Emmanuel Lutheran School

G.S. 110-90 · Violation

Name of Operation: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 6/26/2026 Number Present: 78 Completed Date: 6/26/2026 Age: From 0 To 6 Total Minutes: 145 Time In: 09:35 AM Time Out: 12:00 PM 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 unannounced visit follow-up. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to you. Today, Ms. Loria was available during the visit. Limited monitoring of child care requirements were conducted including but not limited to supervision, staff/child ratios, adequate/approved space, permit restrictions and staff records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-three (83) percent as of today prior to this visit. The program operates with a four-star center license issued on 6/20/19 with restrictions: daytime care, meets enhanced space, children under 2 ½ years old in rooms with direct exits only, meets reduced ratios. Upon arrival, I announced my presence and the purpose of the visit. During a walk-through following was verified: Center was in compliance with permit restrictions for use of approved/adequate space and all children under 2 ½ years old in rooms with direct exits only. Additionally, the care was only provided during daytime. Staff/child ratios: Space #1 (117): a group of six (6) children, an infant and one-year of age, were present with two (2) staff members. Space #2 (114): a group of ten (10) children, four-to-six years of age, were present with two (2) staff members. Space #3 (101): a group of seven (7) children, two-to-three years of age, were present with two (2) staff members Space #4 (102): a group of eleven (11) children, all three (3) of age, were present with three (3) staff members. Space #5 (103): a group of seven (7) children, two-to-three years of age, were present with two (2) staff members. Space #6 (203): a group of six (6) children, all two (2) years of age, were present with two (2) staff members. Space #7 (202): a group of (6) children, one-to-two years of age, were present with two (2) staff members. Space #8 (201): a group of three (3) children all one (1) year of age, were present with two (2) staff members. Space #9 (111): a group of ten (10) children, three-to-four years of age, were present with two (2) staff members. Space #10 (113): a group of twelve (12) children, four-to-five years of age, were present with two (2) staff members. Observation of children: In space #1, two (2) staff members attended to children in various ways. Two (2) children were in high chairs for morning snacks, while the other children were on the floor, crawling and walking around and exploring the environment and materials. One (1) staff member supervised the children in high chairs while the other staff member supervised the rest of the group. In space #2, a group of ten (10) children sat at the table and had breakfast. Some children packed their breakfast from home, and others had the meal provided by the center. Seven (7) children from space #3 and seven (7) children from space #5 had water play in the courtyard outside of their classrooms. Two (2) sprinklers and multiple water tables were set up. Children used cups and scooped the water and poured them in the grass area or in the water tables. Four (4) staff members were present and supervised the children. Eleven (11) children in space #4 engaged in free play with coloring materials, puzzles and other materials in the classroom. Three (3) staff members were present, interacted and supervised them. In space #6, a group of six (6) children engaged in free play. One (1) staff member sat with children and read books and interacted with them. The other staff member changed children’s diapers. In space #7, a group of six (6) children played on the playground. When two (2) children were in conflict over a toy, one (1) staff member intervened and facilitated the process. Children rode cars and played with balls and other accessories. In space #8, three (3) children engaged in free play. One (1) child had a pretend grape in the mouth, while others walked around/crawled and played with materials. Children in space #9 played on the playground. They climbed and sled on the slide and a climber, while others used pretend kitchen. One (1) staff member took two (2) children inside to use the bathroom during observation. In space #10, a group of twelve (12) children gathered in the group area and read books before transitioning outside. One (1) staff member supervised children while other staff member cleaned the tables and prepared a clipboard and backpack for outdoor play. Staff records were reviewed and Ms. Loria was interviewed: One (1) staff member’s criminal background letter and another staff member’s CPR/First Aid certificates were reviewed. One (1) staff member’s criminal background check expired on 6/10/26 and the application to renew the background check was submitted on 6/16/26. In the staff file, valid qualification was not present as the criminal background check is being processed currently per ABCMS review during today’s visit. The other staff file was reviewed for CPR/First Aid certificates. The staff completed Basic Life Support (BLS) training on 6/5/26 through American Heart Association. This staff is scheduled to complete CPR/First Aid training for adults and pediatrics on 6/27/26. 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 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). One (1) staff member's qualification letter expired on 6/10/26, and the application process was not started until 6/16/26. G.S. 110-90.2(b) & .2703(n)&(o) 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 member with employment date of 10/21/25 did not complete a required First Aid training within ninety (90) days of employment. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. A staff member with employment date of 10/21/25 did not complete a required CPR training within ninety (90) days. .1102(d) 1757 A valid qualification letter was not on file and available to review at the facility. One (1) staff member did not have a valid qualification letter on file. G.S. 110-90.2(b) & (d) & .2703(e) Technical assistance was provided as follows: Repeat violation1044: criminal background check renewal Prior to the expiration date of the qualification letter, the child care provide shall complete and submit required forms to complete a criminal background check. ABCMS record indicated that M. Peach completed and submitted an application to renew the criminal background check on 6/16/26. The qualification letter expired on 6/10/26. This upcoming expiration date of qualification letter for M. Peach was reminded under consultation during a routine unannounced visit conducted on 6/2/26. Ms. Loria stated that she had enlisted help with keeping track of background checks and training hours for her staff members on the compliance statement submitted on 6/16/26. During today’s visit, Ms. Loria shared her Excel tracking sheet for staff criminal background checks. She explained that managing all administrative tasks on her own had resulted in some renewal dates being missed. Beginning in August, an Administrative Assistant will be joining the team, and Ms. Loria anticipates that this added support will improve the management of tracking responsibilities. Based on this violation being a repeat violation, you may be considered administrative action. Repeat violation 1757: valid qualification letter on file A valid qualification letter must be on file and available for review. To comply, a valid qualification letter for M. Peach must be printed and filed on his/her staff file. In your compliance letter, please verify that the qualification letter for M. Peach was printed and filed. Per ABCMS, a qualification letter had not been issued as of today. The staff member has up to fifteen (15) days to complete the criminal background renewal process. If the valid qualification letter is not issued, printed and filed by July 11, 2026, M. Peach cannot report to work starting July 13, 2026, until qualification letter is issued. 1048: First Aid training First aid training must be completed within ninety (90) days of employment, and the certification must continue to be current thereafter. To comply, K. Greene must complete first aid training by an approved agency for the ages program serving, print the certificates and maintain them on his/her staff file. Per Ms. Loria, K. Greene is scheduled to complete First Aid training on 6/27/26. In your compliance letter, please verify that the CPR/First Aid training was completed and the certificates were filed. 1049: CPR training: CPR training must be completed within ninety (90) days of employment, and the certification must continue to be current thereafter. This violation was cited due to a staff member with an employment date of 10/21/25 did not complete a CPR training on or prior to 1/19/26. K. Greene completed Basic Life Support training that included CPR training on 6/5/26. Therefore, this violation was marked corrected during visit. 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 7/10/26. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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 briefly discussed QRIS during today’s visit. Due to accreditation process taking longer than expected, the program will renew the Rated License Assessment with pathway 2 – Classroom and Instructional Quality Pathway. The program will use Teaching Strategies Gold as its formative assessment tool. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 6/26/2026 Number Present: 78 Completed Date: 6/26/2026 Age: From 0 To 6 Total Minutes: 145 Time In: 09:35 AM Time Out: 12:00 PM 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 unannounced visit follow-up. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to you. Today, Ms. Loria was available during the visit. Limited monitoring of child care requirements were conducted including but not limited to supervision, staff/child ratios, adequate/approved space, permit restrictions and staff records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-three (83) percent as of today prior to this visit. The program operates with a four-star center license issued on 6/20/19 with restrictions: daytime care, meets enhanced space, children under 2 ½ years old in rooms with direct exits only, meets reduced ratios. Upon arrival, I announced my presence and the purpose of the visit. During a walk-through following was verified: Center was in compliance with permit restrictions for use of approved/adequate space and all children under 2 ½ years old in rooms with direct exits only. Additionally, the care was only provided during daytime. Staff/child ratios: Space #1 (117): a group of six (6) children, an infant and one-year of age, were present with two (2) staff members. Space #2 (114): a group of ten (10) children, four-to-six years of age, were present with two (2) staff members. Space #3 (101): a group of seven (7) children, two-to-three years of age, were present with two (2) staff members Space #4 (102): a group of eleven (11) children, all three (3) of age, were present with three (3) staff members. Space #5 (103): a group of seven (7) children, two-to-three years of age, were present with two (2) staff members. Space #6 (203): a group of six (6) children, all two (2) years of age, were present with two (2) staff members. Space #7 (202): a group of (6) children, one-to-two years of age, were present with two (2) staff members. Space #8 (201): a group of three (3) children all one (1) year of age, were present with two (2) staff members. Space #9 (111): a group of ten (10) children, three-to-four years of age, were present with two (2) staff members. Space #10 (113): a group of twelve (12) children, four-to-five years of age, were present with two (2) staff members. Observation of children: In space #1, two (2) staff members attended to children in various ways. Two (2) children were in high chairs for morning snacks, while the other children were on the floor, crawling and walking around and exploring the environment and materials. One (1) staff member supervised the children in high chairs while the other staff member supervised the rest of the group. In space #2, a group of ten (10) children sat at the table and had breakfast. Some children packed their breakfast from home, and others had the meal provided by the center. Seven (7) children from space #3 and seven (7) children from space #5 had water play in the courtyard outside of their classrooms. Two (2) sprinklers and multiple water tables were set up. Children used cups and scooped the water and poured them in the grass area or in the water tables. Four (4) staff members were present and supervised the children. Eleven (11) children in space #4 engaged in free play with coloring materials, puzzles and other materials in the classroom. Three (3) staff members were present, interacted and supervised them. In space #6, a group of six (6) children engaged in free play. One (1) staff member sat with children and read books and interacted with them. The other staff member changed children’s diapers. In space #7, a group of six (6) children played on the playground. When two (2) children were in conflict over a toy, one (1) staff member intervened and facilitated the process. Children rode cars and played with balls and other accessories. In space #8, three (3) children engaged in free play. One (1) child had a pretend grape in the mouth, while others walked around/crawled and played with materials. Children in space #9 played on the playground. They climbed and sled on the slide and a climber, while others used pretend kitchen. One (1) staff member took two (2) children inside to use the bathroom during observation. In space #10, a group of twelve (12) children gathered in the group area and read books before transitioning outside. One (1) staff member supervised children while other staff member cleaned the tables and prepared a clipboard and backpack for outdoor play. Staff records were reviewed and Ms. Loria was interviewed: One (1) staff member’s criminal background letter and another staff member’s CPR/First Aid certificates were reviewed. One (1) staff member’s criminal background check expired on 6/10/26 and the application to renew the background check was submitted on 6/16/26. In the staff file, valid qualification was not present as the criminal background check is being processed currently per ABCMS review during today’s visit. The other staff file was reviewed for CPR/First Aid certificates. The staff completed Basic Life Support (BLS) training on 6/5/26 through American Heart Association. This staff is scheduled to complete CPR/First Aid training for adults and pediatrics on 6/27/26. 