-four percent (84%) as of 4/22/24. The facility operates on a three (3) star license issued 11/12/19. Restrictions include 1st shift (daytime care), meets enhanced space. Per report, there is a concern regarding nutrition. Video footage of the incident was available for review. At 2:56pm on 4/19/24, the child was given a bottle and puffs. Upon arrival I was greeted by Ms. McConnell and Ms. Bailey. A brief walk-through of classroom space 5 was conducted. There were four (4) children ages 0-1 with one (1) caregivers present. The feeding plan for the child was viewed today. The feeding plan was completed on 12/11/23 and states to give the child a bottle every three (3) hours. The feeding plan states to give the child a bottle and hold and rock the child thirty (30) minutes prior to pick-up if the child seems hungry or is crying. I spoke with the caregiver present with the child on the date of the incident. The caregivers stated that the child was not crying and did not seem hungry prior to the parent’s arrival. After further review of the allegations within the complaint report, it was determined the concerns regarding nutrition are substantiated. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. The feeding plan for one (1) nine month old child in classroom space 5 was not followed. The child was not given a bottle every three (3) hours. 10A NCAC 09 .0902(a) Technical Assistance provided as follows: Item #540 For compliance, have the parent update the feeding plan for the one (1) child. As children’s needs change or if parents report a change in eating habits, have the parents document this information on the feeding plan to ensure consistency and accuracy. 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center. This plan shall include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan shall be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant shall include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/9/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed nutrition and feeding procedures were reviewed with all staff to ensure consistency of care across the facility. Please see the nutrition guidelines for infants in the rule below: 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center. This plan shall include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan shall be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant shall include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers. (b) Each infant shall be held for bottle feeding until able to hold his or her own bottle. Bottles shall not be propped. Each child shall be held or placed in feeding chairs or other age-appropriate seating apparatus to be fed. The feeding chair or other seating apparatus shall be disassembled for cleaning purposes. (c) Infants shall not be served juice in a bottle without a prescription or written statement on file from a health care professional or licensed dietitian/nutritionist. (d) Each infant shall be served only bottles labeled with their individual name. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 4/4/2024 Number Present: 16 Completed Date: 4/4/2024 Age: From 0 To 8 Total Minutes: 90 Time In: 10:00 AM Time Out: 11:30 AM Time In: Time Out: List to Use: Center Type Of Visit: Unannounced Visit Follow-Up Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an unannounced follow-up visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Office Assistant, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present and available to ask and answer questions throughout the visit today. Limited monitoring was conducted today, including supervision, staff/child ratios, permit restrictions, discipline, program records, and age appropriate activities and safe sleep procedures were monitored. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-three percent (83%) as of 4/1/24. Permit type – Three (3) star licensed issued 11/12/19. Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last fire inspection was approved on 10/21/22. An inspection was conducted on 3/15/24. Due to a broken emergency light, a re-inspection was conducted on 3/18/24. You stated today that all corrections have been made and the fire alarm system tried to send the required documentation to the fire marshal’s office. The alarm system stated the documentation was returned to them. You spoke to the fire marshal approximately three (3) weeks ago and were instructed to pay the fine in order to receive an approved inspection. The fines have been paid and you have not been contacted by the fire marshal’s office. You contacted the fire marshal directly as well as the fire marshal’s office during the visit today. There was no answer and you left a voicemail. I also tried contacting the fire marshal’s direct line. There was no answer, a voicemail was left with a request for a call back. During a Complaint visit on 2/29/24, a concern regarding nurture and care was substantiated. Discipline was monitored today during the walkthrough of caregiving spaces. Staff/child ratios were observed as follows: Classroom space 5: Five (5) children ages infant to one year old with two (2) caregivers. Classroom space 3: Eleven (11) children ages two (2) years and five (5) months to eight (8) years old with three (3) caregivers. Children in classroom space 5 were exploring cloth books, rattling toys and bouncy balls. One (1) infant was awake and was being rocked in a bouncy chair. Caregivers were actively engaged with the children. One (1) caregiver was observed in a play pen with an infant, engaging them in play. Children in classroom space 3 were sitting at tables, preparing for a teacher-led art activity. Interactions were positive and nurturing. Supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 106 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 fire inspection was approved on 10/21/22. 10A NCAC 09 .0304(a) Technical assistance was provided as follows: Item #106 Plan to obtain an approved fire inspection. If the inspection is handwritten, plan to mail the original copy to me within seven (7) days of the inspection. If the inspection is electronically signed, you can forward the inspection to my email. Continue to document all contacts with the fire marshal’s office. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/18/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Continue to reach out to the fire marshal’s office to check on the status of your fire inspection. I will continue to contact them on my end as well. I appreciate your communication on this matter. We discussed that follow-up visits may continue every four (4) to six (6) weeks. Due to the nurture and care concern substantiated on 2/29/24, an Administrative Action may be recommended. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 4/4/2024 Number Present: 16 Completed Date: 4/4/2024 Age: From 0 To 8 Total Minutes: 90 Time In: 10:00 AM Time Out: 11:30 AM Time In: Time Out: List to Use: Center Type Of Visit: Unannounced Visit Follow-Up Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an unannounced follow-up visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Office Assistant, during the visit. A signed copy of the visit summary was emailed to you. Ms. Bailey was present and available to ask and answer questions throughout the visit today. Limited monitoring was conducted today, including supervision, staff/child ratios, permit restrictions, discipline, program records, and age appropriate activities and safe sleep procedures were monitored. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-three percent (83%) as of 4/1/24. Permit type – Three (3) star licensed issued 11/12/19. Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last fire inspection was approved on 10/21/22. An inspection was conducted on 3/15/24. Due to a broken emergency light, a re-inspection was conducted on 3/18/24. You stated today that all corrections have been made and the fire alarm system tried to send the required documentation to the fire marshal’s office. The alarm system stated the documentation was returned to them. You spoke to the fire marshal approximately three (3) weeks ago and were instructed to pay the fine in order to receive an approved inspection. The fines have been paid and you have not been contacted by the fire marshal’s office. You contacted the fire marshal directly as well as the fire marshal’s office during the visit today. There was no answer and you left a voicemail. I also tried contacting the fire marshal’s direct line. There was no answer, a voicemail was left with a request for a call back. During a Complaint visit on 2/29/24, a concern regarding nurture and care was substantiated. Discipline was monitored today during the walkthrough of caregiving spaces. Staff/child ratios were observed as follows: Classroom space 5: Five (5) children ages infant to one year old with two (2) caregivers. Classroom space 3: Eleven (11) children ages two (2) years and five (5) months to eight (8) years old with three (3) caregivers. Children in classroom space 5 were exploring cloth books, rattling toys and bouncy balls. One (1) infant was awake and was being rocked in a bouncy chair. Caregivers were actively engaged with the children. One (1) caregiver was observed in a play pen with an infant, engaging them in play. Children in classroom space 3 were sitting at tables, preparing for a teacher-led art activity. Interactions were positive and nurturing. Supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 106 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 fire inspection was approved on 10/21/22. 10A NCAC 09 .0304(a) Technical assistance was provided as follows: Item #106 Plan to obtain an approved fire inspection. If the inspection is handwritten, plan to mail the original copy to me within seven (7) days of the inspection. If the inspection is electronically signed, you can forward the inspection to my email. Continue to document all contacts with the fire marshal’s office. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/18/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Continue to reach out to the fire marshal’s office to check on the status of your fire inspection. I will continue to contact them on my end as well. I appreciate your communication on this matter. We discussed that follow-up visits may continue every four (4) to six (6) weeks. Due to the nurture and care concern substantiated on 2/29/24, an Administrative Action may be recommended. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 3/19/2024 Number Present: 19 Completed Date: 3/19/2024 Age: From 0 To 5 Total Minutes: 40 Time In: 08:50 AM Time Out: 09:30 AM Time In: Time Out: List to Use: Center Type Of Visit: Unannounced Visit Follow-Up Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an Unannounced Follow-up visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Heather McConnell, Administrator, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. McConnell and Kim Bailey, Office Assistant, were present and available to ask and answer questions throughout the visit today. Limited monitored was conducted today including program records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-three percent (83%) as of 3/18/24. The facility operates on a three (3) star licensed issued 11/12/19. During the Routine Unannounced visit on 2/22/24, item #106 was cited due to an overdue fire inspection. The last fire inspection was approved on 10/21/22. I received an email from Heather McConnell, Administrator, on 3/16/24 containing documentation of a fire inspection that occurred on 3/15/24. The inspection was unable to be approved due to a broken emergency light. Per provider report, the inspector returned Monday, 3/18/24. The inspector stated the facility was in compliance but is awaiting documentation from the alarm system company. Due to the length of time the fire inspection is overdue, a repeat violation will be cited today. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 106 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 fire inspection was approved on 10/21/22. 10A NCAC 09 .0304(a) Technical assistance was provided as follows: Item #106 In your letter of compliance, plan to include a statement that indicates how you will prevent this violation from occurring in the future. As a reminder, it is the operator’s responsibility to schedule and obtain an approved fire inspection within 12 months of the center’s previous inspection. Please see the rule reference below for details. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/2/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Continue to work with the Fire Marshal to complete the steps needed to obtain an approved fire inspection. Please notify me, in writing, of any extensions that are needed to ensure compliance. Once the approved fire inspection is received, make a copy for your records and mail the original to me within one week of the inspection. You can mail the original to me at the address below: Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 3/19/2024 Number Present: 19 Completed Date: 3/19/2024 Age: From 0 To 5 Total Minutes: 40 Time In: 08:50 AM Time Out: 09:30 AM Time In: Time Out: List to Use: Center Type Of Visit: Unannounced Visit Follow-Up Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an Unannounced Follow-up visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Heather McConnell, Administrator, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. McConnell and Kim Bailey, Office Assistant, were present and available to ask and answer questions throughout the visit today. Limited monitored was conducted today including program records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-three percent (83%) as of 3/18/24. The facility operates on a three (3) star licensed issued 11/12/19. During the Routine Unannounced visit on 2/22/24, item #106 was cited due to an overdue fire inspection. The last fire inspection was approved on 10/21/22. I received an email from Heather McConnell, Administrator, on 3/16/24 containing documentation of a fire inspection that occurred on 3/15/24. The inspection was unable to be approved due to a broken emergency light. Per provider report, the inspector returned Monday, 3/18/24. The inspector stated the facility was in compliance but is awaiting documentation from the alarm system company. Due to the length of time the fire inspection is overdue, a repeat violation will be cited today. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 106 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 fire inspection was approved on 10/21/22. 10A NCAC 09 .0304(a) Technical assistance was provided as follows: Item #106 In your letter of compliance, plan to include a statement that indicates how you will prevent this violation from occurring in the future. As a reminder, it is the operator’s responsibility to schedule and obtain an approved fire inspection within 12 months of the center’s previous inspection. Please see the rule reference below for details. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/2/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Continue to work with the Fire Marshal to complete the steps needed to obtain an approved fire inspection. Please notify me, in writing, of any extensions that are needed to ensure compliance. Once the approved fire inspection is received, make a copy for your records and mail the original to me within one week of the inspection. You can mail the original to me at the address below: Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0508 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: 0224-326L Visit Date: 3/7/2024 Number Present: 5 Completed Date: 3/7/2024 Age: From 0 To 1 Total Minutes: 225 Time In: 09:00 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Follow-Up Announced/Unannounced: Unannounced The purpose of today’s visit is to verify compliance with violations cited during a complaint visit conducted on 2/29/24. During the complaint visit on 2/29/24, a concern regarding nurture and care was substantiated. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Heather McConnell, Administrator, during the visit. An electronic signed copy of the visit summary was emailed to you. Limited monitoring was conducted today including discipline, supervision, staff/child ratios, developmentally appropriate activities, staff records and program records. Upon arrival, I was greeted by Ms. McConnell and Kim Bailey, Office Assistant. I observed the children in classroom space 5. There was one (1) caregiver, four (1) one year old children and one (1) infant present. Children were observed engaged in free play with plush toys, musical instruments and small toy vehicles. The infant was in the gated off play pen area exploring buttons on a toy tablet, and exploring a variety of plush toys. Children ate breakfast consisting of sausage, pancakes, apricots and milk. The infant was fed applesauce. Caregivers responded to the needs of the children. Interactions were positive and nurturing. Supervision was adequate. The infant child was able to freely explore their environment in the gated off area. The infant was placed in a bouncy chair while the older children finished breakfast. The child was in the bouncy seat for less than ten (10) minutes. The discipline violation from 2/29/24 is corrected today. The following violations were cited during the visit today: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. The posted activity plan did not include a date. GS 110-91(12); .0508(a) 721 All equipment and furnishings were not in good repair. A trough used for storing toys had cracked and chipping plastic on the bottom of the bin. G.S. 110-91(6); .0601(b) 887 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. Sleep checks were not documented for any children in classroom space 5 on 3/1/24 and 3/5/24. .0606(g) 1065 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 ITS-SIDS training certificate for A. S. was not available for review. Per provider report, the training was completed on 10/3/22. .1102(f) Technical Assistance provided as follows: Item #428 An updated activity plan was posted during the visit today. Technical Assistance was given on how to reflect activities for both infants and one year old children present in the room. Moving forward, plan to date the activity plans and update the activities weekly. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item #721 The trough was removed during this visit. This was corrected. 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Item #887 In your letter of compliance, include a statement that indicates how you will ensure sleep checks are conducted and documented as required. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Item #1065 Plan to locate the training certificate for the ITS-SIDS training that occurred on 10/3/22. Maintain this documentation in the staff member’s file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (f) In centers that are licensed to care for infants, the child care administrator and any child care provider scheduled to work in the infant room shall complete ITS-SIDS training. ITS-SIDS training shall be completed within two months of an individual assuming responsibilities in the infant room and every three years thereafter. Child care administrators, as defined in G.S. 110-86(2a), shall complete ITS-SIDS training within 90 days of employment and every three years thereafter. Completion of ITS-SIDS training shall be included once every three years in the number of hours needed to meet on-going training requirements in this Section. At all times, one child care provider who has completed ITS-SIDS training shall be present in the infant room while children are in care. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Consultation is provided as follows: We discussed the use of play pens. Currently, you have a gated off area in the infant and one year old classroom to prevent injury to infants as they are exploring their environment. You expressed interest in purchasing a new play pen. Plan to check the manufacturer’s instructions to ensure the equipment has ASTM certification. We discussed an incident report for an incident that occurred on 2/22/24. The equipment involved in the incident was observed today. The edge that caused the injury to the child was not observed to be sharp or hazardous. However, the bottom of the equipment was beginning to chip and was therefore removed from the classroom. We discussed education standards for staff. A. Bailey has grades on file that document completion of EDU119. Plan to submit this education to WORKS to receive a letter indicating A. Bailey is approved for the role of Lead Teacher. We discussed that A. Sukennikoff is listed as a Teacher but has been fulfilling the role of a Lead Teacher in the one year old classroom. A. Sukennikoff is currently paired with A. Bailey or a substitute in classroom space 5 until the end of March. Please see the requirements in rule below regarding Lead Teacher education: 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (c) Within six months of an individual assuming lead teacher or child care administrator duties, each center shall maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. (d) If the individual does not yet meet the staff qualifications required by G.S. 110-91(8) when assuming lead teacher or administrative duties, the individual shall submit to the Division documentation of completion of the coursework or credential to be considered for equivalency within six months of assuming the duties. We discussed the warning labels on the pink bouncy seat in classroom space 5. When this seat is in use, plan to move it within very close proximity to the caregiver to prevent injury. There is a fall hazard and a strangulation hazard listed on the label. This equipment should only be used under heavy supervision. Due to the substantiated nurture and care concern and the resulting discipline violation, an Administrative Action may be recommended. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0601 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: 0224-326L Visit Date: 3/7/2024 Number Present: 5 Completed Date: 3/7/2024 Age: From 0 To 1 Total Minutes: 225 Time In: 09:00 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Follow-Up Announced/Unannounced: Unannounced The purpose of today’s visit is to verify compliance with violations cited during a complaint visit conducted on 2/29/24. During the complaint visit on 2/29/24, a concern regarding nurture and care was substantiated. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Heather McConnell, Administrator, during the visit. An electronic signed copy of the visit summary was emailed to you. Limited monitoring was conducted today including discipline, supervision, staff/child ratios, developmentally appropriate activities, staff records and program records. Upon arrival, I was greeted by Ms. McConnell and Kim Bailey, Office Assistant. I observed the children in classroom space 5. There was one (1) caregiver, four (1) one year old children and one (1) infant present. Children were observed engaged in free play with plush toys, musical instruments and small toy vehicles. The infant was in the gated off play pen area exploring buttons on a toy tablet, and exploring a variety of plush toys. Children ate breakfast consisting of sausage, pancakes, apricots and milk. The infant was fed applesauce. Caregivers responded to the needs of the children. Interactions were positive and nurturing. Supervision was adequate. The infant child was able to freely explore their environment in the gated off area. The infant was placed in a bouncy chair while the older children finished breakfast. The child was in the bouncy seat for less than ten (10) minutes. The discipline violation from 2/29/24 is corrected today. The following violations were cited during the visit today: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. The posted activity plan did not include a date. GS 110-91(12); .0508(a) 721 All equipment and furnishings were not in good repair. A trough used for storing toys had cracked and chipping plastic on the bottom of the bin. G.S. 110-91(6); .0601(b) 887 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. Sleep checks were not documented for any children in classroom space 5 on 3/1/24 and 3/5/24. .0606(g) 1065 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 ITS-SIDS training certificate for A. S. was not available for review. Per provider report, the training was completed on 10/3/22. .1102(f) Technical Assistance provided as follows: Item #428 An updated activity plan was posted during the visit today. Technical Assistance was given on how to reflect activities for both infants and one year old children present in the room. Moving forward, plan to date the activity plans and update the activities weekly. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item #721 The trough was removed during this visit. This was corrected. 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Item #887 In your letter of compliance, include a statement that indicates how you will ensure sleep checks are conducted and documented as required. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Item #1065 Plan to locate the training certificate for the ITS-SIDS training that occurred on 10/3/22. Maintain this documentation in the staff member’s file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (f) In centers that are licensed to care for infants, the child care administrator and any child care provider scheduled to work in the infant room shall complete ITS-SIDS training. ITS-SIDS training shall be completed within two months of an individual assuming responsibilities in the infant room and every three years thereafter. Child care administrators, as defined in G.S. 110-86(2a), shall complete ITS-SIDS training within 90 days of employment and every three years thereafter. Completion of ITS-SIDS training shall be included once every three years in the number of hours needed to meet on-going training requirements in this Section. At all times, one child care provider who has completed ITS-SIDS training shall be present in the infant room while children are in care. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Consultation is provided as follows: We discussed the use of play pens. Currently, you have a gated off area in the infant and one year old classroom to prevent injury to infants as they are exploring their environment. You expressed interest in purchasing a new play pen. Plan to check the manufacturer’s instructions to ensure the equipment has ASTM certification. We discussed an incident report for an incident that occurred on 2/22/24. The equipment involved in the incident was observed today. The edge that caused the injury to the child was not observed to be sharp or hazardous. However, the bottom of the equipment was beginning to chip and was therefore removed from the classroom. We discussed education standards for staff. A. Bailey has grades on file that document completion of EDU119. Plan to submit this education to WORKS to receive a letter indicating A. Bailey is approved for the role of Lead Teacher. We discussed that A. Sukennikoff is listed as a Teacher but has been fulfilling the role of a Lead Teacher in the one year old classroom. A. Sukennikoff is currently paired with A. Bailey or a substitute in classroom space 5 until the end of March. Please see the requirements in rule below regarding Lead Teacher education: 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (c) Within six months of an individual assuming lead teacher or child care administrator duties, each center shall maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. (d) If the individual does not yet meet the staff qualifications required by G.S. 110-91(8) when assuming lead teacher or administrative duties, the individual shall submit to the Division documentation of completion of the coursework or credential to be considered for equivalency within six months of assuming the duties. We discussed the warning labels on the pink bouncy seat in classroom space 5. When this seat is in use, plan to move it within very close proximity to the caregiver to prevent injury. There is a fall hazard and a strangulation hazard listed on the label. This equipment should only be used under heavy supervision. Due to the substantiated nurture and care concern and the resulting discipline violation, an Administrative Action may be recommended. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0606 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: 0224-326L Visit Date: 3/7/2024 Number Present: 5 Completed Date: 3/7/2024 Age: From 0 To 1 Total Minutes: 225 Time In: 09:00 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Follow-Up Announced/Unannounced: Unannounced The purpose of today’s visit is to verify compliance with violations cited during a complaint visit conducted on 2/29/24. During the complaint visit on 2/29/24, a concern regarding nurture and care was substantiated. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Heather McConnell, Administrator, during the visit. An electronic signed copy of the visit summary was emailed to you. Limited monitoring was conducted today including discipline, supervision, staff/child ratios, developmentally appropriate activities, staff records and program records. Upon arrival, I was greeted by Ms. McConnell and Kim Bailey, Office Assistant. I observed the children in classroom space 5. There was one (1) caregiver, four (1) one year old children and one (1) infant present. Children were observed engaged in free play with plush toys, musical instruments and small toy vehicles. The infant was in the gated off play pen area exploring buttons on a toy tablet, and exploring a variety of plush toys. Children ate breakfast consisting of sausage, pancakes, apricots and milk. The infant was fed applesauce. Caregivers responded to the needs of the children. Interactions were positive and nurturing. Supervision was adequate. The infant child was able to freely explore their environment in the gated off area. The infant was placed in a bouncy chair while the older children finished breakfast. The child was in the bouncy seat for less than ten (10) minutes. The discipline violation from 2/29/24 is corrected today. The following violations were cited during the visit today: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. The posted activity plan did not include a date. GS 110-91(12); .0508(a) 721 All equipment and furnishings were not in good repair. A trough used for storing toys had cracked and chipping plastic on the bottom of the bin. G.S. 110-91(6); .0601(b) 887 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. Sleep checks were not documented for any children in classroom space 5 on 3/1/24 and 3/5/24. .0606(g) 1065 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 ITS-SIDS training certificate for A. S. was not available for review. Per provider report, the training was completed on 10/3/22. .1102(f) Technical Assistance provided as follows: Item #428 An updated activity plan was posted during the visit today. Technical Assistance was given on how to reflect activities for both infants and one year old children present in the room. Moving forward, plan to date the activity plans and update the activities weekly. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item #721 The trough was removed during this visit. This was corrected. 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Item #887 In your letter of compliance, include a statement that indicates how you will ensure sleep checks are conducted and documented as required. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Item #1065 Plan to locate the training certificate for the ITS-SIDS training that occurred on 10/3/22. Maintain this documentation in the staff member’s file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (f) In centers that are licensed to care for infants, the child care administrator and any child care provider scheduled to work in the infant room shall complete ITS-SIDS training. ITS-SIDS training shall be completed within two months of an individual assuming responsibilities in the infant room and every three years thereafter. Child care administrators, as defined in G.S. 110-86(2a), shall complete ITS-SIDS training within 90 days of employment and every three years thereafter. Completion of ITS-SIDS training shall be included once every three years in the number of hours needed to meet on-going training requirements in this Section. At all times, one child care provider who has completed ITS-SIDS training shall be present in the infant room while children are in care. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Consultation is provided as follows: We discussed the use of play pens. Currently, you have a gated off area in the infant and one year old classroom to prevent injury to infants as they are exploring their environment. You expressed interest in purchasing a new play pen. Plan to check the manufacturer’s instructions to ensure the equipment has ASTM certification. We discussed an incident report for an incident that occurred on 2/22/24. The equipment involved in the incident was observed today. The edge that caused the injury to the child was not observed to be sharp or hazardous. However, the bottom of the equipment was beginning to chip and was therefore removed from the classroom. We discussed education standards for staff. A. Bailey has grades on file that document completion of EDU119. Plan to submit this education to WORKS to receive a letter indicating A. Bailey is approved for the role of Lead Teacher. We discussed that A. Sukennikoff is listed as a Teacher but has been fulfilling the role of a Lead Teacher in the one year old classroom. A. Sukennikoff is currently paired with A. Bailey or a substitute in classroom space 5 until the end of March. Please see the requirements in rule below regarding Lead Teacher education: 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (c) Within six months of an individual assuming lead teacher or child care administrator duties, each center shall maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. (d) If the individual does not yet meet the staff qualifications required by G.S. 110-91(8) when assuming lead teacher or administrative duties, the individual shall submit to the Division documentation of completion of the coursework or credential to be considered for equivalency within six months of assuming the duties. We discussed the warning labels on the pink bouncy seat in classroom space 5. When this seat is in use, plan to move it within very close proximity to the caregiver to prevent injury. There is a fall hazard and a strangulation hazard listed on the label. This equipment should only be used under heavy supervision. Due to the substantiated nurture and care concern and the resulting discipline violation, an Administrative Action may be recommended. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0703 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: 0224-326L Visit Date: 3/7/2024 Number Present: 5 Completed Date: 3/7/2024 Age: From 0 To 1 Total Minutes: 225 Time In: 09:00 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Follow-Up Announced/Unannounced: Unannounced The purpose of today’s visit is to verify compliance with violations cited during a complaint visit conducted on 2/29/24. During the complaint visit on 2/29/24, a concern regarding nurture and care was substantiated. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Heather McConnell, Administrator, during the visit. An electronic signed copy of the visit summary was emailed to you. Limited monitoring was conducted today including discipline, supervision, staff/child ratios, developmentally appropriate activities, staff records and program records. Upon arrival, I was greeted by Ms. McConnell and Kim Bailey, Office Assistant. I observed the children in classroom space 5. There was one (1) caregiver, four (1) one year old children and one (1) infant present. Children were observed engaged in free play with plush toys, musical instruments and small toy vehicles. The infant was in the gated off play pen area exploring buttons on a toy tablet, and exploring a variety of plush toys. Children ate breakfast consisting of sausage, pancakes, apricots and milk. The infant was fed applesauce. Caregivers responded to the needs of the children. Interactions were positive and nurturing. Supervision was adequate. The infant child was able to freely explore their environment in the gated off area. The infant was placed in a bouncy chair while the older children finished breakfast. The child was in the bouncy seat for less than ten (10) minutes. The discipline violation from 2/29/24 is corrected today. The following violations were cited during the visit today: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. The posted activity plan did not include a date. GS 110-91(12); .0508(a) 721 All equipment and furnishings were not in good repair. A trough used for storing toys had cracked and chipping plastic on the bottom of the bin. G.S. 110-91(6); .0601(b) 887 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. Sleep checks were not documented for any children in classroom space 5 on 3/1/24 and 3/5/24. .0606(g) 1065 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 ITS-SIDS training certificate for A. S. was not available for review. Per provider report, the training was completed on 10/3/22. .1102(f) Technical Assistance provided as follows: Item #428 An updated activity plan was posted during the visit today. Technical Assistance was given on how to reflect activities for both infants and one year old children present in the room. Moving forward, plan to date the activity plans and update the activities weekly. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item #721 The trough was removed during this visit. This was corrected. 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Item #887 In your letter of compliance, include a statement that indicates how you will ensure sleep checks are conducted and documented as required. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Item #1065 Plan to locate the training certificate for the ITS-SIDS training that occurred on 10/3/22. Maintain this documentation in the staff member’s file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (f) In centers that are licensed to care for infants, the child care administrator and any child care provider scheduled to work in the infant room shall complete ITS-SIDS training. ITS-SIDS training shall be completed within two months of an individual assuming responsibilities in the infant room and every three years thereafter. Child care administrators, as defined in G.S. 110-86(2a), shall complete ITS-SIDS training within 90 days of employment and every three years thereafter. Completion of ITS-SIDS training shall be included once every three years in the number of hours needed to meet on-going training requirements in this Section. At all times, one child care provider who has completed ITS-SIDS training shall be present in the infant room while children are in care. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Consultation is provided as follows: We discussed the use of play pens. Currently, you have a gated off area in the infant and one year old classroom to prevent injury to infants as they are exploring their environment. You expressed interest in purchasing a new play pen. Plan to check the manufacturer’s instructions to ensure the equipment has ASTM certification. We discussed an incident report for an incident that occurred on 2/22/24. The equipment involved in the incident was observed today. The edge that caused the injury to the child was not observed to be sharp or hazardous. However, the bottom of the equipment was beginning to chip and was therefore removed from the classroom. We discussed education standards for staff. A. Bailey has grades on file that document completion of EDU119. Plan to submit this education to WORKS to receive a letter indicating A. Bailey is approved for the role of Lead Teacher. We discussed that A. Sukennikoff is listed as a Teacher but has been fulfilling the role of a Lead Teacher in the one year old classroom. A. Sukennikoff is currently paired with A. Bailey or a substitute in classroom space 5 until the end of March. Please see the requirements in rule below regarding Lead Teacher education: 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (c) Within six months of an individual assuming lead teacher or child care administrator duties, each center shall maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. (d) If the individual does not yet meet the staff qualifications required by G.S. 110-91(8) when assuming lead teacher or administrative duties, the individual shall submit to the Division documentation of completion of the coursework or credential to be considered for equivalency within six months of assuming the duties. We discussed the warning labels on the pink bouncy seat in classroom space 5. When this seat is in use, plan to move it within very close proximity to the caregiver to prevent injury. There is a fall hazard and a strangulation hazard listed on the label. This equipment should only be used under heavy supervision. Due to the substantiated nurture and care concern and the resulting discipline violation, an Administrative Action may be recommended. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: 0224-326L Visit Date: 3/7/2024 Number Present: 5 Completed Date: 3/7/2024 Age: From 0 To 1 Total Minutes: 225 Time In: 09:00 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Follow-Up Announced/Unannounced: Unannounced The purpose of today’s visit is to verify compliance with violations cited during a complaint visit conducted on 2/29/24. During the complaint visit on 2/29/24, a concern regarding nurture and care was substantiated. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Heather McConnell, Administrator, during the visit. An electronic signed copy of the visit summary was emailed to you. Limited monitoring was conducted today including discipline, supervision, staff/child ratios, developmentally appropriate activities, staff records and program records. Upon arrival, I was greeted by Ms. McConnell and Kim Bailey, Office Assistant. I observed the children in classroom space 5. There was one (1) caregiver, four (1) one year old children and one (1) infant present. Children were observed engaged in free play with plush toys, musical instruments and small toy vehicles. The infant was in the gated off play pen area exploring buttons on a toy tablet, and exploring a variety of plush toys. Children ate breakfast consisting of sausage, pancakes, apricots and milk. The infant was fed applesauce. Caregivers responded to the needs of the children. Interactions were positive and nurturing. Supervision was adequate. The infant child was able to freely explore their environment in the gated off area. The infant was placed in a bouncy chair while the older children finished breakfast. The child was in the bouncy seat for less than ten (10) minutes. The discipline violation from 2/29/24 is corrected today. The following violations were cited during the visit today: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. The posted activity plan did not include a date. GS 110-91(12); .0508(a) 721 All equipment and furnishings were not in good repair. A trough used for storing toys had cracked and chipping plastic on the bottom of the bin. G.S. 110-91(6); .0601(b) 887 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. Sleep checks were not documented for any children in classroom space 5 on 3/1/24 and 3/5/24. .0606(g) 1065 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 ITS-SIDS training certificate for A. S. was not available for review. Per provider report, the training was completed on 10/3/22. .1102(f) Technical Assistance provided as follows: Item #428 An updated activity plan was posted during the visit today. Technical Assistance was given on how to reflect activities for both infants and one year old children present in the room. Moving forward, plan to date the activity plans and update the activities weekly. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item #721 The trough was removed during this visit. This was corrected. 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Item #887 In your letter of compliance, include a statement that indicates how you will ensure sleep checks are conducted and documented as required. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Item #1065 Plan to locate the training certificate for the ITS-SIDS training that occurred on 10/3/22. Maintain this documentation in the staff member’s file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (f) In centers that are licensed to care for infants, the child care administrator and any child care provider scheduled to work in the infant room shall complete ITS-SIDS training. ITS-SIDS training shall be completed within two months of an individual assuming responsibilities in the infant room and every three years thereafter. Child care administrators, as defined in G.S. 110-86(2a), shall complete ITS-SIDS training within 90 days of employment and every three years thereafter. Completion of ITS-SIDS training shall be included once every three years in the number of hours needed to meet on-going training requirements in this Section. At all times, one child care provider who has completed ITS-SIDS training shall be present in the infant room while children are in care. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Consultation is provided as follows: We discussed the use of play pens. Currently, you have a gated off area in the infant and one year old classroom to prevent injury to infants as they are exploring their environment. You expressed interest in purchasing a new play pen. Plan to check the manufacturer’s instructions to ensure the equipment has ASTM certification. We discussed an incident report for an incident that occurred on 2/22/24. The equipment involved in the incident was observed today. The edge that caused the injury to the child was not observed to be sharp or hazardous. However, the bottom of the equipment was beginning to chip and was therefore removed from the classroom. We discussed education standards for staff. A. Bailey has grades on file that document completion of EDU119. Plan to submit this education to WORKS to receive a letter indicating A. Bailey is approved for the role of Lead Teacher. We discussed that A. Sukennikoff is listed as a Teacher but has been fulfilling the role of a Lead Teacher in the one year old classroom. A. Sukennikoff is currently paired with A. Bailey or a substitute in classroom space 5 until the end of March. Please see the requirements in rule below regarding Lead Teacher education: 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (c) Within six months of an individual assuming lead teacher or child care administrator duties, each center shall maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. (d) If the individual does not yet meet the staff qualifications required by G.S. 110-91(8) when assuming lead teacher or administrative duties, the individual shall submit to the Division documentation of completion of the coursework or credential to be considered for equivalency within six months of assuming the duties. We discussed the warning labels on the pink bouncy seat in classroom space 5. When this seat is in use, plan to move it within very close proximity to the caregiver to prevent injury. There is a fall hazard and a strangulation hazard listed on the label. This equipment should only be used under heavy supervision. Due to the substantiated nurture and care concern and the resulting discipline violation, an Administrative Action may be recommended. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-86 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: 0224-326L Visit Date: 3/7/2024 Number Present: 5 Completed Date: 3/7/2024 Age: From 0 To 1 Total Minutes: 225 Time In: 09:00 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Follow-Up Announced/Unannounced: Unannounced The purpose of today’s visit is to verify compliance with violations cited during a complaint visit conducted on 2/29/24. During the complaint visit on 2/29/24, a concern regarding nurture and care was substantiated. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Heather McConnell, Administrator, during the visit. An electronic signed copy of the visit summary was emailed to you. Limited monitoring was conducted today including discipline, supervision, staff/child ratios, developmentally appropriate activities, staff records and program records. Upon arrival, I was greeted by Ms. McConnell and Kim Bailey, Office Assistant. I observed the children in classroom space 5. There was one (1) caregiver, four (1) one year old children and one (1) infant present. Children were observed engaged in free play with plush toys, musical instruments and small toy vehicles. The infant was in the gated off play pen area exploring buttons on a toy tablet, and exploring a variety of plush toys. Children ate breakfast consisting of sausage, pancakes, apricots and milk. The infant was fed applesauce. Caregivers responded to the needs of the children. Interactions were positive and nurturing. Supervision was adequate. The infant child was able to freely explore their environment in the gated off area. The infant was placed in a bouncy chair while the older children finished breakfast. The child was in the bouncy seat for less than ten (10) minutes. The discipline violation from 2/29/24 is corrected today. The following violations were cited during the visit today: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. The posted activity plan did not include a date. GS 110-91(12); .0508(a) 721 All equipment and furnishings were not in good repair. A trough used for storing toys had cracked and chipping plastic on the bottom of the bin. G.S. 110-91(6); .0601(b) 887 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. Sleep checks were not documented for any children in classroom space 5 on 3/1/24 and 3/5/24. .0606(g) 1065 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 ITS-SIDS training certificate for A. S. was not available for review. Per provider report, the training was completed on 10/3/22. .1102(f) Technical Assistance provided as follows: Item #428 An updated activity plan was posted during the visit today. Technical Assistance was given on how to reflect activities for both infants and one year old children present in the room. Moving forward, plan to date the activity plans and update the activities weekly. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item #721 The trough was removed during this visit. This was corrected. 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Item #887 In your letter of compliance, include a statement that indicates how you will ensure sleep checks are conducted and documented as required. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Item #1065 Plan to locate the training certificate for the ITS-SIDS training that occurred on 10/3/22. Maintain this documentation in the staff member’s file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (f) In centers that are licensed to care for infants, the child care administrator and any child care provider scheduled to work in the infant room shall complete ITS-SIDS training. ITS-SIDS training shall be completed within two months of an individual assuming responsibilities in the infant room and every three years thereafter. Child care administrators, as defined in G.S. 110-86(2a), shall complete ITS-SIDS training within 90 days of employment and every three years thereafter. Completion of ITS-SIDS training shall be included once every three years in the number of hours needed to meet on-going training requirements in this Section. At all times, one child care provider who has completed ITS-SIDS training shall be present in the infant room while children are in care. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Consultation is provided as follows: We discussed the use of play pens. Currently, you have a gated off area in the infant and one year old classroom to prevent injury to infants as they are exploring their environment. You expressed interest in purchasing a new play pen. Plan to check the manufacturer’s instructions to ensure the equipment has ASTM certification. We discussed an incident report for an incident that occurred on 2/22/24. The equipment involved in the incident was observed today. The edge that caused the injury to the child was not observed to be sharp or hazardous. However, the bottom of the equipment was beginning to chip and was therefore removed from the classroom. We discussed education standards for staff. A. Bailey has grades on file that document completion of EDU119. Plan to submit this education to WORKS to receive a letter indicating A. Bailey is approved for the role of Lead Teacher. We discussed that A. Sukennikoff is listed as a Teacher but has been fulfilling the role of a Lead Teacher in the one year old classroom. A. Sukennikoff is currently paired with A. Bailey or a substitute in classroom space 5 until the end of March. Please see the requirements in rule below regarding Lead Teacher education: 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (c) Within six months of an individual assuming lead teacher or child care administrator duties, each center shall maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. (d) If the individual does not yet meet the staff qualifications required by G.S. 110-91(8) when assuming lead teacher or administrative duties, the individual shall submit to the Division documentation of completion of the coursework or credential to be considered for equivalency within six months of assuming the duties. We discussed the warning labels on the pink bouncy seat in classroom space 5. When this seat is in use, plan to move it within very close proximity to the caregiver to prevent injury. There is a fall hazard and a strangulation hazard listed on the label. This equipment should only be used under heavy supervision. Due to the substantiated nurture and care concern and the resulting discipline violation, an Administrative Action may be recommended. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-91 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: 0224-326L Visit Date: 3/7/2024 Number Present: 5 Completed Date: 3/7/2024 Age: From 0 To 1 Total Minutes: 225 Time In: 09:00 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Follow-Up Announced/Unannounced: Unannounced The purpose of today’s visit is to verify compliance with violations cited during a complaint visit conducted on 2/29/24. During the complaint visit on 2/29/24, a concern regarding nurture and care was substantiated. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Heather McConnell, Administrator, during the visit. An electronic signed copy of the visit summary was emailed to you. Limited monitoring was conducted today including discipline, supervision, staff/child ratios, developmentally appropriate activities, staff records and program records. Upon arrival, I was greeted by Ms. McConnell and Kim Bailey, Office Assistant. I observed the children in classroom space 5. There was one (1) caregiver, four (1) one year old children and one (1) infant present. Children were observed engaged in free play with plush toys, musical instruments and small toy vehicles. The infant was in the gated off play pen area exploring buttons on a toy tablet, and exploring a variety of plush toys. Children ate breakfast consisting of sausage, pancakes, apricots and milk. The infant was fed applesauce. Caregivers responded to the needs of the children. Interactions were positive and nurturing. Supervision was adequate. The infant child was able to freely explore their environment in the gated off area. The infant was placed in a bouncy chair while the older children finished breakfast. The child was in the bouncy seat for less than ten (10) minutes. The discipline violation from 2/29/24 is corrected today. The following violations were cited during the visit today: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. The posted activity plan did not include a date. GS 110-91(12); .0508(a) 721 All equipment and furnishings were not in good repair. A trough used for storing toys had cracked and chipping plastic on the bottom of the bin. G.S. 110-91(6); .0601(b) 887 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. Sleep checks were not documented for any children in classroom space 5 on 3/1/24 and 3/5/24. .0606(g) 1065 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 ITS-SIDS training certificate for A. S. was not available for review. Per provider report, the training was completed on 10/3/22. .1102(f) Technical Assistance provided as follows: Item #428 An updated activity plan was posted during the visit today. Technical Assistance was given on how to reflect activities for both infants and one year old children present in the room. Moving forward, plan to date the activity plans and update the activities weekly. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item #721 The trough was removed during this visit. This was corrected. 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Item #887 In your letter of compliance, include a statement that indicates how you will ensure sleep checks are conducted and documented as required. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Item #1065 Plan to locate the training certificate for the ITS-SIDS training that occurred on 10/3/22. Maintain this documentation in the staff member’s file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (f) In centers that are licensed to care for infants, the child care administrator and any child care provider scheduled to work in the infant room shall complete ITS-SIDS training. ITS-SIDS training shall be completed within two months of an individual assuming responsibilities in the infant room and every three years thereafter. Child care administrators, as defined in G.S. 110-86(2a), shall complete ITS-SIDS training within 90 days of employment and every three years thereafter. Completion of ITS-SIDS training shall be included once every three years in the number of hours needed to meet on-going training requirements in this Section. At all times, one child care provider who has completed ITS-SIDS training shall be present in the infant room while children are in care. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Consultation is provided as follows: We discussed the use of play pens. Currently, you have a gated off area in the infant and one year old classroom to prevent injury to infants as they are exploring their environment. You expressed interest in purchasing a new play pen. Plan to check the manufacturer’s instructions to ensure the equipment has ASTM certification. We discussed an incident report for an incident that occurred on 2/22/24. The equipment involved in the incident was observed today. The edge that caused the injury to the child was not observed to be sharp or hazardous. However, the bottom of the equipment was beginning to chip and was therefore removed from the classroom. We discussed education standards for staff. A. Bailey has grades on file that document completion of EDU119. Plan to submit this education to WORKS to receive a letter indicating A. Bailey is approved for the role of Lead Teacher. We discussed that A. Sukennikoff is listed as a Teacher but has been fulfilling the role of a Lead Teacher in the one year old classroom. A. Sukennikoff is currently paired with A. Bailey or a substitute in classroom space 5 until the end of March. Please see the requirements in rule below regarding Lead Teacher education: 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (c) Within six months of an individual assuming lead teacher or child care administrator duties, each center shall maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. (d) If the individual does not yet meet the staff qualifications required by G.S. 110-91(8) when assuming lead teacher or administrative duties, the individual shall submit to the Division documentation of completion of the coursework or credential to be considered for equivalency within six months of assuming the duties. We discussed the warning labels on the pink bouncy seat in classroom space 5. When this seat is in use, plan to move it within very close proximity to the caregiver to prevent injury. There is a fall hazard and a strangulation hazard listed on the label. This equipment should only be used under heavy supervision. Due to the substantiated nurture and care concern and the resulting discipline violation, an Administrative Action may be recommended. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-91 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: 0224-326L Visit Date: 3/7/2024 Number Present: 5 Completed Date: 3/7/2024 Age: From 0 To 1 Total Minutes: 225 Time In: 09:00 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Follow-Up Announced/Unannounced: Unannounced The purpose of today’s visit is to verify compliance with violations cited during a complaint visit conducted on 2/29/24. During the complaint visit on 2/29/24, a concern regarding nurture and care was substantiated. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Heather McConnell, Administrator, during the visit. An electronic signed copy of the visit summary was emailed to you. Limited monitoring was conducted today including discipline, supervision, staff/child ratios, developmentally appropriate activities, staff records and program records. Upon arrival, I was greeted by Ms. McConnell and Kim Bailey, Office Assistant. I observed the children in classroom space 5. There was one (1) caregiver, four (1) one year old children and one (1) infant present. Children were observed engaged in free play with plush toys, musical instruments and small toy vehicles. The infant was in the gated off play pen area exploring buttons on a toy tablet, and exploring a variety of plush toys. Children ate breakfast consisting of sausage, pancakes, apricots and milk. The infant was fed applesauce. Caregivers responded to the needs of the children. Interactions were positive and nurturing. Supervision was adequate. The infant child was able to freely explore their environment in the gated off area. The infant was placed in a bouncy chair while the older children finished breakfast. The child was in the bouncy seat for less than ten (10) minutes. The discipline violation from 2/29/24 is corrected today. The following violations were cited during the visit today: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. The posted activity plan did not include a date. GS 110-91(12); .0508(a) 721 All equipment and furnishings were not in good repair. A trough used for storing toys had cracked and chipping plastic on the bottom of the bin. G.S. 110-91(6); .0601(b) 887 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. Sleep checks were not documented for any children in classroom space 5 on 3/1/24 and 3/5/24. .0606(g) 1065 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 ITS-SIDS training certificate for A. S. was not available for review. Per provider report, the training was completed on 10/3/22. .1102(f) Technical Assistance provided as follows: Item #428 An updated activity plan was posted during the visit today. Technical Assistance was given on how to reflect activities for both infants and one year old children present in the room. Moving forward, plan to date the activity plans and update the activities weekly. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item #721 The trough was removed during this visit. This was corrected. 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Item #887 In your letter of compliance, include a statement that indicates how you will ensure sleep checks are conducted and documented as required. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Item #1065 Plan to locate the training certificate for the ITS-SIDS training that occurred on 10/3/22. Maintain this documentation in the staff member’s file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (f) In centers that are licensed to care for infants, the child care administrator and any child care provider scheduled to work in the infant room shall complete ITS-SIDS training. ITS-SIDS training shall be completed within two months of an individual assuming responsibilities in the infant room and every three years thereafter. Child care administrators, as defined in G.S. 110-86(2a), shall complete ITS-SIDS training within 90 days of employment and every three years thereafter. Completion of ITS-SIDS training shall be included once every three years in the number of hours needed to meet on-going training requirements in this Section. At all times, one child care provider who has completed ITS-SIDS training shall be present in the infant room while children are in care. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Consultation is provided as follows: We discussed the use of play pens. Currently, you have a gated off area in the infant and one year old classroom to prevent injury to infants as they are exploring their environment. You expressed interest in purchasing a new play pen. Plan to check the manufacturer’s instructions to ensure the equipment has ASTM certification. We discussed an incident report for an incident that occurred on 2/22/24. The equipment involved in the incident was observed today. The edge that caused the injury to the child was not observed to be sharp or hazardous. However, the bottom of the equipment was beginning to chip and was therefore removed from the classroom. We discussed education standards for staff. A. Bailey has grades on file that document completion of EDU119. Plan to submit this education to WORKS to receive a letter indicating A. Bailey is approved for the role of Lead Teacher. We discussed that A. Sukennikoff is listed as a Teacher but has been fulfilling the role of a Lead Teacher in the one year old classroom. A. Sukennikoff is currently paired with A. Bailey or a substitute in classroom space 5 until the end of March. Please see the requirements in rule below regarding Lead Teacher education: 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (c) Within six months of an individual assuming lead teacher or child care administrator duties, each center shall maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. (d) If the individual does not yet meet the staff qualifications required by G.S. 110-91(8) when assuming lead teacher or administrative duties, the individual shall submit to the Division documentation of completion of the coursework or credential to be considered for equivalency within six months of assuming the duties. We discussed the warning labels on the pink bouncy seat in classroom space 5. When this seat is in use, plan to move it within very close proximity to the caregiver to prevent injury. There is a fall hazard and a strangulation hazard listed on the label. This equipment should only be used under heavy supervision. Due to the substantiated nurture and care concern and the resulting discipline violation, an Administrative Action may be recommended. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0510 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: 0224-326L Visit Date: 2/29/2024 Number Present: 19 Completed Date: 2/29/2024 Age: From 0 To 5 Total Minutes: 180 Time In: 10:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to investigate a complaint received by the Division of Child Development and Early Education (DCDEE) on 2/23/24 and sent to Kaitlyn Marshall, Child Care Consultant, on 2/26/24. The reported concern is regarding nurture and care and developmentally appropriate environment. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Heather McConnell, Administrator during the visit. Ms. McConnell was on-site and available to discuss the concerns. The facility operates on a three (3) star permit issued on 11/12/19 with restrictions as follows: Daytime care only, meets enhanced space. Limited monitoring of child care requirements occurred during my visit today. Supervision, staff child ratio, discipline, staff records and program records were monitored. Per report, a one-year-old child was picked up and swung by their arm. Additionally, the report states that another six-month-old child is not given tummy time, does not sleep in a crib and is kept in a bouncy chair. Upon arrival, I announced my presence and the purpose of the visit. Video footage of the incident on 2/21/24 at 10:12 am was available and was reviewed during the visit today. Ms. McConnell and Kim Bailey, Office Assistant, were interviewed during the visit today. Ms. McConnell and Ms. Bailey stated that the staff in the classroom for infant and one year old children did not have any prior performance concerns. A copy of the staff member’s most recent Annual Staff evaluation, completed on 11/13/23, was provided for review today. No performance concerns were noted. Written documentation of the incident on 2/21/24 was available for review today. The documentation was signed by the Administrator and the staff member involved in the incident. Ms. McConnell stated that tummy time is provided throughout the day depending on individual children’s needs. Ms. McConnell stated that staff are required to keep their phones in storage except for an emergency. A copy of the phone policy for the facility was reviewed during the visit today. The phone policy states that phones may be used in an emergency or to play music for the children. The discipline policy was provided for review today. The facility's discipline policy states "We DO NOT handle children roughly in any way, including shaking, pushing, shoving, pinching, slapping, biting, kicking, or spanking." Classroom space 5 was observed today. One (1) caregiver and three (3) children were present including two (2) one year old children and one (1) infant. The one (1) infant was observed being picked up out of a bouncy seat and was carried to their designated crib and was rocked until they fell asleep in less than one (1) minute. The sleep check was recorded on the sleep chart by the caregiver. Two (2) one year old children were observed in a play pen. One (1) child was crying and one (1) child was exploring difference shapes on a toy. The crying child was addressed verbally by the caregiver who stated “you’re okay.” As the caregiver finished putting the infant to sleep, they joined the one year old children in play pen. The caregiver wiped a child’s nose and washed their hands. The caregiver then rejoined the children in play, playing musical instruments and clapped with the children. The crying child was soothed and stopped crying once play began. The daily schedule includes tummy time during the morning from 7:00am- 9:00am and again from 3:00pm-3:30pm. The staff member (AB) involved in the incident on 2/21/24 was interviewed today. The staff member explained strategies that are used to calm crying children which include close proximity to the child and playing with toys with them. The staff member stated that tummy time is provided for children whenever they are not sleeping or eating. The staff member stated that the one (1) infant currently enrolled in the program is more active and prefers to crawl and cruise. The staff member explained that free movement and gross motor time is provided to infants by placing them on the floor and getting down on the floor with the children. The staff member stated that children do not sleep in bouncy seats. Due to video evidence and documentation of the incident signed by the staff member and administrator, the concern regarding nurture and care is substantiated. Due to the reports of the caregivers and observations conducted during the visit today, the concern regarding developmentally appropriate practice is unsubstantiated. The following violations were cited during today’s visit: Violation Number Comment Rule 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. As observed via video footage from 2/21/24 at 10:12am, a one year old child was picked up by their arm and swung. G.S. 110-91(10) Technical Assistance provided as follows: Item #904 Children cannot be picked up by their arm. This is due to the risk of injury to joints in the child’s arm that can occur by picking up a child by their arm. In your letter of compliance, include a statement that indicates you have reviewed safe and nurturing ways to move children in the classroom. Additionally, plan to review your facility’s discipline policy with all staff to prevent future incidents. 10A NCAC 09 .1803 PROHIBITED DISCIPLINE IN CHILD CARE CENTERS (a) No child shall be subjected to any form of corporal punishment by the owner, operator, director, or staff of any child care center. For purposes of this Rule, "staff" shall mean any regular or substitute caregiver, any volunteer, and any auxiliary personnel, including cooks, secretaries, janitors, maids, or vehicle drivers. The following shall apply at all child care centers: (1) no child shall be handled roughly in any way, including shaking, pushing, shoving, pinching, slapping, biting, kicking, or spanking; Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/14/24. Due to the discipline violation, an Administrative Action may be recommended. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192 or email kaitlyn.marhall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation provided as follows: Plan to review sections .0508, .0510 and .0511 with staff to ensure developmentally appropriate activities are implemented consistently. 10A NCAC 09 .0510 ACTIVITY AREAS (e) When children under three years old are in care the following apply: (4) on a daily basis caregivers shall provide developmentally appropriate activities that support health and physical development. An open area that allows freedom of movement shall be available, both indoors and outdoors, for infants and for toddlers; (6) each child under the age of 12 months shall be given supervised tummy time positioned on his or her stomach while awake and alert each day. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1803 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: 0224-326L Visit Date: 2/29/2024 Number Present: 19 Completed Date: 2/29/2024 Age: From 0 To 5 Total Minutes: 180 Time In: 10:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to investigate a complaint received by the Division of Child Development and Early Education (DCDEE) on 2/23/24 and sent to Kaitlyn Marshall, Child Care Consultant, on 2/26/24. The reported concern is regarding nurture and care and developmentally appropriate environment. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Heather McConnell, Administrator during the visit. Ms. McConnell was on-site and available to discuss the concerns. The facility operates on a three (3) star permit issued on 11/12/19 with restrictions as follows: Daytime care only, meets enhanced space. Limited monitoring of child care requirements occurred during my visit today. Supervision, staff child ratio, discipline, staff records and program records were monitored. Per report, a one-year-old child was picked up and swung by their arm. Additionally, the report states that another six-month-old child is not given tummy time, does not sleep in a crib and is kept in a bouncy chair. Upon arrival, I announced my presence and the purpose of the visit. Video footage of the incident on 2/21/24 at 10:12 am was available and was reviewed during the visit today. Ms. McConnell and Kim Bailey, Office Assistant, were interviewed during the visit today. Ms. McConnell and Ms. Bailey stated that the staff in the classroom for infant and one year old children did not have any prior performance concerns. A copy of the staff member’s most recent Annual Staff evaluation, completed on 11/13/23, was provided for review today. No performance concerns were noted. Written documentation of the incident on 2/21/24 was available for review today. The documentation was signed by the Administrator and the staff member involved in the incident. Ms. McConnell stated that tummy time is provided throughout the day depending on individual children’s needs. Ms. McConnell stated that staff are required to keep their phones in storage except for an emergency. A copy of the phone policy for the facility was reviewed during the visit today. The phone policy states that phones may be used in an emergency or to play music for the children. The discipline policy was provided for review today. The facility's discipline policy states "We DO NOT handle children roughly in any way, including shaking, pushing, shoving, pinching, slapping, biting, kicking, or spanking." Classroom space 5 was observed today. One (1) caregiver and three (3) children were present including two (2) one year old children and one (1) infant. The one (1) infant was observed being picked up out of a bouncy seat and was carried to their designated crib and was rocked until they fell asleep in less than one (1) minute. The sleep check was recorded on the sleep chart by the caregiver. Two (2) one year old children were observed in a play pen. One (1) child was crying and one (1) child was exploring difference shapes on a toy. The crying child was addressed verbally by the caregiver who stated “you’re okay.” As the caregiver finished putting the infant to sleep, they joined the one year old children in play pen. The caregiver wiped a child’s nose and washed their hands. The caregiver then rejoined the children in play, playing musical instruments and clapped with the children. The crying child was soothed and stopped crying once play began. The daily schedule includes tummy time during the morning from 7:00am- 9:00am and again from 3:00pm-3:30pm. The staff member (AB) involved in the incident on 2/21/24 was interviewed today. The staff member explained strategies that are used to calm crying children which include close proximity to the child and playing with toys with them. The staff member stated that tummy time is provided for children whenever they are not sleeping or eating. The staff member stated that the one (1) infant currently enrolled in the program is more active and prefers to crawl and cruise. The staff member explained that free movement and gross motor time is provided to infants by placing them on the floor and getting down on the floor with the children. The staff member stated that children do not sleep in bouncy seats. Due to video evidence and documentation of the incident signed by the staff member and administrator, the concern regarding nurture and care is substantiated. Due to the reports of the caregivers and observations conducted during the visit today, the concern regarding developmentally appropriate practice is unsubstantiated. The following violations were cited during today’s visit: Violation Number Comment Rule 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. As observed via video footage from 2/21/24 at 10:12am, a one year old child was picked up by their arm and swung. G.S. 110-91(10) Technical Assistance provided as follows: Item #904 Children cannot be picked up by their arm. This is due to the risk of injury to joints in the child’s arm that can occur by picking up a child by their arm. In your letter of compliance, include a statement that indicates you have reviewed safe and nurturing ways to move children in the classroom. Additionally, plan to review your facility’s discipline policy with all staff to prevent future incidents. 10A NCAC 09 .1803 PROHIBITED DISCIPLINE IN CHILD CARE CENTERS (a) No child shall be subjected to any form of corporal punishment by the owner, operator, director, or staff of any child care center. For purposes of this Rule, "staff" shall mean any regular or substitute caregiver, any volunteer, and any auxiliary personnel, including cooks, secretaries, janitors, maids, or vehicle drivers. The following shall apply at all child care centers: (1) no child shall be handled roughly in any way, including shaking, pushing, shoving, pinching, slapping, biting, kicking, or spanking; Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/14/24. Due to the discipline violation, an Administrative Action may be recommended. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192 or email kaitlyn.marhall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation provided as follows: Plan to review sections .0508, .0510 and .0511 with staff to ensure developmentally appropriate activities are implemented consistently. 10A NCAC 09 .0510 ACTIVITY AREAS (e) When children under three years old are in care the following apply: (4) on a daily basis caregivers shall provide developmentally appropriate activities that support health and physical development. An open area that allows freedom of movement shall be available, both indoors and outdoors, for infants and for toddlers; (6) each child under the age of 12 months shall be given supervised tummy time positioned on his or her stomach while awake and alert each day. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: 0224-326L Visit Date: 2/29/2024 Number Present: 19 Completed Date: 2/29/2024 Age: From 0 To 5 Total Minutes: 180 Time In: 10:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to investigate a complaint received by the Division of Child Development and Early Education (DCDEE) on 2/23/24 and sent to Kaitlyn Marshall, Child Care Consultant, on 2/26/24. The reported concern is regarding nurture and care and developmentally appropriate environment. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Heather McConnell, Administrator during the visit. Ms. McConnell was on-site and available to discuss the concerns. The facility operates on a three (3) star permit issued on 11/12/19 with restrictions as follows: Daytime care only, meets enhanced space. Limited monitoring of child care requirements occurred during my visit today. Supervision, staff child ratio, discipline, staff records and program records were monitored. Per report, a one-year-old child was picked up and swung by their arm. Additionally, the report states that another six-month-old child is not given tummy time, does not sleep in a crib and is kept in a bouncy chair. Upon arrival, I announced my presence and the purpose of the visit. Video footage of the incident on 2/21/24 at 10:12 am was available and was reviewed during the visit today. Ms. McConnell and Kim Bailey, Office Assistant, were interviewed during the visit today. Ms. McConnell and Ms. Bailey stated that the staff in the classroom for infant and one year old children did not have any prior performance concerns. A copy of the staff member’s most recent Annual Staff evaluation, completed on 11/13/23, was provided for review today. No performance concerns were noted. Written documentation of the incident on 2/21/24 was available for review today. The documentation was signed by the Administrator and the staff member involved in the incident. Ms. McConnell stated that tummy time is provided throughout the day depending on individual children’s needs. Ms. McConnell stated that staff are required to keep their phones in storage except for an emergency. A copy of the phone policy for the facility was reviewed during the visit today. The phone policy states that phones may be used in an emergency or to play music for the children. The discipline policy was provided for review today. The facility's discipline policy states "We DO NOT handle children roughly in any way, including shaking, pushing, shoving, pinching, slapping, biting, kicking, or spanking." Classroom space 5 was observed today. One (1) caregiver and three (3) children were present including two (2) one year old children and one (1) infant. The one (1) infant was observed being picked up out of a bouncy seat and was carried to their designated crib and was rocked until they fell asleep in less than one (1) minute. The sleep check was recorded on the sleep chart by the caregiver. Two (2) one year old children were observed in a play pen. One (1) child was crying and one (1) child was exploring difference shapes on a toy. The crying child was addressed verbally by the caregiver who stated “you’re okay.” As the caregiver finished putting the infant to sleep, they joined the one year old children in play pen. The caregiver wiped a child’s nose and washed their hands. The caregiver then rejoined the children in play, playing musical instruments and clapped with the children. The crying child was soothed and stopped crying once play began. The daily schedule includes tummy time during the morning from 7:00am- 9:00am and again from 3:00pm-3:30pm. The staff member (AB) involved in the incident on 2/21/24 was interviewed today. The staff member explained strategies that are used to calm crying children which include close proximity to the child and playing with toys with them. The staff member stated that tummy time is provided for children whenever they are not sleeping or eating. The staff member stated that the one (1) infant currently enrolled in the program is more active and prefers to crawl and cruise. The staff member explained that free movement and gross motor time is provided to infants by placing them on the floor and getting down on the floor with the children. The staff member stated that children do not sleep in bouncy seats. Due to video evidence and documentation of the incident signed by the staff member and administrator, the concern regarding nurture and care is substantiated. Due to the reports of the caregivers and observations conducted during the visit today, the concern regarding developmentally appropriate practice is unsubstantiated. The following violations were cited during today’s visit: Violation Number Comment Rule 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. As observed via video footage from 2/21/24 at 10:12am, a one year old child was picked up by their arm and swung. G.S. 110-91(10) Technical Assistance provided as follows: Item #904 Children cannot be picked up by their arm. This is due to the risk of injury to joints in the child’s arm that can occur by picking up a child by their arm. In your letter of compliance, include a statement that indicates you have reviewed safe and nurturing ways to move children in the classroom. Additionally, plan to review your facility’s discipline policy with all staff to prevent future incidents. 10A NCAC 09 .1803 PROHIBITED DISCIPLINE IN CHILD CARE CENTERS (a) No child shall be subjected to any form of corporal punishment by the owner, operator, director, or staff of any child care center. For purposes of this Rule, "staff" shall mean any regular or substitute caregiver, any volunteer, and any auxiliary personnel, including cooks, secretaries, janitors, maids, or vehicle drivers. The following shall apply at all child care centers: (1) no child shall be handled roughly in any way, including shaking, pushing, shoving, pinching, slapping, biting, kicking, or spanking; Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/14/24. Due to the discipline violation, an Administrative Action may be recommended. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192 or email kaitlyn.marhall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation provided as follows: Plan to review sections .0508, .0510 and .0511 with staff to ensure developmentally appropriate activities are implemented consistently. 10A NCAC 09 .0510 ACTIVITY AREAS (e) When children under three years old are in care the following apply: (4) on a daily basis caregivers shall provide developmentally appropriate activities that support health and physical development. An open area that allows freedom of movement shall be available, both indoors and outdoors, for infants and for toddlers; (6) each child under the age of 12 months shall be given supervised tummy time positioned on his or her stomach while awake and alert each day. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-91 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: 0224-326L Visit Date: 2/29/2024 Number Present: 19 Completed Date: 2/29/2024 Age: From 0 To 5 Total Minutes: 180 Time In: 10:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to investigate a complaint received by the Division of Child Development and Early Education (DCDEE) on 2/23/24 and sent to Kaitlyn Marshall, Child Care Consultant, on 2/26/24. The reported concern is regarding nurture and care and developmentally appropriate environment. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Heather McConnell, Administrator during the visit. Ms. McConnell was on-site and available to discuss the concerns. The facility operates on a three (3) star permit issued on 11/12/19 with restrictions as follows: Daytime care only, meets enhanced space. Limited monitoring of child care requirements occurred during my visit today. Supervision, staff child ratio, discipline, staff records and program records were monitored. Per report, a one-year-old child was picked up and swung by their arm. Additionally, the report states that another six-month-old child is not given tummy time, does not sleep in a crib and is kept in a bouncy chair. Upon arrival, I announced my presence and the purpose of the visit. Video footage of the incident on 2/21/24 at 10:12 am was available and was reviewed during the visit today. Ms. McConnell and Kim Bailey, Office Assistant, were interviewed during the visit today. Ms. McConnell and Ms. Bailey stated that the staff in the classroom for infant and one year old children did not have any prior performance concerns. A copy of the staff member’s most recent Annual Staff evaluation, completed on 11/13/23, was provided for review today. No performance concerns were noted. Written documentation of the incident on 2/21/24 was available for review today. The documentation was signed by the Administrator and the staff member involved in the incident. Ms. McConnell stated that tummy time is provided throughout the day depending on individual children’s needs. Ms. McConnell stated that staff are required to keep their phones in storage except for an emergency. A copy of the phone policy for the facility was reviewed during the visit today. The phone policy states that phones may be used in an emergency or to play music for the children. The discipline policy was provided for review today. The facility's discipline policy states "We DO NOT handle children roughly in any way, including shaking, pushing, shoving, pinching, slapping, biting, kicking, or spanking." Classroom space 5 was observed today. One (1) caregiver and three (3) children were present including two (2) one year old children and one (1) infant. The one (1) infant was observed being picked up out of a bouncy seat and was carried to their designated crib and was rocked until they fell asleep in less than one (1) minute. The sleep check was recorded on the sleep chart by the caregiver. Two (2) one year old children were observed in a play pen. One (1) child was crying and one (1) child was exploring difference shapes on a toy. The crying child was addressed verbally by the caregiver who stated “you’re okay.” As the caregiver finished putting the infant to sleep, they joined the one year old children in play pen. The caregiver wiped a child’s nose and washed their hands. The caregiver then rejoined the children in play, playing musical instruments and clapped with the children. The crying child was soothed and stopped crying once play began. The daily schedule includes tummy time during the morning from 7:00am- 9:00am and again from 3:00pm-3:30pm. The staff member (AB) involved in the incident on 2/21/24 was interviewed today. The staff member explained strategies that are used to calm crying children which include close proximity to the child and playing with toys with them. The staff member stated that tummy time is provided for children whenever they are not sleeping or eating. The staff member stated that the one (1) infant currently enrolled in the program is more active and prefers to crawl and cruise. The staff member explained that free movement and gross motor time is provided to infants by placing them on the floor and getting down on the floor with the children. The staff member stated that children do not sleep in bouncy seats. Due to video evidence and documentation of the incident signed by the staff member and administrator, the concern regarding nurture and care is substantiated. Due to the reports of the caregivers and observations conducted during the visit today, the concern regarding developmentally appropriate practice is unsubstantiated. The following violations were cited during today’s visit: Violation Number Comment Rule 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. As observed via video footage from 2/21/24 at 10:12am, a one year old child was picked up by their arm and swung. G.S. 110-91(10) Technical Assistance provided as follows: Item #904 Children cannot be picked up by their arm. This is due to the risk of injury to joints in the child’s arm that can occur by picking up a child by their arm. In your letter of compliance, include a statement that indicates you have reviewed safe and nurturing ways to move children in the classroom. Additionally, plan to review your facility’s discipline policy with all staff to prevent future incidents. 10A NCAC 09 .1803 PROHIBITED DISCIPLINE IN CHILD CARE CENTERS (a) No child shall be subjected to any form of corporal punishment by the owner, operator, director, or staff of any child care center. For purposes of this Rule, "staff" shall mean any regular or substitute caregiver, any volunteer, and any auxiliary personnel, including cooks, secretaries, janitors, maids, or vehicle drivers. The following shall apply at all child care centers: (1) no child shall be handled roughly in any way, including shaking, pushing, shoving, pinching, slapping, biting, kicking, or spanking; Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/14/24. Due to the discipline violation, an Administrative Action may be recommended. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192 or email kaitlyn.marhall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation provided as follows: Plan to review sections .0508, .0510 and .0511 with staff to ensure developmentally appropriate activities are implemented consistently. 10A NCAC 09 .0510 ACTIVITY AREAS (e) When children under three years old are in care the following apply: (4) on a daily basis caregivers shall provide developmentally appropriate activities that support health and physical development. An open area that allows freedom of movement shall be available, both indoors and outdoors, for infants and for toddlers; (6) each child under the age of 12 months shall be given supervised tummy time positioned on his or her stomach while awake and alert each day. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0102 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 2/22/2024 Number Present: 19 Completed Date: 2/22/2024 Age: From 0 To 11 Total Minutes: 240 Time In: 09:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a Routine Unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Office Assistant, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. Bailey was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 2/20/24. The last fire drill was practiced on 1/16/24. The last lockdown drill was conducted on 11/1/23. The last fire inspection was approved on 10/21/22. The program’s most recent sanitation inspection was completed on 9/29/23, with two (2) demerits for a superior rating. The Emergency Medical Care Plan was posted and current. Staff are current on CPR/First Aid and ITS-SIDS training as required in rule. There is one (1) new staff. One (1) new staff file was monitored today. Upon arrival I was greeted by Ms. Bailey. In classroom space 5, children were eating breakfast consisting of bagel with cream cheese, pineapple and milk. In classroom space 2, children were pretending to cook with play food. In classroom space 4, children put on their coats to prepare to go outside. Once outside, children were observed pushing wheeled objects, swinging, and going down slides. In classroom space 3, children read books, built small structures with wooden blocks, and pretended to conduct housekeeping activities in the dramatic play center. Children were actively supervised at all times. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were cited during the visit today: Violation Number Comment Rule 106 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 fire inspection was approved on 10/21/22. 10A NCAC 09 .0304(a) 1032 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. One (1) staff (employment terminated April 2022 and rehired 2/19/24) had a medical report on file dated 8/13/21. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. One (1) new staff (employment terminated April 2022 and rehired 2/19/24) had a TB screening on file dated 10/25/20. .0701(a) 1035 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 (1) new staff (employment terminated April 2022 and rehired 2/19/24) had an emergency information form on file dated 4/22/22. .0701(a) 1874 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 (rehired 2/19/24) did not have a policy acknowledgement for the Prevention of Shaken Baby Syndrome and Abusive Head Trauma Policy on file. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Aquaphor for one (1) child in classroom space 5 had parent authorization form valid from 9/19/22-9/19/23. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 9995 A violation was found for which there is no item number. Sanitizing solution was observed below five (5) feet in classroom space 5. This is a sanitation requirement regarding storage of sanitizing solutions. 15A NCAC 18A 2820 (c). Technical Assistance provided as follows: Item #106 Plan to schedule and obtain a fire inspection. You stated today that you had an initial inspection in November and needed to correct some items before a reinspection. You stated that you called to schedule the re-inspection but did not receive a response. Plan to reach out to the fire marshal’s office again. Feel free to contact me if you continue to have difficulties with a response. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. Item #9995 The sanitizing solution was moved to a location inaccessible to children during the visit. This was corrected. 15A NCAC 18A .2820 STORAGE (c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Item #1032 The one (1) new staff must receive a new medical report from a medical professional. Ensure that the report received from the medical professional states that the individual is emotionally and physically fit to care for children. The best way to ensure this is to bring the Medical Report form from the DCDEE website to the medical professional. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Item #1033 The one (1) staff must receive a new TB test or screening. The results must be maintained in the staff member’s file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. Item # 1035 The Emergency Information form for one (1) new staff was completed during the visit today. This was corrected. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers. Item Requirements: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Item #1874 The one (1) new staff signed the policy acknowledgement during the visit today. This was corrected. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual's name; (2) the date the center's policy was given and explained to the individual; (3) the individual's signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member's file. Item #1882 The one (1) medication administration authorization for the Aquaphor in classroom space 5 must be updated, or the medication must be returned to the parent. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/7/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: A lockdown or shelter-in-place drill will need to be conducted by 2/29/24. A fire drill will need to be conducted by 2/29/24. If your new staff plan to work in the infant room, they will need ITS-SIDS by 4/19/24. If the time between termination and rehire is ninety (90) days or more, the rehired staff are considered new hires and will need paperwork on a new hire timeline. New staff AF will need to update any information that has changed on the application for employment on file. Plan to move the mulch from under the picnic tables and other areas on the playground to the high traffic areas such as the base of the slide and under the swings. Plan to increase the depth to six (6) inches in the high traffic crash zones that are beginning to wear down. Plan to monitor the paint coating that is beginning to peel on the top railing of the fence. Your facility has been placed in cohort 2. Your prep year will be 7/1/24-6/30/25. Your reassessment year will be 7/1/25-6/30/26. Please visit ncrlap.org to learn more about ways to prepare for the Environment Rating Scale assessments. We discussed the importance of ensuring all staff have their education evaluated by WORKS. We discussed that, to maintain a three (3) star license, you must maintain four (4) points in education standards, two (2) points in program standards and one (1) quality point. Please see the education requirements in rule needed to maintain four (4) points for Administrator, Lead Teacher and Teacher: On-Site Administrator (.2819) Point Level: 4 Points NC Early Childhood Administration Credential or its equivalent: Level I; Semester Hours and Type of Work Experience: 18 hours in early childhood education or child development; and 1 year of child care administration experience; or 6 hours in early childhood education or child development and 10 years of child care administration experience; and If providing school-age care: 450 hours of verifiable time in a licensed child care program; or 600 hours of verifiable time in an unlicensed school-age care or camp setting; or BSAC training. Lead Teacher (.2820) Point Level: 4 Points NC Early Childhood Credential or its equivalent: All lead teachers; Other Education and Experience Requirements: 75 percent of the lead teachers shall have: (1) completed 6 semester hours in early childhood education or childhood development and have completed or are enrolled in 3 additional semester hours in early childhood education; or (2) completed 3 semester hours of early childhood education and have 3 years of full-time verifiable early childhood work experience; or (3) completed 5 years of full-time verifiable early childhood work experience; or (4) Any combination of (1), (2), and (3) of this requirement. Teacher (.2821) Point Level: 4 Points NC Early Childhood Credential or its equivalent: 50 percent of teachers; Please refer to section .2819-.2821 of the rules for more information and for information on the NC Early Care and Education Professional Scale for each point level for each position. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 2/22/2024 Number Present: 19 Completed Date: 2/22/2024 Age: From 0 To 11 Total Minutes: 240 Time In: 09:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a Routine Unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Office Assistant, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. Bailey was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 2/20/24. The last fire drill was practiced on 1/16/24. The last lockdown drill was conducted on 11/1/23. The last fire inspection was approved on 10/21/22. The program’s most recent sanitation inspection was completed on 9/29/23, with two (2) demerits for a superior rating. The Emergency Medical Care Plan was posted and current. Staff are current on CPR/First Aid and ITS-SIDS training as required in rule. There is one (1) new staff. One (1) new staff file was monitored today. Upon arrival I was greeted by Ms. Bailey. In classroom space 5, children were eating breakfast consisting of bagel with cream cheese, pineapple and milk. In classroom space 2, children were pretending to cook with play food. In classroom space 4, children put on their coats to prepare to go outside. Once outside, children were observed pushing wheeled objects, swinging, and going down slides. In classroom space 3, children read books, built small structures with wooden blocks, and pretended to conduct housekeeping activities in the dramatic play center. Children were actively supervised at all times. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were cited during the visit today: Violation Number Comment Rule 106 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 fire inspection was approved on 10/21/22. 10A NCAC 09 .0304(a) 1032 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. One (1) staff (employment terminated April 2022 and rehired 2/19/24) had a medical report on file dated 8/13/21. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. One (1) new staff (employment terminated April 2022 and rehired 2/19/24) had a TB screening on file dated 10/25/20. .0701(a) 1035 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 (1) new staff (employment terminated April 2022 and rehired 2/19/24) had an emergency information form on file dated 4/22/22. .0701(a) 1874 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 (rehired 2/19/24) did not have a policy acknowledgement for the Prevention of Shaken Baby Syndrome and Abusive Head Trauma Policy on file. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Aquaphor for one (1) child in classroom space 5 had parent authorization form valid from 9/19/22-9/19/23. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 9995 A violation was found for which there is no item number. Sanitizing solution was observed below five (5) feet in classroom space 5. This is a sanitation requirement regarding storage of sanitizing solutions. 15A NCAC 18A 2820 (c). Technical Assistance provided as follows: Item #106 Plan to schedule and obtain a fire inspection. You stated today that you had an initial inspection in November and needed to correct some items before a reinspection. You stated that you called to schedule the re-inspection but did not receive a response. Plan to reach out to the fire marshal’s office again. Feel free to contact me if you continue to have difficulties with a response. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. Item #9995 The sanitizing solution was moved to a location inaccessible to children during the visit. This was corrected. 15A NCAC 18A .2820 STORAGE (c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Item #1032 The one (1) new staff must receive a new medical report from a medical professional. Ensure that the report received from the medical professional states that the individual is emotionally and physically fit to care for children. The best way to ensure this is to bring the Medical Report form from the DCDEE website to the medical professional. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Item #1033 The one (1) staff must receive a new TB test or screening. The results must be maintained in the staff member’s file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. Item # 1035 The Emergency Information form for one (1) new staff was completed during the visit today. This was corrected. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers. Item Requirements: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Item #1874 The one (1) new staff signed the policy acknowledgement during the visit today. This was corrected. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual's name; (2) the date the center's policy was given and explained to the individual; (3) the individual's signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member's file. Item #1882 The one (1) medication administration authorization for the Aquaphor in classroom space 5 must be updated, or the medication must be returned to the parent. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/7/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: A lockdown or shelter-in-place drill will need to be conducted by 2/29/24. A fire drill will need to be conducted by 2/29/24. If your new staff plan to work in the infant room, they will need ITS-SIDS by 4/19/24. If the time between termination and rehire is ninety (90) days or more, the rehired staff are considered new hires and will need paperwork on a new hire timeline. New staff AF will need to update any information that has changed on the application for employment on file. Plan to move the mulch from under the picnic tables and other areas on the playground to the high traffic areas such as the base of the slide and under the swings. Plan to increase the depth to six (6) inches in the high traffic crash zones that are beginning to wear down. Plan to monitor the paint coating that is beginning to peel on the top railing of the fence. Your facility has been placed in cohort 2. Your prep year will be 7/1/24-6/30/25. Your reassessment year will be 7/1/25-6/30/26. Please visit ncrlap.org to learn more about ways to prepare for the Environment Rating Scale assessments. We discussed the importance of ensuring all staff have their education evaluated by WORKS. We discussed that, to maintain a three (3) star license, you must maintain four (4) points in education standards, two (2) points in program standards and one (1) quality point. Please see the education requirements in rule needed to maintain four (4) points for Administrator, Lead Teacher and Teacher: On-Site Administrator (.2819) Point Level: 4 Points NC Early Childhood Administration Credential or its equivalent: Level I; Semester Hours and Type of Work Experience: 18 hours in early childhood education or child development; and 1 year of child care administration experience; or 6 hours in early childhood education or child development and 10 years of child care administration experience; and If providing school-age care: 450 hours of verifiable time in a licensed child care program; or 600 hours of verifiable time in an unlicensed school-age care or camp setting; or BSAC training. Lead Teacher (.2820) Point Level: 4 Points NC Early Childhood Credential or its equivalent: All lead teachers; Other Education and Experience Requirements: 75 percent of the lead teachers shall have: (1) completed 6 semester hours in early childhood education or childhood development and have completed or are enrolled in 3 additional semester hours in early childhood education; or (2) completed 3 semester hours of early childhood education and have 3 years of full-time verifiable early childhood work experience; or (3) completed 5 years of full-time verifiable early childhood work experience; or (4) Any combination of (1), (2), and (3) of this requirement. Teacher (.2821) Point Level: 4 Points NC Early Childhood Credential or its equivalent: 50 percent of teachers; Please refer to section .2819-.2821 of the rules for more information and for information on the NC Early Care and Education Professional Scale for each point level for each position. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0608 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 2/22/2024 Number Present: 19 Completed Date: 2/22/2024 Age: From 0 To 11 Total Minutes: 240 Time In: 09:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a Routine Unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Office Assistant, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. Bailey was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 2/20/24. The last fire drill was practiced on 1/16/24. The last lockdown drill was conducted on 11/1/23. The last fire inspection was approved on 10/21/22. The program’s most recent sanitation inspection was completed on 9/29/23, with two (2) demerits for a superior rating. The Emergency Medical Care Plan was posted and current. Staff are current on CPR/First Aid and ITS-SIDS training as required in rule. There is one (1) new staff. One (1) new staff file was monitored today. Upon arrival I was greeted by Ms. Bailey. In classroom space 5, children were eating breakfast consisting of bagel with cream cheese, pineapple and milk. In classroom space 2, children were pretending to cook with play food. In classroom space 4, children put on their coats to prepare to go outside. Once outside, children were observed pushing wheeled objects, swinging, and going down slides. In classroom space 3, children read books, built small structures with wooden blocks, and pretended to conduct housekeeping activities in the dramatic play center. Children were actively supervised at all times. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were cited during the visit today: Violation Number Comment Rule 106 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 fire inspection was approved on 10/21/22. 10A NCAC 09 .0304(a) 1032 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. One (1) staff (employment terminated April 2022 and rehired 2/19/24) had a medical report on file dated 8/13/21. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. One (1) new staff (employment terminated April 2022 and rehired 2/19/24) had a TB screening on file dated 10/25/20. .0701(a) 1035 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 (1) new staff (employment terminated April 2022 and rehired 2/19/24) had an emergency information form on file dated 4/22/22. .0701(a) 1874 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 (rehired 2/19/24) did not have a policy acknowledgement for the Prevention of Shaken Baby Syndrome and Abusive Head Trauma Policy on file. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Aquaphor for one (1) child in classroom space 5 had parent authorization form valid from 9/19/22-9/19/23. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 9995 A violation was found for which there is no item number. Sanitizing solution was observed below five (5) feet in classroom space 5. This is a sanitation requirement regarding storage of sanitizing solutions. 15A NCAC 18A 2820 (c). Technical Assistance provided as follows: Item #106 Plan to schedule and obtain a fire inspection. You stated today that you had an initial inspection in November and needed to correct some items before a reinspection. You stated that you called to schedule the re-inspection but did not receive a response. Plan to reach out to the fire marshal’s office again. Feel free to contact me if you continue to have difficulties with a response. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. Item #9995 The sanitizing solution was moved to a location inaccessible to children during the visit. This was corrected. 15A NCAC 18A .2820 STORAGE (c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Item #1032 The one (1) new staff must receive a new medical report from a medical professional. Ensure that the report received from the medical professional states that the individual is emotionally and physically fit to care for children. The best way to ensure this is to bring the Medical Report form from the DCDEE website to the medical professional. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Item #1033 The one (1) staff must receive a new TB test or screening. The results must be maintained in the staff member’s file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. Item # 1035 The Emergency Information form for one (1) new staff was completed during the visit today. This was corrected. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers. Item Requirements: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Item #1874 The one (1) new staff signed the policy acknowledgement during the visit today. This was corrected. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual's name; (2) the date the center's policy was given and explained to the individual; (3) the individual's signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member's file. Item #1882 The one (1) medication administration authorization for the Aquaphor in classroom space 5 must be updated, or the medication must be returned to the parent. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/7/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: A lockdown or shelter-in-place drill will need to be conducted by 2/29/24. A fire drill will need to be conducted by 2/29/24. If your new staff plan to work in the infant room, they will need ITS-SIDS by 4/19/24. If the time between termination and rehire is ninety (90) days or more, the rehired staff are considered new hires and will need paperwork on a new hire timeline. New staff AF will need to update any information that has changed on the application for employment on file. Plan to move the mulch from under the picnic tables and other areas on the playground to the high traffic areas such as the base of the slide and under the swings. Plan to increase the depth to six (6) inches in the high traffic crash zones that are beginning to wear down. Plan to monitor the paint coating that is beginning to peel on the top railing of the fence. Your facility has been placed in cohort 2. Your prep year will be 7/1/24-6/30/25. Your reassessment year will be 7/1/25-6/30/26. Please visit ncrlap.org to learn more about ways to prepare for the Environment Rating Scale assessments. We discussed the importance of ensuring all staff have their education evaluated by WORKS. We discussed that, to maintain a three (3) star license, you must maintain four (4) points in education standards, two (2) points in program standards and one (1) quality point. Please see the education requirements in rule needed to maintain four (4) points for Administrator, Lead Teacher and Teacher: On-Site Administrator (.2819) Point Level: 4 Points NC Early Childhood Administration Credential or its equivalent: Level I; Semester Hours and Type of Work Experience: 18 hours in early childhood education or child development; and 1 year of child care administration experience; or 6 hours in early childhood education or child development and 10 years of child care administration experience; and If providing school-age care: 450 hours of verifiable time in a licensed child care program; or 600 hours of verifiable time in an unlicensed school-age care or camp setting; or BSAC training. Lead Teacher (.2820) Point Level: 4 Points NC Early Childhood Credential or its equivalent: All lead teachers; Other Education and Experience Requirements: 75 percent of the lead teachers shall have: (1) completed 6 semester hours in early childhood education or childhood development and have completed or are enrolled in 3 additional semester hours in early childhood education; or (2) completed 3 semester hours of early childhood education and have 3 years of full-time verifiable early childhood work experience; or (3) completed 5 years of full-time verifiable early childhood work experience; or (4) Any combination of (1), (2), and (3) of this requirement. Teacher (.2821) Point Level: 4 Points NC Early Childhood Credential or its equivalent: 50 percent of teachers; Please refer to section .2819-.2821 of the rules for more information and for information on the NC Early Care and Education Professional Scale for each point level for each position. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0701 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 2/22/2024 Number Present: 19 Completed Date: 2/22/2024 Age: From 0 To 11 Total Minutes: 240 Time In: 09:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a Routine Unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Office Assistant, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. Bailey was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 2/20/24. The last fire drill was practiced on 1/16/24. The last lockdown drill was conducted on 11/1/23. The last fire inspection was approved on 10/21/22. The program’s most recent sanitation inspection was completed on 9/29/23, with two (2) demerits for a superior rating. The Emergency Medical Care Plan was posted and current. Staff are current on CPR/First Aid and ITS-SIDS training as required in rule. There is one (1) new staff. One (1) new staff file was monitored today. Upon arrival I was greeted by Ms. Bailey. In classroom space 5, children were eating breakfast consisting of bagel with cream cheese, pineapple and milk. In classroom space 2, children were pretending to cook with play food. In classroom space 4, children put on their coats to prepare to go outside. Once outside, children were observed pushing wheeled objects, swinging, and going down slides. In classroom space 3, children read books, built small structures with wooden blocks, and pretended to conduct housekeeping activities in the dramatic play center. Children were actively supervised at all times. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were cited during the visit today: Violation Number Comment Rule 106 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 fire inspection was approved on 10/21/22. 10A NCAC 09 .0304(a) 1032 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. One (1) staff (employment terminated April 2022 and rehired 2/19/24) had a medical report on file dated 8/13/21. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. One (1) new staff (employment terminated April 2022 and rehired 2/19/24) had a TB screening on file dated 10/25/20. .0701(a) 1035 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 (1) new staff (employment terminated April 2022 and rehired 2/19/24) had an emergency information form on file dated 4/22/22. .0701(a) 1874 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 (rehired 2/19/24) did not have a policy acknowledgement for the Prevention of Shaken Baby Syndrome and Abusive Head Trauma Policy on file. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Aquaphor for one (1) child in classroom space 5 had parent authorization form valid from 9/19/22-9/19/23. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 9995 A violation was found for which there is no item number. Sanitizing solution was observed below five (5) feet in classroom space 5. This is a sanitation requirement regarding storage of sanitizing solutions. 15A NCAC 18A 2820 (c). Technical Assistance provided as follows: Item #106 Plan to schedule and obtain a fire inspection. You stated today that you had an initial inspection in November and needed to correct some items before a reinspection. You stated that you called to schedule the re-inspection but did not receive a response. Plan to reach out to the fire marshal’s office again. Feel free to contact me if you continue to have difficulties with a response. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. Item #9995 The sanitizing solution was moved to a location inaccessible to children during the visit. This was corrected. 15A NCAC 18A .2820 STORAGE (c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Item #1032 The one (1) new staff must receive a new medical report from a medical professional. Ensure that the report received from the medical professional states that the individual is emotionally and physically fit to care for children. The best way to ensure this is to bring the Medical Report form from the DCDEE website to the medical professional. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Item #1033 The one (1) staff must receive a new TB test or screening. The results must be maintained in the staff member’s file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. Item # 1035 The Emergency Information form for one (1) new staff was completed during the visit today. This was corrected. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers. Item Requirements: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Item #1874 The one (1) new staff signed the policy acknowledgement during the visit today. This was corrected. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual's name; (2) the date the center's policy was given and explained to the individual; (3) the individual's signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member's file. Item #1882 The one (1) medication administration authorization for the Aquaphor in classroom space 5 must be updated, or the medication must be returned to the parent. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/7/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: A lockdown or shelter-in-place drill will need to be conducted by 2/29/24. A fire drill will need to be conducted by 2/29/24. If your new staff plan to work in the infant room, they will need ITS-SIDS by 4/19/24. If the time between termination and rehire is ninety (90) days or more, the rehired staff are considered new hires and will need paperwork on a new hire timeline. New staff AF will need to update any information that has changed on the application for employment on file. Plan to move the mulch from under the picnic tables and other areas on the playground to the high traffic areas such as the base of the slide and under the swings. Plan to increase the depth to six (6) inches in the high traffic crash zones that are beginning to wear down. Plan to monitor the paint coating that is beginning to peel on the top railing of the fence. Your facility has been placed in cohort 2. Your prep year will be 7/1/24-6/30/25. Your reassessment year will be 7/1/25-6/30/26. Please visit ncrlap.org to learn more about ways to prepare for the Environment Rating Scale assessments. We discussed the importance of ensuring all staff have their education evaluated by WORKS. We discussed that, to maintain a three (3) star license, you must maintain four (4) points in education standards, two (2) points in program standards and one (1) quality point. Please see the education requirements in rule needed to maintain four (4) points for Administrator, Lead Teacher and Teacher: On-Site Administrator (.2819) Point Level: 4 Points NC Early Childhood Administration Credential or its equivalent: Level I; Semester Hours and Type of Work Experience: 18 hours in early childhood education or child development; and 1 year of child care administration experience; or 6 hours in early childhood education or child development and 10 years of child care administration experience; and If providing school-age care: 450 hours of verifiable time in a licensed child care program; or 600 hours of verifiable time in an unlicensed school-age care or camp setting; or BSAC training. Lead Teacher (.2820) Point Level: 4 Points NC Early Childhood Credential or its equivalent: All lead teachers; Other Education and Experience Requirements: 75 percent of the lead teachers shall have: (1) completed 6 semester hours in early childhood education or childhood development and have completed or are enrolled in 3 additional semester hours in early childhood education; or (2) completed 3 semester hours of early childhood education and have 3 years of full-time verifiable early childhood work experience; or (3) completed 5 years of full-time verifiable early childhood work experience; or (4) Any combination of (1), (2), and (3) of this requirement. Teacher (.2821) Point Level: 4 Points NC Early Childhood Credential or its equivalent: 50 percent of teachers; Please refer to section .2819-.2821 of the rules for more information and for information on the NC Early Care and Education Professional Scale for each point level for each position. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0803 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 2/22/2024 Number Present: 19 Completed Date: 2/22/2024 Age: From 0 To 11 Total Minutes: 240 Time In: 09:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a Routine Unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Office Assistant, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. Bailey was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 2/20/24. The last fire drill was practiced on 1/16/24. The last lockdown drill was conducted on 11/1/23. The last fire inspection was approved on 10/21/22. The program’s most recent sanitation inspection was completed on 9/29/23, with two (2) demerits for a superior rating. The Emergency Medical Care Plan was posted and current. Staff are current on CPR/First Aid and ITS-SIDS training as required in rule. There is one (1) new staff. One (1) new staff file was monitored today. Upon arrival I was greeted by Ms. Bailey. In classroom space 5, children were eating breakfast consisting of bagel with cream cheese, pineapple and milk. In classroom space 2, children were pretending to cook with play food. In classroom space 4, children put on their coats to prepare to go outside. Once outside, children were observed pushing wheeled objects, swinging, and going down slides. In classroom space 3, children read books, built small structures with wooden blocks, and pretended to conduct housekeeping activities in the dramatic play center. Children were actively supervised at all times. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were cited during the visit today: Violation Number Comment Rule 106 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 fire inspection was approved on 10/21/22. 10A NCAC 09 .0304(a) 1032 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. One (1) staff (employment terminated April 2022 and rehired 2/19/24) had a medical report on file dated 8/13/21. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. One (1) new staff (employment terminated April 2022 and rehired 2/19/24) had a TB screening on file dated 10/25/20. .0701(a) 1035 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 (1) new staff (employment terminated April 2022 and rehired 2/19/24) had an emergency information form on file dated 4/22/22. .0701(a) 1874 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 (rehired 2/19/24) did not have a policy acknowledgement for the Prevention of Shaken Baby Syndrome and Abusive Head Trauma Policy on file. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Aquaphor for one (1) child in classroom space 5 had parent authorization form valid from 9/19/22-9/19/23. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 9995 A violation was found for which there is no item number. Sanitizing solution was observed below five (5) feet in classroom space 5. This is a sanitation requirement regarding storage of sanitizing solutions. 15A NCAC 18A 2820 (c). Technical Assistance provided as follows: Item #106 Plan to schedule and obtain a fire inspection. You stated today that you had an initial inspection in November and needed to correct some items before a reinspection. You stated that you called to schedule the re-inspection but did not receive a response. Plan to reach out to the fire marshal’s office again. Feel free to contact me if you continue to have difficulties with a response. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. Item #9995 The sanitizing solution was moved to a location inaccessible to children during the visit. This was corrected. 15A NCAC 18A .2820 STORAGE (c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Item #1032 The one (1) new staff must receive a new medical report from a medical professional. Ensure that the report received from the medical professional states that the individual is emotionally and physically fit to care for children. The best way to ensure this is to bring the Medical Report form from the DCDEE website to the medical professional. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Item #1033 The one (1) staff must receive a new TB test or screening. The results must be maintained in the staff member’s file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. Item # 1035 The Emergency Information form for one (1) new staff was completed during the visit today. This was corrected. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers. Item Requirements: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Item #1874 The one (1) new staff signed the policy acknowledgement during the visit today. This was corrected. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual's name; (2) the date the center's policy was given and explained to the individual; (3) the individual's signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member's file. Item #1882 The one (1) medication administration authorization for the Aquaphor in classroom space 5 must be updated, or the medication must be returned to the parent. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/7/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: A lockdown or shelter-in-place drill will need to be conducted by 2/29/24. A fire drill will need to be conducted by 2/29/24. If your new staff plan to work in the infant room, they will need ITS-SIDS by 4/19/24. If the time between termination and rehire is ninety (90) days or more, the rehired staff are considered new hires and will need paperwork on a new hire timeline. New staff AF will need to update any information that has changed on the application for employment on file. Plan to move the mulch from under the picnic tables and other areas on the playground to the high traffic areas such as the base of the slide and under the swings. Plan to increase the depth to six (6) inches in the high traffic crash zones that are beginning to wear down. Plan to monitor the paint coating that is beginning to peel on the top railing of the fence. Your facility has been placed in cohort 2. Your prep year will be 7/1/24-6/30/25. Your reassessment year will be 7/1/25-6/30/26. Please visit ncrlap.org to learn more about ways to prepare for the Environment Rating Scale assessments. We discussed the importance of ensuring all staff have their education evaluated by WORKS. We discussed that, to maintain a three (3) star license, you must maintain four (4) points in education standards, two (2) points in program standards and one (1) quality point. Please see the education requirements in rule needed to maintain four (4) points for Administrator, Lead Teacher and Teacher: On-Site Administrator (.2819) Point Level: 4 Points NC Early Childhood Administration Credential or its equivalent: Level I; Semester Hours and Type of Work Experience: 18 hours in early childhood education or child development; and 1 year of child care administration experience; or 6 hours in early childhood education or child development and 10 years of child care administration experience; and If providing school-age care: 450 hours of verifiable time in a licensed child care program; or 600 hours of verifiable time in an unlicensed school-age care or camp setting; or BSAC training. Lead Teacher (.2820) Point Level: 4 Points NC Early Childhood Credential or its equivalent: All lead teachers; Other Education and Experience Requirements: 75 percent of the lead teachers shall have: (1) completed 6 semester hours in early childhood education or childhood development and have completed or are enrolled in 3 additional semester hours in early childhood education; or (2) completed 3 semester hours of early childhood education and have 3 years of full-time verifiable early childhood work experience; or (3) completed 5 years of full-time verifiable early childhood work experience; or (4) Any combination of (1), (2), and (3) of this requirement. Teacher (.2821) Point Level: 4 Points NC Early Childhood Credential or its equivalent: 50 percent of teachers; Please refer to section .2819-.2821 of the rules for more information and for information on the NC Early Care and Education Professional Scale for each point level for each position. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 2/22/2024 Number Present: 19 Completed Date: 2/22/2024 Age: From 0 To 11 Total Minutes: 240 Time In: 09:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a Routine Unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Kim Bailey, Office Assistant, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. Bailey was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 2/20/24. The last fire drill was practiced on 1/16/24. The last lockdown drill was conducted on 11/1/23. The last fire inspection was approved on 10/21/22. The program’s most recent sanitation inspection was completed on 9/29/23, with two (2) demerits for a superior rating. The Emergency Medical Care Plan was posted and current. Staff are current on CPR/First Aid and ITS-SIDS training as required in rule. There is one (1) new staff. One (1) new staff file was monitored today. Upon arrival I was greeted by Ms. Bailey. In classroom space 5, children were eating breakfast consisting of bagel with cream cheese, pineapple and milk. In classroom space 2, children were pretending to cook with play food. In classroom space 4, children put on their coats to prepare to go outside. Once outside, children were observed pushing wheeled objects, swinging, and going down slides. In classroom space 3, children read books, built small structures with wooden blocks, and pretended to conduct housekeeping activities in the dramatic play center. Children were actively supervised at all times. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were cited during the visit today: Violation Number Comment Rule 106 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 fire inspection was approved on 10/21/22. 10A NCAC 09 .0304(a) 1032 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. One (1) staff (employment terminated April 2022 and rehired 2/19/24) had a medical report on file dated 8/13/21. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. One (1) new staff (employment terminated April 2022 and rehired 2/19/24) had a TB screening on file dated 10/25/20. .0701(a) 1035 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 (1) new staff (employment terminated April 2022 and rehired 2/19/24) had an emergency information form on file dated 4/22/22. .0701(a) 1874 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 (rehired 2/19/24) did not have a policy acknowledgement for the Prevention of Shaken Baby Syndrome and Abusive Head Trauma Policy on file. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Aquaphor for one (1) child in classroom space 5 had parent authorization form valid from 9/19/22-9/19/23. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 9995 A violation was found for which there is no item number. Sanitizing solution was observed below five (5) feet in classroom space 5. This is a sanitation requirement regarding storage of sanitizing solutions. 15A NCAC 18A 2820 (c). Technical Assistance provided as follows: Item #106 Plan to schedule and obtain a fire inspection. You stated today that you had an initial inspection in November and needed to correct some items before a reinspection. You stated that you called to schedule the re-inspection but did not receive a response. Plan to reach out to the fire marshal’s office again. Feel free to contact me if you continue to have difficulties with a response. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. Item #9995 The sanitizing solution was moved to a location inaccessible to children during the visit. This was corrected. 15A NCAC 18A .2820 STORAGE (c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Item #1032 The one (1) new staff must receive a new medical report from a medical professional. Ensure that the report received from the medical professional states that the individual is emotionally and physically fit to care for children. The best way to ensure this is to bring the Medical Report form from the DCDEE website to the medical professional. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Item #1033 The one (1) staff must receive a new TB test or screening. The results must be maintained in the staff member’s file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. Item # 1035 The Emergency Information form for one (1) new staff was completed during the visit today. This was corrected. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers. Item Requirements: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Item #1874 The one (1) new staff signed the policy acknowledgement during the visit today. This was corrected. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual's name; (2) the date the center's policy was given and explained to the individual; (3) the individual's signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member's file. Item #1882 The one (1) medication administration authorization for the Aquaphor in classroom space 5 must be updated, or the medication must be returned to the parent. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/7/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: A lockdown or shelter-in-place drill will need to be conducted by 2/29/24. A fire drill will need to be conducted by 2/29/24. If your new staff plan to work in the infant room, they will need ITS-SIDS by 4/19/24. If the time between termination and rehire is ninety (90) days or more, the rehired staff are considered new hires and will need paperwork on a new hire timeline. New staff AF will need to update any information that has changed on the application for employment on file. Plan to move the mulch from under the picnic tables and other areas on the playground to the high traffic areas such as the base of the slide and under the swings. Plan to increase the depth to six (6) inches in the high traffic crash zones that are beginning to wear down. Plan to monitor the paint coating that is beginning to peel on the top railing of the fence. Your facility has been placed in cohort 2. Your prep year will be 7/1/24-6/30/25. Your reassessment year will be 7/1/25-6/30/26. Please visit ncrlap.org to learn more about ways to prepare for the Environment Rating Scale assessments. We discussed the importance of ensuring all staff have their education evaluated by WORKS. We discussed that, to maintain a three (3) star license, you must maintain four (4) points in education standards, two (2) points in program standards and one (1) quality point. Please see the education requirements in rule needed to maintain four (4) points for Administrator, Lead Teacher and Teacher: On-Site Administrator (.2819) Point Level: 4 Points NC Early Childhood Administration Credential or its equivalent: Level I; Semester Hours and Type of Work Experience: 18 hours in early childhood education or child development; and 1 year of child care administration experience; or 6 hours in early childhood education or child development and 10 years of child care administration experience; and If providing school-age care: 450 hours of verifiable time in a licensed child care program; or 600 hours of verifiable time in an unlicensed school-age care or camp setting; or BSAC training. Lead Teacher (.2820) Point Level: 4 Points NC Early Childhood Credential or its equivalent: All lead teachers; Other Education and Experience Requirements: 75 percent of the lead teachers shall have: (1) completed 6 semester hours in early childhood education or childhood development and have completed or are enrolled in 3 additional semester hours in early childhood education; or (2) completed 3 semester hours of early childhood education and have 3 years of full-time verifiable early childhood work experience; or (3) completed 5 years of full-time verifiable early childhood work experience; or (4) Any combination of (1), (2), and (3) of this requirement. Teacher (.2821) Point Level: 4 Points NC Early Childhood Credential or its equivalent: 50 percent of teachers; Please refer to section .2819-.2821 of the rules for more information and for information on the NC Early Care and Education Professional Scale for each point level for each position. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 10/19/2023 Number Present: 21 Completed Date: 10/19/2023 Age: From 0 To 5 Total Minutes: 60 Time In: 09:15 AM Time Out: 10:15 AM Time In: Time Out: List to Use: Center Type Of Visit: Unannounced Visit Follow-Up Announced/Unannounced: Unannounced The purpose of today’s visit is to follow-up on violations received during the Annual Compliance visit on 9/27/23. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Heather McConnell, Administrator during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. McConnell was present to ask and answer questions throughout the visit today. Staff records were monitored today. During the Annual Compliance visit on 9/27/23, one (1) staff member (hire date 6/26/23) had received an approved CPR training, but had not received an approved First Aid training. The staff member completed American Red Cross Adult and Pediatric CPR/AED training. The staff member had a CPR/First Aid training scheduled for 10/14/23. An extension was approved to 10/16/23. In an email on 10/18/23, Ms. McConnell stated that the staff member was unable to attend the training due to illness. A new training was scheduled for 10/26/23. Ms. McConnell stated that the staff member was reimbursed for this date only. First Aid training violations are related to the safety and health of children and, therefore, cannot be out of compliance for an extended period of time. Therefore, item #1048 was cited again today. The following violations were cited today: Violation Number Comment Rule 1048 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 hired 6/26/23 did not complete an approved First Aid training course. .1102(c) Technical Assistance provided as follows: Item #1048 The one (1) staff member must complete an approved First Aid training course. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/2/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation provided as follows: Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 10/19/2023 Number Present: 21 Completed Date: 10/19/2023 Age: From 0 To 5 Total Minutes: 60 Time In: 09:15 AM Time Out: 10:15 AM Time In: Time Out: List to Use: Center Type Of Visit: Unannounced Visit Follow-Up Announced/Unannounced: Unannounced The purpose of today’s visit is to follow-up on violations received during the Annual Compliance visit on 9/27/23. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Heather McConnell, Administrator during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. McConnell was present to ask and answer questions throughout the visit today. Staff records were monitored today. During the Annual Compliance visit on 9/27/23, one (1) staff member (hire date 6/26/23) had received an approved CPR training, but had not received an approved First Aid training. The staff member completed American Red Cross Adult and Pediatric CPR/AED training. The staff member had a CPR/First Aid training scheduled for 10/14/23. An extension was approved to 10/16/23. In an email on 10/18/23, Ms. McConnell stated that the staff member was unable to attend the training due to illness. A new training was scheduled for 10/26/23. Ms. McConnell stated that the staff member was reimbursed for this date only. First Aid training violations are related to the safety and health of children and, therefore, cannot be out of compliance for an extended period of time. Therefore, item #1048 was cited again today. The following violations were cited today: Violation Number Comment Rule 1048 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 hired 6/26/23 did not complete an approved First Aid training course. .1102(c) Technical Assistance provided as follows: Item #1048 The one (1) staff member must complete an approved First Aid training course. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/2/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation provided as follows: Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 9/27/2023 Number Present: 19 Completed Date: 9/27/2023 Age: From 0 To 4 Total Minutes: 240 Time In: 09:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Heather McConnell, Administrator, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. McConnell was present and available to ask and answer questions. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-two percent (82%) as of 9/25/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc. is current/active as of 9/25/23. Permit type – Three (3) star license issued 11/12/19 Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 10/19/22. The last fire drill was practiced on 8/30/23. The last shelter-in-place drill was practiced on 8/8/23. The last playground inspection was documented on 8/30/23. The last fire inspection was approved on 10/21/22. The last sanitation inspection was conducted on 10/27/22 with thirteen (13) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The center’s Emergency Preparedness and Response plan was updated on 5/10/23. Upon arrival I was greeted by Ms. McConnell. In classroom space 5, children were engaged in play with mechanical toys and being soothed by caregivers. In classroom space 2, children were engaged in pretend play, eating and sharing play food with one another and singing with the caregiver. In classroom space 3, children were engaged in pretend play, dressing up in various garments. In classroom space 4, children were preparing to eat breakfast. Breakfast today consisted of graham crackers, raisins and milk. Interactions were positive and nurturing, supervision was adequate. Three (3) children’s files were monitored today. One (1) existing staff file was monitored today. There are no new staff. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 858 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 classroom space 4, baby wipes were stored in an area accessible to children. The wipes package contained a choking hazard warning. .0604(q) 1048 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, re-hire date 6/26/23, did not have a First Aid certificate on site. .1102(c) Technical assistance was provided as follows: Item #858 Plan to keep all plastic wipes containers stored five (5) feet or higher. This was corrected during the visit. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Item #1048 The one (1) staff must obtain an approved First Aid certificate immediately. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/11/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed the Epipen for the one (1) child in classroom space 4. The expiration for the Epipen is 7/2023. Plan to return the Epipen to the parent and request updated medication for the child. We discussed the mulch on the playground is beginning to be packed down. It will need to be raked to provide extra cushioning. We discussed the facility has a contract with a mulch service that provides maintenance. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Your facility has been placed in cohort 2. Your prep year is 7/1/24-6/30/25. Your reassessment year is 7/1/25-6/30/26. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0604 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 9/27/2023 Number Present: 19 Completed Date: 9/27/2023 Age: From 0 To 4 Total Minutes: 240 Time In: 09:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Heather McConnell, Administrator, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. McConnell was present and available to ask and answer questions. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-two percent (82%) as of 9/25/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc. is current/active as of 9/25/23. Permit type – Three (3) star license issued 11/12/19 Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 10/19/22. The last fire drill was practiced on 8/30/23. The last shelter-in-place drill was practiced on 8/8/23. The last playground inspection was documented on 8/30/23. The last fire inspection was approved on 10/21/22. The last sanitation inspection was conducted on 10/27/22 with thirteen (13) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The center’s Emergency Preparedness and Response plan was updated on 5/10/23. Upon arrival I was greeted by Ms. McConnell. In classroom space 5, children were engaged in play with mechanical toys and being soothed by caregivers. In classroom space 2, children were engaged in pretend play, eating and sharing play food with one another and singing with the caregiver. In classroom space 3, children were engaged in pretend play, dressing up in various garments. In classroom space 4, children were preparing to eat breakfast. Breakfast today consisted of graham crackers, raisins and milk. Interactions were positive and nurturing, supervision was adequate. Three (3) children’s files were monitored today. One (1) existing staff file was monitored today. There are no new staff. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 858 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 classroom space 4, baby wipes were stored in an area accessible to children. The wipes package contained a choking hazard warning. .0604(q) 1048 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, re-hire date 6/26/23, did not have a First Aid certificate on site. .1102(c) Technical assistance was provided as follows: Item #858 Plan to keep all plastic wipes containers stored five (5) feet or higher. This was corrected during the visit. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Item #1048 The one (1) staff must obtain an approved First Aid certificate immediately. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/11/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed the Epipen for the one (1) child in classroom space 4. The expiration for the Epipen is 7/2023. Plan to return the Epipen to the parent and request updated medication for the child. We discussed the mulch on the playground is beginning to be packed down. It will need to be raked to provide extra cushioning. We discussed the facility has a contract with a mulch service that provides maintenance. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Your facility has been placed in cohort 2. Your prep year is 7/1/24-6/30/25. Your reassessment year is 7/1/25-6/30/26. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 9/27/2023 Number Present: 19 Completed Date: 9/27/2023 Age: From 0 To 4 Total Minutes: 240 Time In: 09:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Heather McConnell, Administrator, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. McConnell was present and available to ask and answer questions. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-two percent (82%) as of 9/25/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc. is current/active as of 9/25/23. Permit type – Three (3) star license issued 11/12/19 Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 10/19/22. The last fire drill was practiced on 8/30/23. The last shelter-in-place drill was practiced on 8/8/23. The last playground inspection was documented on 8/30/23. The last fire inspection was approved on 10/21/22. The last sanitation inspection was conducted on 10/27/22 with thirteen (13) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The center’s Emergency Preparedness and Response plan was updated on 5/10/23. Upon arrival I was greeted by Ms. McConnell. In classroom space 5, children were engaged in play with mechanical toys and being soothed by caregivers. In classroom space 2, children were engaged in pretend play, eating and sharing play food with one another and singing with the caregiver. In classroom space 3, children were engaged in pretend play, dressing up in various garments. In classroom space 4, children were preparing to eat breakfast. Breakfast today consisted of graham crackers, raisins and milk. Interactions were positive and nurturing, supervision was adequate. Three (3) children’s files were monitored today. One (1) existing staff file was monitored today. There are no new staff. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 858 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 classroom space 4, baby wipes were stored in an area accessible to children. The wipes package contained a choking hazard warning. .0604(q) 1048 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, re-hire date 6/26/23, did not have a First Aid certificate on site. .1102(c) Technical assistance was provided as follows: Item #858 Plan to keep all plastic wipes containers stored five (5) feet or higher. This was corrected during the visit. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Item #1048 The one (1) staff must obtain an approved First Aid certificate immediately. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/11/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed the Epipen for the one (1) child in classroom space 4. The expiration for the Epipen is 7/2023. Plan to return the Epipen to the parent and request updated medication for the child. We discussed the mulch on the playground is beginning to be packed down. It will need to be raked to provide extra cushioning. We discussed the facility has a contract with a mulch service that provides maintenance. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Your facility has been placed in cohort 2. Your prep year is 7/1/24-6/30/25. Your reassessment year is 7/1/25-6/30/26. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 9/27/2023 Number Present: 19 Completed Date: 9/27/2023 Age: From 0 To 4 Total Minutes: 240 Time In: 09:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Heather McConnell, Administrator, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. McConnell was present and available to ask and answer questions. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-two percent (82%) as of 9/25/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc. is current/active as of 9/25/23. Permit type – Three (3) star license issued 11/12/19 Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 10/19/22. The last fire drill was practiced on 8/30/23. The last shelter-in-place drill was practiced on 8/8/23. The last playground inspection was documented on 8/30/23. The last fire inspection was approved on 10/21/22. The last sanitation inspection was conducted on 10/27/22 with thirteen (13) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The center’s Emergency Preparedness and Response plan was updated on 5/10/23. Upon arrival I was greeted by Ms. McConnell. In classroom space 5, children were engaged in play with mechanical toys and being soothed by caregivers. In classroom space 2, children were engaged in pretend play, eating and sharing play food with one another and singing with the caregiver. In classroom space 3, children were engaged in pretend play, dressing up in various garments. In classroom space 4, children were preparing to eat breakfast. Breakfast today consisted of graham crackers, raisins and milk. Interactions were positive and nurturing, supervision was adequate. Three (3) children’s files were monitored today. One (1) existing staff file was monitored today. There are no new staff. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 858 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 classroom space 4, baby wipes were stored in an area accessible to children. The wipes package contained a choking hazard warning. .0604(q) 1048 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, re-hire date 6/26/23, did not have a First Aid certificate on site. .1102(c) Technical assistance was provided as follows: Item #858 Plan to keep all plastic wipes containers stored five (5) feet or higher. This was corrected during the visit. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Item #1048 The one (1) staff must obtain an approved First Aid certificate immediately. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/11/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed the Epipen for the one (1) child in classroom space 4. The expiration for the Epipen is 7/2023. Plan to return the Epipen to the parent and request updated medication for the child. We discussed the mulch on the playground is beginning to be packed down. It will need to be raked to provide extra cushioning. We discussed the facility has a contract with a mulch service that provides maintenance. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Your facility has been placed in cohort 2. Your prep year is 7/1/24-6/30/25. Your reassessment year is 7/1/25-6/30/26. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 9/27/2023 Number Present: 19 Completed Date: 9/27/2023 Age: From 0 To 4 Total Minutes: 240 Time In: 09:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Heather McConnell, Administrator, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. McConnell was present and available to ask and answer questions. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-two percent (82%) as of 9/25/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc. is current/active as of 9/25/23. Permit type – Three (3) star license issued 11/12/19 Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 10/19/22. The last fire drill was practiced on 8/30/23. The last shelter-in-place drill was practiced on 8/8/23. The last playground inspection was documented on 8/30/23. The last fire inspection was approved on 10/21/22. The last sanitation inspection was conducted on 10/27/22 with thirteen (13) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The center’s Emergency Preparedness and Response plan was updated on 5/10/23. Upon arrival I was greeted by Ms. McConnell. In classroom space 5, children were engaged in play with mechanical toys and being soothed by caregivers. In classroom space 2, children were engaged in pretend play, eating and sharing play food with one another and singing with the caregiver. In classroom space 3, children were engaged in pretend play, dressing up in various garments. In classroom space 4, children were preparing to eat breakfast. Breakfast today consisted of graham crackers, raisins and milk. Interactions were positive and nurturing, supervision was adequate. Three (3) children’s files were monitored today. One (1) existing staff file was monitored today. There are no new staff. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 858 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 classroom space 4, baby wipes were stored in an area accessible to children. The wipes package contained a choking hazard warning. .0604(q) 1048 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, re-hire date 6/26/23, did not have a First Aid certificate on site. .1102(c) Technical assistance was provided as follows: Item #858 Plan to keep all plastic wipes containers stored five (5) feet or higher. This was corrected during the visit. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Item #1048 The one (1) staff must obtain an approved First Aid certificate immediately. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/11/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed the Epipen for the one (1) child in classroom space 4. The expiration for the Epipen is 7/2023. Plan to return the Epipen to the parent and request updated medication for the child. We discussed the mulch on the playground is beginning to be packed down. It will need to be raked to provide extra cushioning. We discussed the facility has a contract with a mulch service that provides maintenance. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Your facility has been placed in cohort 2. Your prep year is 7/1/24-6/30/25. Your reassessment year is 7/1/25-6/30/26. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: BUILDING BLOCKS CHILD CARE CENTER, INC. Facility ID: 11000627 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 9/27/2023 Number Present: 19 Completed Date: 9/27/2023 Age: From 0 To 4 Total Minutes: 240 Time In: 09:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Heather McConnell, Administrator, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. McConnell was present and available to ask and answer questions. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-two percent (82%) as of 9/25/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the business corporation, Building Blocks Child Care Center, Inc. is current/active as of 9/25/23. Permit type – Three (3) star license issued 11/12/19 Special Services/Restrictions – 1st shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 10/19/22. The last fire drill was practiced on 8/30/23. The last shelter-in-place drill was practiced on 8/8/23. The last playground inspection was documented on 8/30/23. The last fire inspection was approved on 10/21/22. The last sanitation inspection was conducted on 10/27/22 with thirteen (13) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The center’s Emergency Preparedness and Response plan was updated on 5/10/23. Upon arrival I was greeted by Ms. McConnell. In classroom space 5, children were engaged in play with mechanical toys and being soothed by caregivers. In classroom space 2, children were engaged in pretend play, eating and sharing play food with one another and singing with the caregiver. In classroom space 3, children were engaged in pretend play, dressing up in various garments. In classroom space 4, children were preparing to eat breakfast. Breakfast today consisted of graham crackers, raisins and milk. Interactions were positive and nurturing, supervision was adequate. Three (3) children’s files were monitored today. One (1) existing staff file was monitored today. There are no new staff. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 858 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 classroom space 4, baby wipes were stored in an area accessible to children. The wipes package contained a choking hazard warning. .0604(q) 1048 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, re-hire date 6/26/23, did not have a First Aid certificate on site. .1102(c) Technical assistance was provided as follows: Item #858 Plan to keep all plastic wipes containers stored five (5) feet or higher. This was corrected during the visit. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Item #1048 The one (1) staff must obtain an approved First Aid certificate immediately. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/11/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed the Epipen for the one (1) child in classroom space 4. The expiration for the Epipen is 7/2023. Plan to return the Epipen to the parent and request updated medication for the child. We discussed the mulch on the playground is beginning to be packed down. It will need to be raked to provide extra cushioning. We discussed the facility has a contract with a mulch service that provides maintenance. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Your facility has been placed in cohort 2. Your prep year is 7/1/24-6/30/25. Your reassessment year is 7/1/25-6/30/26. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times