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 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). One (1) staff member's qualification letter expired on 6/10/26, and the application process was not started until 6/16/26. G.S. 110-90.2(b) & .2703(n)&(o) 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 member with employment date of 10/21/25 did not complete a required First Aid training within ninety (90) days of employment. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. A staff member with employment date of 10/21/25 did not complete a required CPR training within ninety (90) days. .1102(d) 1757 A valid qualification letter was not on file and available to review at the facility. One (1) staff member did not have a valid qualification letter on file. G.S. 110-90.2(b) & (d) & .2703(e) Technical assistance was provided as follows: Repeat violation1044: criminal background check renewal Prior to the expiration date of the qualification letter, the child care provide shall complete and submit required forms to complete a criminal background check. ABCMS record indicated that M. Peach completed and submitted an application to renew the criminal background check on 6/16/26. The qualification letter expired on 6/10/26. This upcoming expiration date of qualification letter for M. Peach was reminded under consultation during a routine unannounced visit conducted on 6/2/26. Ms. Loria stated that she had enlisted help with keeping track of background checks and training hours for her staff members on the compliance statement submitted on 6/16/26. During today’s visit, Ms. Loria shared her Excel tracking sheet for staff criminal background checks. She explained that managing all administrative tasks on her own had resulted in some renewal dates being missed. Beginning in August, an Administrative Assistant will be joining the team, and Ms. Loria anticipates that this added support will improve the management of tracking responsibilities. Based on this violation being a repeat violation, you may be considered administrative action. Repeat violation 1757: valid qualification letter on file A valid qualification letter must be on file and available for review. To comply, a valid qualification letter for M. Peach must be printed and filed on his/her staff file. In your compliance letter, please verify that the qualification letter for M. Peach was printed and filed. Per ABCMS, a qualification letter had not been issued as of today. The staff member has up to fifteen (15) days to complete the criminal background renewal process. If the valid qualification letter is not issued, printed and filed by July 11, 2026, M. Peach cannot report to work starting July 13, 2026, until qualification letter is issued. 1048: First Aid training First aid training must be completed within ninety (90) days of employment, and the certification must continue to be current thereafter. To comply, K. Greene must complete first aid training by an approved agency for the ages program serving, print the certificates and maintain them on his/her staff file. Per Ms. Loria, K. Greene is scheduled to complete First Aid training on 6/27/26. In your compliance letter, please verify that the CPR/First Aid training was completed and the certificates were filed. 1049: CPR training: CPR training must be completed within ninety (90) days of employment, and the certification must continue to be current thereafter. This violation was cited due to a staff member with an employment date of 10/21/25 did not complete a CPR training on or prior to 1/19/26. K. Greene completed Basic Life Support training that included CPR training on 6/5/26. Therefore, this violation was marked corrected during visit. 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 7/10/26. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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 briefly discussed QRIS during today’s visit. Due to accreditation process taking longer than expected, the program will renew the Rated License Assessment with pathway 2 – Classroom and Instructional Quality Pathway. The program will use Teaching Strategies Gold as its formative assessment tool. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 6/2/2026 Number Present: 104 Completed Date: 6/2/2026 Age: From 0 To 6 Total Minutes: 437 Time In: 09:20 AM Time Out: 04:37 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 Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to you. Today, Ms. Loria was available during the visit. 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-one (81) percent as of today prior to this visit. Permit type – four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space, children under 2 ½ years old in rooms with direct exits only, meets reduced ratios. The last annual compliance visit was conducted on 10/30/25. The last fire drill was practiced on 5/28/26. The last lockdown drill was practiced on 4/13/26. The last playground inspection was documented on 5/8/26. The last fire inspection was approved on 3/13/26 but was completed on the wrong form. I requested Ms. Loria to obtain fire inspection on the correct form. The last sanitation inspection was conducted on 3/11/26 with seven (7) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum is Creative Curriculum. Lead water testing was completed on 1/8/24 without hazards. Lead paint has no records. Asbestos testing was completed on 4/9/26. Twenty-six (26) staff members were listed on the Automated Criminal Background Check Management System (ABCMS). Upon arrival, I announced my presence and the purpose of the visit. Walk-through: In space #1 (117), a group of seven (7) children, infants and one (1) year of age, were present with two (2) staff members. Five (5) children, all one (1) were strapped on the Bye-Bye Buggy and went for a walk while, two (2) infants remained in the classroom with one (1) staff member. One (1) child’s diaper was changed while the other child crawled in the classroom. In space #2 (114), a group of thirteen (13) children, four-to-six year of age, were present with two (2) staff members. The child who was six (6) had not started elementary school. Children transitioned from bathroom to the classroom. Upon arrival in the classroom, children were instructed to join the group discussion. A permission form for Benadryl was on file for a child, but medicine was not brought in, according to a staff member. The same child had allergy to a food item, but not severe enough for epi-pen. In space #3 (101), a group of seven (7) children, two (2) to three (3) years of age, were present with one (1) staff member. The children transitioned from playground to inside. They held a walking rope and followed the staff member. Upon arrival in the classroom, children took turns and washed their hands before transitioning to free play. In space #4 (102) a group of fourteen (14) children, two (2) and three (3) years of age, were present with two (2) staff members. Children participated in group dance/song led by a staff member, while the other staff member changed a child’s clothes. In space #5 (103) a group of twelve (12) children, two (2) and three (3) years of age, were present with two (2) staff members. During observation, children played with pretend cars, housekeeping materials and manipulatives. Two (2) children asked for morning snacks and had them at the table. One (1) staff member took seven (7) children to the playground while one (1) staff member kept five (5) children in the classroom until two (2) of them finished the snacks. In space #6 (203), a group of nine (9) children, all two (2) years old, were present with two (2) staff members. In space #7 (202), a group of seven (7) children, one (1) and two (2) years of age, were present with two (2) staff members. Children from space #6 and #7 played together on the infant/toddler playground. Children engaged in gross motor play with balls, slides, riding toys. In space #8 (201), a group of seven (7) children, all one (1) year of age, were present with two (2) staff members. In space #9 (111), a group of twelve (12) children, three (3) and four (4) years of age, were present with two (2) staff members. During observation, one (1) staff member took three (3) children to the bathroom, while the other staff member cared for nine (9) children. Children played with camp accessories, such as pretend s’mores, pretend camp hire, grill, etc., playdough, manipulatives, sand and other materials. There is a small patio area outside between space #9 and #10. During today’s visit, I noticed that children’s drawings were on the concrete and there were some equipment, such as children’s chair, table, pretend kitchen, car track, etc. Per staff member in space #9, some children in #9 and #10 sometimes play in the area. Per Ms. Loria, a small group of children had played in space. A narrow walkway connects the front entrance of the building and the patio. Two (2) air-conditioning units were accessible to the children by the walkway. Top areas of the air-conditioning units were not covered with protectors. In space #10 (113), a group of fifteen (15) children, three-to-five year of age, were present with two (2) staff members. The children sat at the tables and had morning snacks – blueberry muffins and milk were served. After snacks, children cleaned up food, washed their hands and joined group time. Diaper creams, sunscreens, emergency medications and over-the-counter medications were maintained in the classrooms, and all of their product’s expiration, permission forms, action plans were valid. Interaction and supervision were adequate. Two (2) playgrounds were monitored. No safety hazards were found on the infant/toddler playground. On preschool playground, mulch under the climber tunnel was measured for six (6) inches. However, it may need to be fluffed in some sections. There is a shed on the preschool playground where play equipment was maintained. There was a lock on the shed. Due to damaged doors, it created opening between two (2) doors. The opening was as wide as 4 ½ inches. During observation, twelve (12) children from room 103, fourteen (14) children from room 102 were present on the preschool playground. Children ran on the bike tracks, climbed on a climber, played pretend house with mulch and pretend kitchen equipment and a slide. Later, twelve (12) children from room 111 joined the playground. One (1) of the children asked one (1) of the staff members for a truck. The staff member unlocked the shed and pulled three (3) riding/push toys, three (3) tricycles, one (1) scooter, some blocks and two (2) small toy vehicles. Staff files: Four (4) new staff files were monitored in full and Twenty-three (23) existing staff files were monitored partially for criminal background letters, CPR/First Aid certificates and ITS/SIDS certificates. Staff and training worksheet was submitted by Ms. Loria for new staff members during today's visit. The following discrepancies were noted. G. Noell (sub): HQ: 3/22/26 EI: 3/22/26 Application: 3/16/26 EMC/EPR review: 3/23/26 M. Kucin (floater): Application- 4/1/26 EPR/EMC review – 4/21/26 J. Chambers (T): EMC/EPR review – 3/10/26 HQ – 3/5/26 EI: 3/5/26 Medical exam – 3/6/26 Application – 3/5/26 Existing staff members files were monitored for the followings: CBC expiration date: F. Norton (Fl) – 3/16/27 F. Noell (Lt) – 2/24/28 V. Milner (LT) – 4/19/26* Per ABCMS, qualification letter is valid through 5/26/31. Application process started on 5/18/26. C. McCormick – 2/9/28 T) N. Loria- 3/17/27 P. Jones (LT)- 12/22/27 H. Hensley (T) - 12/3/29 K. Greene (T) -2/24/31 C. Green (T)– 5/21/26* Per ABCMS, qualification letter is valid through 5/26/31. CBC application started on 5/18/26. D. Castillo (LT)- 9/5/30 R. Bishop (T) - 8/1/30 M. Bennett (K, FL)- 8/7/29 H. Beck (T) - 6/3/26* Per ABCMS, qualification letter is valid through 6/3/26. Application process was started on 5/22/26. A. Bair (LT) - 8/17/27 C. Whittemore (sub)- 5/1/30 K. Warren (K, Front Desk)- 2/3/27 B. Swatzell (LT) - 5/4/27 C. Smith (sub)- 5/21/26* Per ABCMS, the qualification letter is expired and no application process has been started. L. Smathers (LT) -4/17/30 R. Rutherford (LT)– 2/23/31 J. Riddle (T)a - 8/7/30 M. Rice (LT)- 10/21/27 M. Peach (LT)- 6/10/26* Per ABCMS, no application process has been started. CPR/First Aid expiration date: F. Norton - 8/13/26 F. Noell - 3/22/27 V. Milner – 9/2027 C. McCormick - 6/21/27 N. Loria – 08/2026 P. Jones – 8/13/26 H. Hensley – 02/2027 K. Greene – no certificates on file* CPR/First Aid training scheduled on June 5, 2026. C. Green – 8/13/26 D. Castillo – 8/13/26 R. Bishop - 09/2027 M. Bennett - 8/13/26 H. Beck- 8/13/26 A. Bair- 2/22/27 C. Whittemore- 09/2027 K. Warren- 8/13/26 B. Swatzell – 8/13/26 C. Smith - 08/2026 L. Smathers – 8/13/26 J. Herman - 09/2027 R. Rutherford – 8/13/26 J. Riddle – 09/2027 M. Rice -8/26/27 M. Peach - 09/2027 ITS/SIDS expiration date: F. Norton – 8/5/28 F. Noell – 8/5/28 V. Milner – 8/5/28 C. McCormick – 2/27/26* N. Loria – 8/5/28 P. Jones – 8/5/28 C. Green – 8/5/28 D. Castillo-8/5/28 M. Bennett - 8/5/26 H. Beck- 8/5/26 A. Bair-8/5/26 K. Warren - 8/5/26 B. Swatzell – 8/5/26 L. Smathers - 8/5/25 R. Rutherford - 8/8/25 M. Rice - 1/29/28 M. Peach -8/5/26 R. Bishop – 8/5/28 J. Sherman – 3/19/27 N. Loria: EPR training – 8/19 and 8/21/24 Playground Safety training -11/20/24 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 434 The materials and equipment indoors and outdoors were not sufficient to provide a variety of play experiences to promote the children's emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development. One (1) slide structure, (1) climber tunnel, pretend kitchen with a few pretend dishes were available on the playground for twenty-six (26) children. When additional twelve (12) children joined, two (2) riding/pushing toys, three (3) tricycles, one (1) scooter, some blocks and two (2) small vehicle toys were pulled for children in addition to the permanent structure. Sufficient materials were not available for the thirty-eight (38) children present on the playground. 10A NCAC 09 .0509(2) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. The lock for the shed on the preschool playground created openings between doors as wide as 4 1/2 inches. .0605(g) 828 Air conditioning units were accessible or did not have a guard to keep objects from being thrown into the unit. Two (2) air-conditioning units in the walk path that connects the outside patio between room 111 and 113 were accessible to the children, and the top fans were not covered by guards. .0604 (m) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). Four (4) staff members did not complete the criminal background renewal process prior to the expiration dates of their qualification letters. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. Valid qualification letters were not on file for four (4) staff members. G.S. 110-90.2(b) & (d) & .2703(e) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Ten (10) existing staff members had not been added to the roster, and the seven (7) staff members who were separated from the program had not been removed from the roster. G.S. 110-90.2 & .2703(r) Technical assistance was provided as follows: 434: sufficient material and equipment for variety of learning experience The materials and equipment indoors and outdoors must be sufficient to provide a variety of play experiences to promote the children's emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development. Few equipment and materials lead to conflicts among children and safety concerns as most children gather in the same area on the playground. Sufficient quantities of materials and equipment must be available for children to promote not only gross motor development but also health emotional/social development, approaches to play and learning, language/communication and other areas. To comply, either reduce the number of children on the playground at the same time by creating a playground rotation schedule or bring variety of materials to the playground. 714: Entrapment hazards Openings in equipment, steps, decks, handrails, and fencing shall be less than 3 1/2” or greater than 9”. The shed for playground equipment in preschool playground had a lock, but the door was not closed all the way, creating openings, as wide as 4 ½ inches. To comply, the shed must be closed all the way. In your compliance letter, please state the action you took to meet the compliance. 828: air-conditioning unit The air conditioning units were accessible to children and were not fitted with guards to prevent objects from being thrown into them. Two (2) air conditioning units were located along the walkway leading to classrooms 113 and 111. To comply, air conditioning units must be located so they are not accessible to children or must be fitted with a mesh guard that prevents objects from being thrown into the units. To address this issue, you may install barriers or fencing around the air conditioning units to restrict children's access along the walkway. Alternatively, you may choose not to use the auxiliary outdoor space adjacent to classrooms 113 and 111 as part of the children's activity area. In your compliance letter, please state the action you took to achieve compliance. 1044: CBC process Prior to expiration date of the qualification letter, the child care provider must complete and submit required forms to complete a criminal background check. The following staff member did not complete the criminal background process prior to expiration dates of the qualification letter: C. Smith, H. Beck, C. Green and V. Milner To comply, staff members must start the criminal background renewal process weeks in advance to make sure that their qualifications letters are renewed prior to expiration date. In your compliance letter, please state how you will prevent this violation in detail. 1757: Criminal background check Valid qualification letter must be on file for each staff member at all times. To comply, the following staff members’ qualification letters must be printed and filed: C. Green and V. Milner Additionally, the following staff member must complete the criminal background application process, print the qualification letter and file: C. Smith and H. Beck C. Smith and H. Beck have fifteen (15) days (through the end of June 17, 2026, to complete the criminal background process. If the process is not completed and the staff members’ criminal background letters are not on file by the end of June 17, 2026, above staff members may not be present on-site until valid qualification letters are issued. In your compliance letter, please verify the completion of task that include printing qualification letters for C. Green, V. Milner, C. Smith and H. Beck and filing them in their staff files. 1805: ABCMS roster New employees, including all staff members including cooks, floaters and substitutes must be listed on the ABCMS system within five (5) days of employment. All employees who are separated from the program must also be reported to the system within five (5) business days. To comply, The following staff members must be listed on the ABCMS system: M. Kucin J. Chambers F. Norton V. Milner K. Greene M. Bennett A. Bair H. Beck C. Smith J. Sherman Additionally, please remove the following staff members from the roster: A. Hendryx D. Little C. Mashburn M. McDonald T. Oliver M. Swaney L. Wooten 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 6/16/26. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Reminder: M. Peach– criminal background letter will expire on 6/10/26. Please renew the qualification letter without delays. Auxiliary space: Some Auxiliary space can be accessed by children, even though it is not licensed if children are permitted by parents to be outside of the fenced area. However, this shall not be frequently done, as regulatory accessed space must be licensed. Auxiliary space can be visited a few times/years for special events or occasional special lessons. QIRS discussion: Per conversation with Ms. Loria, she disclosed that the program is considering renewing the Rated License Assessment with pathway 2- Instructional and Classroom Quality Pathway. The program is still going through NECAP Accreditation. In order to receive on-site visits required for NECAP accreditation, the program is required to submit the request for on-site visit by the end of June 2026. Ms. Loria does not think that the program will be ready to do so yet. The program is considering purchasing Teaching Strategies Gold. Growing Meal: Starting next school year, the program will not cook on-site. Parents can choose to pack their children’s lunch or order through Growing Meal. Ms. Loria will work with Growing Meal to discuss nutrition requirements. Administrative Action: A repeat violation of the criminal background check requirement for two consecutive visits may result in an administrative action warrant. 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 .3222 (c) If employment-related changes occur at a facility that result in noncompliance with or failure to meet the standards in the Section for the star rating issued, the operator shall correct the noncompliance within six months. If the operator does not correct the noncompliance within six months, 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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 .0509 · Violation

Name of Operation: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 6/2/2026 Number Present: 104 Completed Date: 6/2/2026 Age: From 0 To 6 Total Minutes: 437 Time In: 09:20 AM Time Out: 04:37 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 Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to you. Today, Ms. Loria was available during the visit. 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-one (81) percent as of today prior to this visit. Permit type – four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space, children under 2 ½ years old in rooms with direct exits only, meets reduced ratios. The last annual compliance visit was conducted on 10/30/25. The last fire drill was practiced on 5/28/26. The last lockdown drill was practiced on 4/13/26. The last playground inspection was documented on 5/8/26. The last fire inspection was approved on 3/13/26 but was completed on the wrong form. I requested Ms. Loria to obtain fire inspection on the correct form. The last sanitation inspection was conducted on 3/11/26 with seven (7) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum is Creative Curriculum. Lead water testing was completed on 1/8/24 without hazards. Lead paint has no records. Asbestos testing was completed on 4/9/26. Twenty-six (26) staff members were listed on the Automated Criminal Background Check Management System (ABCMS). Upon arrival, I announced my presence and the purpose of the visit. Walk-through: In space #1 (117), a group of seven (7) children, infants and one (1) year of age, were present with two (2) staff members. Five (5) children, all one (1) were strapped on the Bye-Bye Buggy and went for a walk while, two (2) infants remained in the classroom with one (1) staff member. One (1) child’s diaper was changed while the other child crawled in the classroom. In space #2 (114), a group of thirteen (13) children, four-to-six year of age, were present with two (2) staff members. The child who was six (6) had not started elementary school. Children transitioned from bathroom to the classroom. Upon arrival in the classroom, children were instructed to join the group discussion. A permission form for Benadryl was on file for a child, but medicine was not brought in, according to a staff member. The same child had allergy to a food item, but not severe enough for epi-pen. In space #3 (101), a group of seven (7) children, two (2) to three (3) years of age, were present with one (1) staff member. The children transitioned from playground to inside. They held a walking rope and followed the staff member. Upon arrival in the classroom, children took turns and washed their hands before transitioning to free play. In space #4 (102) a group of fourteen (14) children, two (2) and three (3) years of age, were present with two (2) staff members. Children participated in group dance/song led by a staff member, while the other staff member changed a child’s clothes. In space #5 (103) a group of twelve (12) children, two (2) and three (3) years of age, were present with two (2) staff members. During observation, children played with pretend cars, housekeeping materials and manipulatives. Two (2) children asked for morning snacks and had them at the table. One (1) staff member took seven (7) children to the playground while one (1) staff member kept five (5) children in the classroom until two (2) of them finished the snacks. In space #6 (203), a group of nine (9) children, all two (2) years old, were present with two (2) staff members. In space #7 (202), a group of seven (7) children, one (1) and two (2) years of age, were present with two (2) staff members. Children from space #6 and #7 played together on the infant/toddler playground. Children engaged in gross motor play with balls, slides, riding toys. In space #8 (201), a group of seven (7) children, all one (1) year of age, were present with two (2) staff members. In space #9 (111), a group of twelve (12) children, three (3) and four (4) years of age, were present with two (2) staff members. During observation, one (1) staff member took three (3) children to the bathroom, while the other staff member cared for nine (9) children. Children played with camp accessories, such as pretend s’mores, pretend camp hire, grill, etc., playdough, manipulatives, sand and other materials. There is a small patio area outside between space #9 and #10. During today’s visit, I noticed that children’s drawings were on the concrete and there were some equipment, such as children’s chair, table, pretend kitchen, car track, etc. Per staff member in space #9, some children in #9 and #10 sometimes play in the area. Per Ms. Loria, a small group of children had played in space. A narrow walkway connects the front entrance of the building and the patio. Two (2) air-conditioning units were accessible to the children by the walkway. Top areas of the air-conditioning units were not covered with protectors. In space #10 (113), a group of fifteen (15) children, three-to-five year of age, were present with two (2) staff members. The children sat at the tables and had morning snacks – blueberry muffins and milk were served. After snacks, children cleaned up food, washed their hands and joined group time. Diaper creams, sunscreens, emergency medications and over-the-counter medications were maintained in the classrooms, and all of their product’s expiration, permission forms, action plans were valid. Interaction and supervision were adequate. Two (2) playgrounds were monitored. No safety hazards were found on the infant/toddler playground. On preschool playground, mulch under the climber tunnel was measured for six (6) inches. However, it may need to be fluffed in some sections. There is a shed on the preschool playground where play equipment was maintained. There was a lock on the shed. Due to damaged doors, it created opening between two (2) doors. The opening was as wide as 4 ½ inches. During observation, twelve (12) children from room 103, fourteen (14) children from room 102 were present on the preschool playground. Children ran on the bike tracks, climbed on a climber, played pretend house with mulch and pretend kitchen equipment and a slide. Later, twelve (12) children from room 111 joined the playground. One (1) of the children asked one (1) of the staff members for a truck. The staff member unlocked the shed and pulled three (3) riding/push toys, three (3) tricycles, one (1) scooter, some blocks and two (2) small toy vehicles. Staff files: Four (4) new staff files were monitored in full and Twenty-three (23) existing staff files were monitored partially for criminal background letters, CPR/First Aid certificates and ITS/SIDS certificates. Staff and training worksheet was submitted by Ms. Loria for new staff members during today's visit. The following discrepancies were noted. G. Noell (sub): HQ: 3/22/26 EI: 3/22/26 Application: 3/16/26 EMC/EPR review: 3/23/26 M. Kucin (floater): Application- 4/1/26 EPR/EMC review – 4/21/26 J. Chambers (T): EMC/EPR review – 3/10/26 HQ – 3/5/26 EI: 3/5/26 Medical exam – 3/6/26 Application – 3/5/26 Existing staff members files were monitored for the followings: CBC expiration date: F. Norton (Fl) – 3/16/27 F. Noell (Lt) – 2/24/28 V. Milner (LT) – 4/19/26* Per ABCMS, qualification letter is valid through 5/26/31. Application process started on 5/18/26. C. McCormick – 2/9/28 T) N. Loria- 3/17/27 P. Jones (LT)- 12/22/27 H. Hensley (T) - 12/3/29 K. Greene (T) -2/24/31 C. Green (T)– 5/21/26* Per ABCMS, qualification letter is valid through 5/26/31. CBC application started on 5/18/26. D. Castillo (LT)- 9/5/30 R. Bishop (T) - 8/1/30 M. Bennett (K, FL)- 8/7/29 H. Beck (T) - 6/3/26* Per ABCMS, qualification letter is valid through 6/3/26. Application process was started on 5/22/26. A. Bair (LT) - 8/17/27 C. Whittemore (sub)- 5/1/30 K. Warren (K, Front Desk)- 2/3/27 B. Swatzell (LT) - 5/4/27 C. Smith (sub)- 5/21/26* Per ABCMS, the qualification letter is expired and no application process has been started. L. Smathers (LT) -4/17/30 R. Rutherford (LT)– 2/23/31 J. Riddle (T)a - 8/7/30 M. Rice (LT)- 10/21/27 M. Peach (LT)- 6/10/26* Per ABCMS, no application process has been started. CPR/First Aid expiration date: F. Norton - 8/13/26 F. Noell - 3/22/27 V. Milner – 9/2027 C. McCormick - 6/21/27 N. Loria – 08/2026 P. Jones – 8/13/26 H. Hensley – 02/2027 K. Greene – no certificates on file* CPR/First Aid training scheduled on June 5, 2026. C. Green – 8/13/26 D. Castillo – 8/13/26 R. Bishop - 09/2027 M. Bennett - 8/13/26 H. Beck- 8/13/26 A. Bair- 2/22/27 C. Whittemore- 09/2027 K. Warren- 8/13/26 B. Swatzell – 8/13/26 C. Smith - 08/2026 L. Smathers – 8/13/26 J. Herman - 09/2027 R. Rutherford – 8/13/26 J. Riddle – 09/2027 M. Rice -8/26/27 M. Peach - 09/2027 ITS/SIDS expiration date: F. Norton – 8/5/28 F. Noell – 8/5/28 V. Milner – 8/5/28 C. McCormick – 2/27/26* N. Loria – 8/5/28 P. Jones – 8/5/28 C. Green – 8/5/28 D. Castillo-8/5/28 M. Bennett - 8/5/26 H. Beck- 8/5/26 A. Bair-8/5/26 K. Warren - 8/5/26 B. Swatzell – 8/5/26 L. Smathers - 8/5/25 R. Rutherford - 8/8/25 M. Rice - 1/29/28 M. Peach -8/5/26 R. Bishop – 8/5/28 J. Sherman – 3/19/27 N. Loria: EPR training – 8/19 and 8/21/24 Playground Safety training -11/20/24 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 434 The materials and equipment indoors and outdoors were not sufficient to provide a variety of play experiences to promote the children's emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development. One (1) slide structure, (1) climber tunnel, pretend kitchen with a few pretend dishes were available on the playground for twenty-six (26) children. When additional twelve (12) children joined, two (2) riding/pushing toys, three (3) tricycles, one (1) scooter, some blocks and two (2) small vehicle toys were pulled for children in addition to the permanent structure. Sufficient materials were not available for the thirty-eight (38) children present on the playground. 10A NCAC 09 .0509(2) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. The lock for the shed on the preschool playground created openings between doors as wide as 4 1/2 inches. .0605(g) 828 Air conditioning units were accessible or did not have a guard to keep objects from being thrown into the unit. Two (2) air-conditioning units in the walk path that connects the outside patio between room 111 and 113 were accessible to the children, and the top fans were not covered by guards. .0604 (m) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). Four (4) staff members did not complete the criminal background renewal process prior to the expiration dates of their qualification letters. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. Valid qualification letters were not on file for four (4) staff members. G.S. 110-90.2(b) & (d) & .2703(e) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Ten (10) existing staff members had not been added to the roster, and the seven (7) staff members who were separated from the program had not been removed from the roster. G.S. 110-90.2 & .2703(r) Technical assistance was provided as follows: 434: sufficient material and equipment for variety of learning experience The materials and equipment indoors and outdoors must be sufficient to provide a variety of play experiences to promote the children's emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development. Few equipment and materials lead to conflicts among children and safety concerns as most children gather in the same area on the playground. Sufficient quantities of materials and equipment must be available for children to promote not only gross motor development but also health emotional/social development, approaches to play and learning, language/communication and other areas. To comply, either reduce the number of children on the playground at the same time by creating a playground rotation schedule or bring variety of materials to the playground. 714: Entrapment hazards Openings in equipment, steps, decks, handrails, and fencing shall be less than 3 1/2” or greater than 9”. The shed for playground equipment in preschool playground had a lock, but the door was not closed all the way, creating openings, as wide as 4 ½ inches. To comply, the shed must be closed all the way. In your compliance letter, please state the action you took to meet the compliance. 828: air-conditioning unit The air conditioning units were accessible to children and were not fitted with guards to prevent objects from being thrown into them. Two (2) air conditioning units were located along the walkway leading to classrooms 113 and 111. To comply, air conditioning units must be located so they are not accessible to children or must be fitted with a mesh guard that prevents objects from being thrown into the units. To address this issue, you may install barriers or fencing around the air conditioning units to restrict children's access along the walkway. Alternatively, you may choose not to use the auxiliary outdoor space adjacent to classrooms 113 and 111 as part of the children's activity area. In your compliance letter, please state the action you took to achieve compliance. 1044: CBC process Prior to expiration date of the qualification letter, the child care provider must complete and submit required forms to complete a criminal background check. The following staff member did not complete the criminal background process prior to expiration dates of the qualification letter: C. Smith, H. Beck, C. Green and V. Milner To comply, staff members must start the criminal background renewal process weeks in advance to make sure that their qualifications letters are renewed prior to expiration date. In your compliance letter, please state how you will prevent this violation in detail. 1757: Criminal background check Valid qualification letter must be on file for each staff member at all times. To comply, the following staff members’ qualification letters must be printed and filed: C. Green and V. Milner Additionally, the following staff member must complete the criminal background application process, print the qualification letter and file: C. Smith and H. Beck C. Smith and H. Beck have fifteen (15) days (through the end of June 17, 2026, to complete the criminal background process. If the process is not completed and the staff members’ criminal background letters are not on file by the end of June 17, 2026, above staff members may not be present on-site until valid qualification letters are issued. In your compliance letter, please verify the completion of task that include printing qualification letters for C. Green, V. Milner, C. Smith and H. Beck and filing them in their staff files. 1805: ABCMS roster New employees, including all staff members including cooks, floaters and substitutes must be listed on the ABCMS system within five (5) days of employment. All employees who are separated from the program must also be reported to the system within five (5) business days. To comply, The following staff members must be listed on the ABCMS system: M. Kucin J. Chambers F. Norton V. Milner K. Greene M. Bennett A. Bair H. Beck C. Smith J. Sherman Additionally, please remove the following staff members from the roster: A. Hendryx D. Little C. Mashburn M. McDonald T. Oliver M. Swaney L. Wooten 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 6/16/26. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Reminder: M. Peach– criminal background letter will expire on 6/10/26. Please renew the qualification letter without delays. Auxiliary space: Some Auxiliary space can be accessed by children, even though it is not licensed if children are permitted by parents to be outside of the fenced area. However, this shall not be frequently done, as regulatory accessed space must be licensed. Auxiliary space can be visited a few times/years for special events or occasional special lessons. QIRS discussion: Per conversation with Ms. Loria, she disclosed that the program is considering renewing the Rated License Assessment with pathway 2- Instructional and Classroom Quality Pathway. The program is still going through NECAP Accreditation. In order to receive on-site visits required for NECAP accreditation, the program is required to submit the request for on-site visit by the end of June 2026. Ms. Loria does not think that the program will be ready to do so yet. The program is considering purchasing Teaching Strategies Gold. Growing Meal: Starting next school year, the program will not cook on-site. Parents can choose to pack their children’s lunch or order through Growing Meal. Ms. Loria will work with Growing Meal to discuss nutrition requirements. Administrative Action: A repeat violation of the criminal background check requirement for two consecutive visits may result in an administrative action warrant. 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 .3222 (c) If employment-related changes occur at a facility that result in noncompliance with or failure to meet the standards in the Section for the star rating issued, the operator shall correct the noncompliance within six months. If the operator does not correct the noncompliance within six months, 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 6/2/2026 Number Present: 104 Completed Date: 6/2/2026 Age: From 0 To 6 Total Minutes: 437 Time In: 09:20 AM Time Out: 04:37 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 Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to you. Today, Ms. Loria was available during the visit. 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-one (81) percent as of today prior to this visit. Permit type – four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space, children under 2 ½ years old in rooms with direct exits only, meets reduced ratios. The last annual compliance visit was conducted on 10/30/25. The last fire drill was practiced on 5/28/26. The last lockdown drill was practiced on 4/13/26. The last playground inspection was documented on 5/8/26. The last fire inspection was approved on 3/13/26 but was completed on the wrong form. I requested Ms. Loria to obtain fire inspection on the correct form. The last sanitation inspection was conducted on 3/11/26 with seven (7) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum is Creative Curriculum. Lead water testing was completed on 1/8/24 without hazards. Lead paint has no records. Asbestos testing was completed on 4/9/26. Twenty-six (26) staff members were listed on the Automated Criminal Background Check Management System (ABCMS). Upon arrival, I announced my presence and the purpose of the visit. Walk-through: In space #1 (117), a group of seven (7) children, infants and one (1) year of age, were present with two (2) staff members. Five (5) children, all one (1) were strapped on the Bye-Bye Buggy and went for a walk while, two (2) infants remained in the classroom with one (1) staff member. One (1) child’s diaper was changed while the other child crawled in the classroom. In space #2 (114), a group of thirteen (13) children, four-to-six year of age, were present with two (2) staff members. The child who was six (6) had not started elementary school. Children transitioned from bathroom to the classroom. Upon arrival in the classroom, children were instructed to join the group discussion. A permission form for Benadryl was on file for a child, but medicine was not brought in, according to a staff member. The same child had allergy to a food item, but not severe enough for epi-pen. In space #3 (101), a group of seven (7) children, two (2) to three (3) years of age, were present with one (1) staff member. The children transitioned from playground to inside. They held a walking rope and followed the staff member. Upon arrival in the classroom, children took turns and washed their hands before transitioning to free play. In space #4 (102) a group of fourteen (14) children, two (2) and three (3) years of age, were present with two (2) staff members. Children participated in group dance/song led by a staff member, while the other staff member changed a child’s clothes. In space #5 (103) a group of twelve (12) children, two (2) and three (3) years of age, were present with two (2) staff members. During observation, children played with pretend cars, housekeeping materials and manipulatives. Two (2) children asked for morning snacks and had them at the table. One (1) staff member took seven (7) children to the playground while one (1) staff member kept five (5) children in the classroom until two (2) of them finished the snacks. In space #6 (203), a group of nine (9) children, all two (2) years old, were present with two (2) staff members. In space #7 (202), a group of seven (7) children, one (1) and two (2) years of age, were present with two (2) staff members. Children from space #6 and #7 played together on the infant/toddler playground. Children engaged in gross motor play with balls, slides, riding toys. In space #8 (201), a group of seven (7) children, all one (1) year of age, were present with two (2) staff members. In space #9 (111), a group of twelve (12) children, three (3) and four (4) years of age, were present with two (2) staff members. During observation, one (1) staff member took three (3) children to the bathroom, while the other staff member cared for nine (9) children. Children played with camp accessories, such as pretend s’mores, pretend camp hire, grill, etc., playdough, manipulatives, sand and other materials. There is a small patio area outside between space #9 and #10. During today’s visit, I noticed that children’s drawings were on the concrete and there were some equipment, such as children’s chair, table, pretend kitchen, car track, etc. Per staff member in space #9, some children in #9 and #10 sometimes play in the area. Per Ms. Loria, a small group of children had played in space. A narrow walkway connects the front entrance of the building and the patio. Two (2) air-conditioning units were accessible to the children by the walkway. Top areas of the air-conditioning units were not covered with protectors. In space #10 (113), a group of fifteen (15) children, three-to-five year of age, were present with two (2) staff members. The children sat at the tables and had morning snacks – blueberry muffins and milk were served. After snacks, children cleaned up food, washed their hands and joined group time. Diaper creams, sunscreens, emergency medications and over-the-counter medications were maintained in the classrooms, and all of their product’s expiration, permission forms, action plans were valid. Interaction and supervision were adequate. Two (2) playgrounds were monitored. No safety hazards were found on the infant/toddler playground. On preschool playground, mulch under the climber tunnel was measured for six (6) inches. However, it may need to be fluffed in some sections. There is a shed on the preschool playground where play equipment was maintained. There was a lock on the shed. Due to damaged doors, it created opening between two (2) doors. The opening was as wide as 4 ½ inches. During observation, twelve (12) children from room 103, fourteen (14) children from room 102 were present on the preschool playground. Children ran on the bike tracks, climbed on a climber, played pretend house with mulch and pretend kitchen equipment and a slide. Later, twelve (12) children from room 111 joined the playground. One (1) of the children asked one (1) of the staff members for a truck. The staff member unlocked the shed and pulled three (3) riding/push toys, three (3) tricycles, one (1) scooter, some blocks and two (2) small toy vehicles. Staff files: Four (4) new staff files were monitored in full and Twenty-three (23) existing staff files were monitored partially for criminal background letters, CPR/First Aid certificates and ITS/SIDS certificates. Staff and training worksheet was submitted by Ms. Loria for new staff members during today's visit. The following discrepancies were noted. G. Noell (sub): HQ: 3/22/26 EI: 3/22/26 Application: 3/16/26 EMC/EPR review: 3/23/26 M. Kucin (floater): Application- 4/1/26 EPR/EMC review – 4/21/26 J. Chambers (T): EMC/EPR review – 3/10/26 HQ – 3/5/26 EI: 3/5/26 Medical exam – 3/6/26 Application – 3/5/26 Existing staff members files were monitored for the followings: CBC expiration date: F. Norton (Fl) – 3/16/27 F. Noell (Lt) – 2/24/28 V. Milner (LT) – 4/19/26* Per ABCMS, qualification letter is valid through 5/26/31. Application process started on 5/18/26. C. McCormick – 2/9/28 T) N. Loria- 3/17/27 P. Jones (LT)- 12/22/27 H. Hensley (T) - 12/3/29 K. Greene (T) -2/24/31 C. Green (T)– 5/21/26* Per ABCMS, qualification letter is valid through 5/26/31. CBC application started on 5/18/26. D. Castillo (LT)- 9/5/30 R. Bishop (T) - 8/1/30 M. Bennett (K, FL)- 8/7/29 H. Beck (T) - 6/3/26* Per ABCMS, qualification letter is valid through 6/3/26. Application process was started on 5/22/26. A. Bair (LT) - 8/17/27 C. Whittemore (sub)- 5/1/30 K. Warren (K, Front Desk)- 2/3/27 B. Swatzell (LT) - 5/4/27 C. Smith (sub)- 5/21/26* Per ABCMS, the qualification letter is expired and no application process has been started. L. Smathers (LT) -4/17/30 R. Rutherford (LT)– 2/23/31 J. Riddle (T)a - 8/7/30 M. Rice (LT)- 10/21/27 M. Peach (LT)- 6/10/26* Per ABCMS, no application process has been started. CPR/First Aid expiration date: F. Norton - 8/13/26 F. Noell - 3/22/27 V. Milner – 9/2027 C. McCormick - 6/21/27 N. Loria – 08/2026 P. Jones – 8/13/26 H. Hensley – 02/2027 K. Greene – no certificates on file* CPR/First Aid training scheduled on June 5, 2026. C. Green – 8/13/26 D. Castillo – 8/13/26 R. Bishop - 09/2027 M. Bennett - 8/13/26 H. Beck- 8/13/26 A. Bair- 2/22/27 C. Whittemore- 09/2027 K. Warren- 8/13/26 B. Swatzell – 8/13/26 C. Smith - 08/2026 L. Smathers – 8/13/26 J. Herman - 09/2027 R. Rutherford – 8/13/26 J. Riddle – 09/2027 M. Rice -8/26/27 M. Peach - 09/2027 ITS/SIDS expiration date: F. Norton – 8/5/28 F. Noell – 8/5/28 V. Milner – 8/5/28 C. McCormick – 2/27/26* N. Loria – 8/5/28 P. Jones – 8/5/28 C. Green – 8/5/28 D. Castillo-8/5/28 M. Bennett - 8/5/26 H. Beck- 8/5/26 A. Bair-8/5/26 K. Warren - 8/5/26 B. Swatzell – 8/5/26 L. Smathers - 8/5/25 R. Rutherford - 8/8/25 M. Rice - 1/29/28 M. Peach -8/5/26 R. Bishop – 8/5/28 J. Sherman – 3/19/27 N. Loria: EPR training – 8/19 and 8/21/24 Playground Safety training -11/20/24 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 434 The materials and equipment indoors and outdoors were not sufficient to provide a variety of play experiences to promote the children's emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development. One (1) slide structure, (1) climber tunnel, pretend kitchen with a few pretend dishes were available on the playground for twenty-six (26) children. When additional twelve (12) children joined, two (2) riding/pushing toys, three (3) tricycles, one (1) scooter, some blocks and two (2) small vehicle toys were pulled for children in addition to the permanent structure. Sufficient materials were not available for the thirty-eight (38) children present on the playground. 10A NCAC 09 .0509(2) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. The lock for the shed on the preschool playground created openings between doors as wide as 4 1/2 inches. .0605(g) 828 Air conditioning units were accessible or did not have a guard to keep objects from being thrown into the unit. Two (2) air-conditioning units in the walk path that connects the outside patio between room 111 and 113 were accessible to the children, and the top fans were not covered by guards. .0604 (m) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). Four (4) staff members did not complete the criminal background renewal process prior to the expiration dates of their qualification letters. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. Valid qualification letters were not on file for four (4) staff members. G.S. 110-90.2(b) & (d) & .2703(e) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Ten (10) existing staff members had not been added to the roster, and the seven (7) staff members who were separated from the program had not been removed from the roster. G.S. 110-90.2 & .2703(r) Technical assistance was provided as follows: 434: sufficient material and equipment for variety of learning experience The materials and equipment indoors and outdoors must be sufficient to provide a variety of play experiences to promote the children's emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development. Few equipment and materials lead to conflicts among children and safety concerns as most children gather in the same area on the playground. Sufficient quantities of materials and equipment must be available for children to promote not only gross motor development but also health emotional/social development, approaches to play and learning, language/communication and other areas. To comply, either reduce the number of children on the playground at the same time by creating a playground rotation schedule or bring variety of materials to the playground. 714: Entrapment hazards Openings in equipment, steps, decks, handrails, and fencing shall be less than 3 1/2” or greater than 9”. The shed for playground equipment in preschool playground had a lock, but the door was not closed all the way, creating openings, as wide as 4 ½ inches. To comply, the shed must be closed all the way. In your compliance letter, please state the action you took to meet the compliance. 828: air-conditioning unit The air conditioning units were accessible to children and were not fitted with guards to prevent objects from being thrown into them. Two (2) air conditioning units were located along the walkway leading to classrooms 113 and 111. To comply, air conditioning units must be located so they are not accessible to children or must be fitted with a mesh guard that prevents objects from being thrown into the units. To address this issue, you may install barriers or fencing around the air conditioning units to restrict children's access along the walkway. Alternatively, you may choose not to use the auxiliary outdoor space adjacent to classrooms 113 and 111 as part of the children's activity area. In your compliance letter, please state the action you took to achieve compliance. 1044: CBC process Prior to expiration date of the qualification letter, the child care provider must complete and submit required forms to complete a criminal background check. The following staff member did not complete the criminal background process prior to expiration dates of the qualification letter: C. Smith, H. Beck, C. Green and V. Milner To comply, staff members must start the criminal background renewal process weeks in advance to make sure that their qualifications letters are renewed prior to expiration date. In your compliance letter, please state how you will prevent this violation in detail. 1757: Criminal background check Valid qualification letter must be on file for each staff member at all times. To comply, the following staff members’ qualification letters must be printed and filed: C. Green and V. Milner Additionally, the following staff member must complete the criminal background application process, print the qualification letter and file: C. Smith and H. Beck C. Smith and H. Beck have fifteen (15) days (through the end of June 17, 2026, to complete the criminal background process. If the process is not completed and the staff members’ criminal background letters are not on file by the end of June 17, 2026, above staff members may not be present on-site until valid qualification letters are issued. In your compliance letter, please verify the completion of task that include printing qualification letters for C. Green, V. Milner, C. Smith and H. Beck and filing them in their staff files. 1805: ABCMS roster New employees, including all staff members including cooks, floaters and substitutes must be listed on the ABCMS system within five (5) days of employment. All employees who are separated from the program must also be reported to the system within five (5) business days. To comply, The following staff members must be listed on the ABCMS system: M. Kucin J. Chambers F. Norton V. Milner K. Greene M. Bennett A. Bair H. Beck C. Smith J. Sherman Additionally, please remove the following staff members from the roster: A. Hendryx D. Little C. Mashburn M. McDonald T. Oliver M. Swaney L. Wooten 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 6/16/26. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Reminder: M. Peach– criminal background letter will expire on 6/10/26. Please renew the qualification letter without delays. Auxiliary space: Some Auxiliary space can be accessed by children, even though it is not licensed if children are permitted by parents to be outside of the fenced area. However, this shall not be frequently done, as regulatory accessed space must be licensed. Auxiliary space can be visited a few times/years for special events or occasional special lessons. QIRS discussion: Per conversation with Ms. Loria, she disclosed that the program is considering renewing the Rated License Assessment with pathway 2- Instructional and Classroom Quality Pathway. The program is still going through NECAP Accreditation. In order to receive on-site visits required for NECAP accreditation, the program is required to submit the request for on-site visit by the end of June 2026. Ms. Loria does not think that the program will be ready to do so yet. The program is considering purchasing Teaching Strategies Gold. Growing Meal: Starting next school year, the program will not cook on-site. Parents can choose to pack their children’s lunch or order through Growing Meal. Ms. Loria will work with Growing Meal to discuss nutrition requirements. Administrative Action: A repeat violation of the criminal background check requirement for two consecutive visits may result in an administrative action warrant. 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 .3222 (c) If employment-related changes occur at a facility that result in noncompliance with or failure to meet the standards in the Section for the star rating issued, the operator shall correct the noncompliance within six months. If the operator does not correct the noncompliance within six months, 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 6/2/2026 Number Present: 104 Completed Date: 6/2/2026 Age: From 0 To 6 Total Minutes: 437 Time In: 09:20 AM Time Out: 04:37 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 Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to you. Today, Ms. Loria was available during the visit. 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-one (81) percent as of today prior to this visit. Permit type – four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space, children under 2 ½ years old in rooms with direct exits only, meets reduced ratios. The last annual compliance visit was conducted on 10/30/25. The last fire drill was practiced on 5/28/26. The last lockdown drill was practiced on 4/13/26. The last playground inspection was documented on 5/8/26. The last fire inspection was approved on 3/13/26 but was completed on the wrong form. I requested Ms. Loria to obtain fire inspection on the correct form. The last sanitation inspection was conducted on 3/11/26 with seven (7) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum is Creative Curriculum. Lead water testing was completed on 1/8/24 without hazards. Lead paint has no records. Asbestos testing was completed on 4/9/26. Twenty-six (26) staff members were listed on the Automated Criminal Background Check Management System (ABCMS). Upon arrival, I announced my presence and the purpose of the visit. Walk-through: In space #1 (117), a group of seven (7) children, infants and one (1) year of age, were present with two (2) staff members. Five (5) children, all one (1) were strapped on the Bye-Bye Buggy and went for a walk while, two (2) infants remained in the classroom with one (1) staff member. One (1) child’s diaper was changed while the other child crawled in the classroom. In space #2 (114), a group of thirteen (13) children, four-to-six year of age, were present with two (2) staff members. The child who was six (6) had not started elementary school. Children transitioned from bathroom to the classroom. Upon arrival in the classroom, children were instructed to join the group discussion. A permission form for Benadryl was on file for a child, but medicine was not brought in, according to a staff member. The same child had allergy to a food item, but not severe enough for epi-pen. In space #3 (101), a group of seven (7) children, two (2) to three (3) years of age, were present with one (1) staff member. The children transitioned from playground to inside. They held a walking rope and followed the staff member. Upon arrival in the classroom, children took turns and washed their hands before transitioning to free play. In space #4 (102) a group of fourteen (14) children, two (2) and three (3) years of age, were present with two (2) staff members. Children participated in group dance/song led by a staff member, while the other staff member changed a child’s clothes. In space #5 (103) a group of twelve (12) children, two (2) and three (3) years of age, were present with two (2) staff members. During observation, children played with pretend cars, housekeeping materials and manipulatives. Two (2) children asked for morning snacks and had them at the table. One (1) staff member took seven (7) children to the playground while one (1) staff member kept five (5) children in the classroom until two (2) of them finished the snacks. In space #6 (203), a group of nine (9) children, all two (2) years old, were present with two (2) staff members. In space #7 (202), a group of seven (7) children, one (1) and two (2) years of age, were present with two (2) staff members. Children from space #6 and #7 played together on the infant/toddler playground. Children engaged in gross motor play with balls, slides, riding toys. In space #8 (201), a group of seven (7) children, all one (1) year of age, were present with two (2) staff members. In space #9 (111), a group of twelve (12) children, three (3) and four (4) years of age, were present with two (2) staff members. During observation, one (1) staff member took three (3) children to the bathroom, while the other staff member cared for nine (9) children. Children played with camp accessories, such as pretend s’mores, pretend camp hire, grill, etc., playdough, manipulatives, sand and other materials. There is a small patio area outside between space #9 and #10. During today’s visit, I noticed that children’s drawings were on the concrete and there were some equipment, such as children’s chair, table, pretend kitchen, car track, etc. Per staff member in space #9, some children in #9 and #10 sometimes play in the area. Per Ms. Loria, a small group of children had played in space. A narrow walkway connects the front entrance of the building and the patio. Two (2) air-conditioning units were accessible to the children by the walkway. Top areas of the air-conditioning units were not covered with protectors. In space #10 (113), a group of fifteen (15) children, three-to-five year of age, were present with two (2) staff members. The children sat at the tables and had morning snacks – blueberry muffins and milk were served. After snacks, children cleaned up food, washed their hands and joined group time. Diaper creams, sunscreens, emergency medications and over-the-counter medications were maintained in the classrooms, and all of their product’s expiration, permission forms, action plans were valid. Interaction and supervision were adequate. Two (2) playgrounds were monitored. No safety hazards were found on the infant/toddler playground. On preschool playground, mulch under the climber tunnel was measured for six (6) inches. However, it may need to be fluffed in some sections. There is a shed on the preschool playground where play equipment was maintained. There was a lock on the shed. Due to damaged doors, it created opening between two (2) doors. The opening was as wide as 4 ½ inches. During observation, twelve (12) children from room 103, fourteen (14) children from room 102 were present on the preschool playground. Children ran on the bike tracks, climbed on a climber, played pretend house with mulch and pretend kitchen equipment and a slide. Later, twelve (12) children from room 111 joined the playground. One (1) of the children asked one (1) of the staff members for a truck. The staff member unlocked the shed and pulled three (3) riding/push toys, three (3) tricycles, one (1) scooter, some blocks and two (2) small toy vehicles. Staff files: Four (4) new staff files were monitored in full and Twenty-three (23) existing staff files were monitored partially for criminal background letters, CPR/First Aid certificates and ITS/SIDS certificates. Staff and training worksheet was submitted by Ms. Loria for new staff members during today's visit. The following discrepancies were noted. G. Noell (sub): HQ: 3/22/26 EI: 3/22/26 Application: 3/16/26 EMC/EPR review: 3/23/26 M. Kucin (floater): Application- 4/1/26 EPR/EMC review – 4/21/26 J. Chambers (T): EMC/EPR review – 3/10/26 HQ – 3/5/26 EI: 3/5/26 Medical exam – 3/6/26 Application – 3/5/26 Existing staff members files were monitored for the followings: CBC expiration date: F. Norton (Fl) – 3/16/27 F. Noell (Lt) – 2/24/28 V. Milner (LT) – 4/19/26* Per ABCMS, qualification letter is valid through 5/26/31. Application process started on 5/18/26. C. McCormick – 2/9/28 T) N. Loria- 3/17/27 P. Jones (LT)- 12/22/27 H. Hensley (T) - 12/3/29 K. Greene (T) -2/24/31 C. Green (T)– 5/21/26* Per ABCMS, qualification letter is valid through 5/26/31. CBC application started on 5/18/26. D. Castillo (LT)- 9/5/30 R. Bishop (T) - 8/1/30 M. Bennett (K, FL)- 8/7/29 H. Beck (T) - 6/3/26* Per ABCMS, qualification letter is valid through 6/3/26. Application process was started on 5/22/26. A. Bair (LT) - 8/17/27 C. Whittemore (sub)- 5/1/30 K. Warren (K, Front Desk)- 2/3/27 B. Swatzell (LT) - 5/4/27 C. Smith (sub)- 5/21/26* Per ABCMS, the qualification letter is expired and no application process has been started. L. Smathers (LT) -4/17/30 R. Rutherford (LT)– 2/23/31 J. Riddle (T)a - 8/7/30 M. Rice (LT)- 10/21/27 M. Peach (LT)- 6/10/26* Per ABCMS, no application process has been started. CPR/First Aid expiration date: F. Norton - 8/13/26 F. Noell - 3/22/27 V. Milner – 9/2027 C. McCormick - 6/21/27 N. Loria – 08/2026 P. Jones – 8/13/26 H. Hensley – 02/2027 K. Greene – no certificates on file* CPR/First Aid training scheduled on June 5, 2026. C. Green – 8/13/26 D. Castillo – 8/13/26 R. Bishop - 09/2027 M. Bennett - 8/13/26 H. Beck- 8/13/26 A. Bair- 2/22/27 C. Whittemore- 09/2027 K. Warren- 8/13/26 B. Swatzell – 8/13/26 C. Smith - 08/2026 L. Smathers – 8/13/26 J. Herman - 09/2027 R. Rutherford – 8/13/26 J. Riddle – 09/2027 M. Rice -8/26/27 M. Peach - 09/2027 ITS/SIDS expiration date: F. Norton – 8/5/28 F. Noell – 8/5/28 V. Milner – 8/5/28 C. McCormick – 2/27/26* N. Loria – 8/5/28 P. Jones – 8/5/28 C. Green – 8/5/28 D. Castillo-8/5/28 M. Bennett - 8/5/26 H. Beck- 8/5/26 A. Bair-8/5/26 K. Warren - 8/5/26 B. Swatzell – 8/5/26 L. Smathers - 8/5/25 R. Rutherford - 8/8/25 M. Rice - 1/29/28 M. Peach -8/5/26 R. Bishop – 8/5/28 J. Sherman – 3/19/27 N. Loria: EPR training – 8/19 and 8/21/24 Playground Safety training -11/20/24 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 434 The materials and equipment indoors and outdoors were not sufficient to provide a variety of play experiences to promote the children's emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development. One (1) slide structure, (1) climber tunnel, pretend kitchen with a few pretend dishes were available on the playground for twenty-six (26) children. When additional twelve (12) children joined, two (2) riding/pushing toys, three (3) tricycles, one (1) scooter, some blocks and two (2) small vehicle toys were pulled for children in addition to the permanent structure. Sufficient materials were not available for the thirty-eight (38) children present on the playground. 10A NCAC 09 .0509(2) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. The lock for the shed on the preschool playground created openings between doors as wide as 4 1/2 inches. .0605(g) 828 Air conditioning units were accessible or did not have a guard to keep objects from being thrown into the unit. Two (2) air-conditioning units in the walk path that connects the outside patio between room 111 and 113 were accessible to the children, and the top fans were not covered by guards. .0604 (m) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). Four (4) staff members did not complete the criminal background renewal process prior to the expiration dates of their qualification letters. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. Valid qualification letters were not on file for four (4) staff members. G.S. 110-90.2(b) & (d) & .2703(e) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Ten (10) existing staff members had not been added to the roster, and the seven (7) staff members who were separated from the program had not been removed from the roster. G.S. 110-90.2 & .2703(r) Technical assistance was provided as follows: 434: sufficient material and equipment for variety of learning experience The materials and equipment indoors and outdoors must be sufficient to provide a variety of play experiences to promote the children's emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development. Few equipment and materials lead to conflicts among children and safety concerns as most children gather in the same area on the playground. Sufficient quantities of materials and equipment must be available for children to promote not only gross motor development but also health emotional/social development, approaches to play and learning, language/communication and other areas. To comply, either reduce the number of children on the playground at the same time by creating a playground rotation schedule or bring variety of materials to the playground. 714: Entrapment hazards Openings in equipment, steps, decks, handrails, and fencing shall be less than 3 1/2” or greater than 9”. The shed for playground equipment in preschool playground had a lock, but the door was not closed all the way, creating openings, as wide as 4 ½ inches. To comply, the shed must be closed all the way. In your compliance letter, please state the action you took to meet the compliance. 828: air-conditioning unit The air conditioning units were accessible to children and were not fitted with guards to prevent objects from being thrown into them. Two (2) air conditioning units were located along the walkway leading to classrooms 113 and 111. To comply, air conditioning units must be located so they are not accessible to children or must be fitted with a mesh guard that prevents objects from being thrown into the units. To address this issue, you may install barriers or fencing around the air conditioning units to restrict children's access along the walkway. Alternatively, you may choose not to use the auxiliary outdoor space adjacent to classrooms 113 and 111 as part of the children's activity area. In your compliance letter, please state the action you took to achieve compliance. 1044: CBC process Prior to expiration date of the qualification letter, the child care provider must complete and submit required forms to complete a criminal background check. The following staff member did not complete the criminal background process prior to expiration dates of the qualification letter: C. Smith, H. Beck, C. Green and V. Milner To comply, staff members must start the criminal background renewal process weeks in advance to make sure that their qualifications letters are renewed prior to expiration date. In your compliance letter, please state how you will prevent this violation in detail. 1757: Criminal background check Valid qualification letter must be on file for each staff member at all times. To comply, the following staff members’ qualification letters must be printed and filed: C. Green and V. Milner Additionally, the following staff member must complete the criminal background application process, print the qualification letter and file: C. Smith and H. Beck C. Smith and H. Beck have fifteen (15) days (through the end of June 17, 2026, to complete the criminal background process. If the process is not completed and the staff members’ criminal background letters are not on file by the end of June 17, 2026, above staff members may not be present on-site until valid qualification letters are issued. In your compliance letter, please verify the completion of task that include printing qualification letters for C. Green, V. Milner, C. Smith and H. Beck and filing them in their staff files. 1805: ABCMS roster New employees, including all staff members including cooks, floaters and substitutes must be listed on the ABCMS system within five (5) days of employment. All employees who are separated from the program must also be reported to the system within five (5) business days. To comply, The following staff members must be listed on the ABCMS system: M. Kucin J. Chambers F. Norton V. Milner K. Greene M. Bennett A. Bair H. Beck C. Smith J. Sherman Additionally, please remove the following staff members from the roster: A. Hendryx D. Little C. Mashburn M. McDonald T. Oliver M. Swaney L. Wooten 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 6/16/26. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Reminder: M. Peach– criminal background letter will expire on 6/10/26. Please renew the qualification letter without delays. Auxiliary space: Some Auxiliary space can be accessed by children, even though it is not licensed if children are permitted by parents to be outside of the fenced area. However, this shall not be frequently done, as regulatory accessed space must be licensed. Auxiliary space can be visited a few times/years for special events or occasional special lessons. QIRS discussion: Per conversation with Ms. Loria, she disclosed that the program is considering renewing the Rated License Assessment with pathway 2- Instructional and Classroom Quality Pathway. The program is still going through NECAP Accreditation. In order to receive on-site visits required for NECAP accreditation, the program is required to submit the request for on-site visit by the end of June 2026. Ms. Loria does not think that the program will be ready to do so yet. The program is considering purchasing Teaching Strategies Gold. Growing Meal: Starting next school year, the program will not cook on-site. Parents can choose to pack their children’s lunch or order through Growing Meal. Ms. Loria will work with Growing Meal to discuss nutrition requirements. Administrative Action: A repeat violation of the criminal background check requirement for two consecutive visits may result in an administrative action warrant. 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 .3222 (c) If employment-related changes occur at a facility that result in noncompliance with or failure to meet the standards in the Section for the star rating issued, the operator shall correct the noncompliance within six months. If the operator does not correct the noncompliance within six months, 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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 .3222 · Violation

Name of Operation: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 6/2/2026 Number Present: 104 Completed Date: 6/2/2026 Age: From 0 To 6 Total Minutes: 437 Time In: 09:20 AM Time Out: 04:37 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 Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to you. Today, Ms. Loria was available during the visit. 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-one (81) percent as of today prior to this visit. Permit type – four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space, children under 2 ½ years old in rooms with direct exits only, meets reduced ratios. The last annual compliance visit was conducted on 10/30/25. The last fire drill was practiced on 5/28/26. The last lockdown drill was practiced on 4/13/26. The last playground inspection was documented on 5/8/26. The last fire inspection was approved on 3/13/26 but was completed on the wrong form. I requested Ms. Loria to obtain fire inspection on the correct form. The last sanitation inspection was conducted on 3/11/26 with seven (7) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum is Creative Curriculum. Lead water testing was completed on 1/8/24 without hazards. Lead paint has no records. Asbestos testing was completed on 4/9/26. Twenty-six (26) staff members were listed on the Automated Criminal Background Check Management System (ABCMS). Upon arrival, I announced my presence and the purpose of the visit. Walk-through: In space #1 (117), a group of seven (7) children, infants and one (1) year of age, were present with two (2) staff members. Five (5) children, all one (1) were strapped on the Bye-Bye Buggy and went for a walk while, two (2) infants remained in the classroom with one (1) staff member. One (1) child’s diaper was changed while the other child crawled in the classroom. In space #2 (114), a group of thirteen (13) children, four-to-six year of age, were present with two (2) staff members. The child who was six (6) had not started elementary school. Children transitioned from bathroom to the classroom. Upon arrival in the classroom, children were instructed to join the group discussion. A permission form for Benadryl was on file for a child, but medicine was not brought in, according to a staff member. The same child had allergy to a food item, but not severe enough for epi-pen. In space #3 (101), a group of seven (7) children, two (2) to three (3) years of age, were present with one (1) staff member. The children transitioned from playground to inside. They held a walking rope and followed the staff member. Upon arrival in the classroom, children took turns and washed their hands before transitioning to free play. In space #4 (102) a group of fourteen (14) children, two (2) and three (3) years of age, were present with two (2) staff members. Children participated in group dance/song led by a staff member, while the other staff member changed a child’s clothes. In space #5 (103) a group of twelve (12) children, two (2) and three (3) years of age, were present with two (2) staff members. During observation, children played with pretend cars, housekeeping materials and manipulatives. Two (2) children asked for morning snacks and had them at the table. One (1) staff member took seven (7) children to the playground while one (1) staff member kept five (5) children in the classroom until two (2) of them finished the snacks. In space #6 (203), a group of nine (9) children, all two (2) years old, were present with two (2) staff members. In space #7 (202), a group of seven (7) children, one (1) and two (2) years of age, were present with two (2) staff members. Children from space #6 and #7 played together on the infant/toddler playground. Children engaged in gross motor play with balls, slides, riding toys. In space #8 (201), a group of seven (7) children, all one (1) year of age, were present with two (2) staff members. In space #9 (111), a group of twelve (12) children, three (3) and four (4) years of age, were present with two (2) staff members. During observation, one (1) staff member took three (3) children to the bathroom, while the other staff member cared for nine (9) children. Children played with camp accessories, such as pretend s’mores, pretend camp hire, grill, etc., playdough, manipulatives, sand and other materials. There is a small patio area outside between space #9 and #10. During today’s visit, I noticed that children’s drawings were on the concrete and there were some equipment, such as children’s chair, table, pretend kitchen, car track, etc. Per staff member in space #9, some children in #9 and #10 sometimes play in the area. Per Ms. Loria, a small group of children had played in space. A narrow walkway connects the front entrance of the building and the patio. Two (2) air-conditioning units were accessible to the children by the walkway. Top areas of the air-conditioning units were not covered with protectors. In space #10 (113), a group of fifteen (15) children, three-to-five year of age, were present with two (2) staff members. The children sat at the tables and had morning snacks – blueberry muffins and milk were served. After snacks, children cleaned up food, washed their hands and joined group time. Diaper creams, sunscreens, emergency medications and over-the-counter medications were maintained in the classrooms, and all of their product’s expiration, permission forms, action plans were valid. Interaction and supervision were adequate. Two (2) playgrounds were monitored. No safety hazards were found on the infant/toddler playground. On preschool playground, mulch under the climber tunnel was measured for six (6) inches. However, it may need to be fluffed in some sections. There is a shed on the preschool playground where play equipment was maintained. There was a lock on the shed. Due to damaged doors, it created opening between two (2) doors. The opening was as wide as 4 ½ inches. During observation, twelve (12) children from room 103, fourteen (14) children from room 102 were present on the preschool playground. Children ran on the bike tracks, climbed on a climber, played pretend house with mulch and pretend kitchen equipment and a slide. Later, twelve (12) children from room 111 joined the playground. One (1) of the children asked one (1) of the staff members for a truck. The staff member unlocked the shed and pulled three (3) riding/push toys, three (3) tricycles, one (1) scooter, some blocks and two (2) small toy vehicles. Staff files: Four (4) new staff files were monitored in full and Twenty-three (23) existing staff files were monitored partially for criminal background letters, CPR/First Aid certificates and ITS/SIDS certificates. Staff and training worksheet was submitted by Ms. Loria for new staff members during today's visit. The following discrepancies were noted. G. Noell (sub): HQ: 3/22/26 EI: 3/22/26 Application: 3/16/26 EMC/EPR review: 3/23/26 M. Kucin (floater): Application- 4/1/26 EPR/EMC review – 4/21/26 J. Chambers (T): EMC/EPR review – 3/10/26 HQ – 3/5/26 EI: 3/5/26 Medical exam – 3/6/26 Application – 3/5/26 Existing staff members files were monitored for the followings: CBC expiration date: F. Norton (Fl) – 3/16/27 F. Noell (Lt) – 2/24/28 V. Milner (LT) – 4/19/26* Per ABCMS, qualification letter is valid through 5/26/31. Application process started on 5/18/26. C. McCormick – 2/9/28 T) N. Loria- 3/17/27 P. Jones (LT)- 12/22/27 H. Hensley (T) - 12/3/29 K. Greene (T) -2/24/31 C. Green (T)– 5/21/26* Per ABCMS, qualification letter is valid through 5/26/31. CBC application started on 5/18/26. D. Castillo (LT)- 9/5/30 R. Bishop (T) - 8/1/30 M. Bennett (K, FL)- 8/7/29 H. Beck (T) - 6/3/26* Per ABCMS, qualification letter is valid through 6/3/26. Application process was started on 5/22/26. A. Bair (LT) - 8/17/27 C. Whittemore (sub)- 5/1/30 K. Warren (K, Front Desk)- 2/3/27 B. Swatzell (LT) - 5/4/27 C. Smith (sub)- 5/21/26* Per ABCMS, the qualification letter is expired and no application process has been started. L. Smathers (LT) -4/17/30 R. Rutherford (LT)– 2/23/31 J. Riddle (T)a - 8/7/30 M. Rice (LT)- 10/21/27 M. Peach (LT)- 6/10/26* Per ABCMS, no application process has been started. CPR/First Aid expiration date: F. Norton - 8/13/26 F. Noell - 3/22/27 V. Milner – 9/2027 C. McCormick - 6/21/27 N. Loria – 08/2026 P. Jones – 8/13/26 H. Hensley – 02/2027 K. Greene – no certificates on file* CPR/First Aid training scheduled on June 5, 2026. C. Green – 8/13/26 D. Castillo – 8/13/26 R. Bishop - 09/2027 M. Bennett - 8/13/26 H. Beck- 8/13/26 A. Bair- 2/22/27 C. Whittemore- 09/2027 K. Warren- 8/13/26 B. Swatzell – 8/13/26 C. Smith - 08/2026 L. Smathers – 8/13/26 J. Herman - 09/2027 R. Rutherford – 8/13/26 J. Riddle – 09/2027 M. Rice -8/26/27 M. Peach - 09/2027 ITS/SIDS expiration date: F. Norton – 8/5/28 F. Noell – 8/5/28 V. Milner – 8/5/28 C. McCormick – 2/27/26* N. Loria – 8/5/28 P. Jones – 8/5/28 C. Green – 8/5/28 D. Castillo-8/5/28 M. Bennett - 8/5/26 H. Beck- 8/5/26 A. Bair-8/5/26 K. Warren - 8/5/26 B. Swatzell – 8/5/26 L. Smathers - 8/5/25 R. Rutherford - 8/8/25 M. Rice - 1/29/28 M. Peach -8/5/26 R. Bishop – 8/5/28 J. Sherman – 3/19/27 N. Loria: EPR training – 8/19 and 8/21/24 Playground Safety training -11/20/24 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 434 The materials and equipment indoors and outdoors were not sufficient to provide a variety of play experiences to promote the children's emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development. One (1) slide structure, (1) climber tunnel, pretend kitchen with a few pretend dishes were available on the playground for twenty-six (26) children. When additional twelve (12) children joined, two (2) riding/pushing toys, three (3) tricycles, one (1) scooter, some blocks and two (2) small vehicle toys were pulled for children in addition to the permanent structure. Sufficient materials were not available for the thirty-eight (38) children present on the playground. 10A NCAC 09 .0509(2) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. The lock for the shed on the preschool playground created openings between doors as wide as 4 1/2 inches. .0605(g) 828 Air conditioning units were accessible or did not have a guard to keep objects from being thrown into the unit. Two (2) air-conditioning units in the walk path that connects the outside patio between room 111 and 113 were accessible to the children, and the top fans were not covered by guards. .0604 (m) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). Four (4) staff members did not complete the criminal background renewal process prior to the expiration dates of their qualification letters. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. Valid qualification letters were not on file for four (4) staff members. G.S. 110-90.2(b) & (d) & .2703(e) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Ten (10) existing staff members had not been added to the roster, and the seven (7) staff members who were separated from the program had not been removed from the roster. G.S. 110-90.2 & .2703(r) Technical assistance was provided as follows: 434: sufficient material and equipment for variety of learning experience The materials and equipment indoors and outdoors must be sufficient to provide a variety of play experiences to promote the children's emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development. Few equipment and materials lead to conflicts among children and safety concerns as most children gather in the same area on the playground. Sufficient quantities of materials and equipment must be available for children to promote not only gross motor development but also health emotional/social development, approaches to play and learning, language/communication and other areas. To comply, either reduce the number of children on the playground at the same time by creating a playground rotation schedule or bring variety of materials to the playground. 714: Entrapment hazards Openings in equipment, steps, decks, handrails, and fencing shall be less than 3 1/2” or greater than 9”. The shed for playground equipment in preschool playground had a lock, but the door was not closed all the way, creating openings, as wide as 4 ½ inches. To comply, the shed must be closed all the way. In your compliance letter, please state the action you took to meet the compliance. 828: air-conditioning unit The air conditioning units were accessible to children and were not fitted with guards to prevent objects from being thrown into them. Two (2) air conditioning units were located along the walkway leading to classrooms 113 and 111. To comply, air conditioning units must be located so they are not accessible to children or must be fitted with a mesh guard that prevents objects from being thrown into the units. To address this issue, you may install barriers or fencing around the air conditioning units to restrict children's access along the walkway. Alternatively, you may choose not to use the auxiliary outdoor space adjacent to classrooms 113 and 111 as part of the children's activity area. In your compliance letter, please state the action you took to achieve compliance. 1044: CBC process Prior to expiration date of the qualification letter, the child care provider must complete and submit required forms to complete a criminal background check. The following staff member did not complete the criminal background process prior to expiration dates of the qualification letter: C. Smith, H. Beck, C. Green and V. Milner To comply, staff members must start the criminal background renewal process weeks in advance to make sure that their qualifications letters are renewed prior to expiration date. In your compliance letter, please state how you will prevent this violation in detail. 1757: Criminal background check Valid qualification letter must be on file for each staff member at all times. To comply, the following staff members’ qualification letters must be printed and filed: C. Green and V. Milner Additionally, the following staff member must complete the criminal background application process, print the qualification letter and file: C. Smith and H. Beck C. Smith and H. Beck have fifteen (15) days (through the end of June 17, 2026, to complete the criminal background process. If the process is not completed and the staff members’ criminal background letters are not on file by the end of June 17, 2026, above staff members may not be present on-site until valid qualification letters are issued. In your compliance letter, please verify the completion of task that include printing qualification letters for C. Green, V. Milner, C. Smith and H. Beck and filing them in their staff files. 1805: ABCMS roster New employees, including all staff members including cooks, floaters and substitutes must be listed on the ABCMS system within five (5) days of employment. All employees who are separated from the program must also be reported to the system within five (5) business days. To comply, The following staff members must be listed on the ABCMS system: M. Kucin J. Chambers F. Norton V. Milner K. Greene M. Bennett A. Bair H. Beck C. Smith J. Sherman Additionally, please remove the following staff members from the roster: A. Hendryx D. Little C. Mashburn M. McDonald T. Oliver M. Swaney L. Wooten 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 6/16/26. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Reminder: M. Peach– criminal background letter will expire on 6/10/26. Please renew the qualification letter without delays. Auxiliary space: Some Auxiliary space can be accessed by children, even though it is not licensed if children are permitted by parents to be outside of the fenced area. However, this shall not be frequently done, as regulatory accessed space must be licensed. Auxiliary space can be visited a few times/years for special events or occasional special lessons. QIRS discussion: Per conversation with Ms. Loria, she disclosed that the program is considering renewing the Rated License Assessment with pathway 2- Instructional and Classroom Quality Pathway. The program is still going through NECAP Accreditation. In order to receive on-site visits required for NECAP accreditation, the program is required to submit the request for on-site visit by the end of June 2026. Ms. Loria does not think that the program will be ready to do so yet. The program is considering purchasing Teaching Strategies Gold. Growing Meal: Starting next school year, the program will not cook on-site. Parents can choose to pack their children’s lunch or order through Growing Meal. Ms. Loria will work with Growing Meal to discuss nutrition requirements. Administrative Action: A repeat violation of the criminal background check requirement for two consecutive visits may result in an administrative action warrant. 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 .3222 (c) If employment-related changes occur at a facility that result in noncompliance with or failure to meet the standards in the Section for the star rating issued, the operator shall correct the noncompliance within six months. If the operator does not correct the noncompliance within six months, 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 6/2/2026 Number Present: 104 Completed Date: 6/2/2026 Age: From 0 To 6 Total Minutes: 437 Time In: 09:20 AM Time Out: 04:37 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 Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to you. Today, Ms. Loria was available during the visit. 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-one (81) percent as of today prior to this visit. Permit type – four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space, children under 2 ½ years old in rooms with direct exits only, meets reduced ratios. The last annual compliance visit was conducted on 10/30/25. The last fire drill was practiced on 5/28/26. The last lockdown drill was practiced on 4/13/26. The last playground inspection was documented on 5/8/26. The last fire inspection was approved on 3/13/26 but was completed on the wrong form. I requested Ms. Loria to obtain fire inspection on the correct form. The last sanitation inspection was conducted on 3/11/26 with seven (7) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum is Creative Curriculum. Lead water testing was completed on 1/8/24 without hazards. Lead paint has no records. Asbestos testing was completed on 4/9/26. Twenty-six (26) staff members were listed on the Automated Criminal Background Check Management System (ABCMS). Upon arrival, I announced my presence and the purpose of the visit. Walk-through: In space #1 (117), a group of seven (7) children, infants and one (1) year of age, were present with two (2) staff members. Five (5) children, all one (1) were strapped on the Bye-Bye Buggy and went for a walk while, two (2) infants remained in the classroom with one (1) staff member. One (1) child’s diaper was changed while the other child crawled in the classroom. In space #2 (114), a group of thirteen (13) children, four-to-six year of age, were present with two (2) staff members. The child who was six (6) had not started elementary school. Children transitioned from bathroom to the classroom. Upon arrival in the classroom, children were instructed to join the group discussion. A permission form for Benadryl was on file for a child, but medicine was not brought in, according to a staff member. The same child had allergy to a food item, but not severe enough for epi-pen. In space #3 (101), a group of seven (7) children, two (2) to three (3) years of age, were present with one (1) staff member. The children transitioned from playground to inside. They held a walking rope and followed the staff member. Upon arrival in the classroom, children took turns and washed their hands before transitioning to free play. In space #4 (102) a group of fourteen (14) children, two (2) and three (3) years of age, were present with two (2) staff members. Children participated in group dance/song led by a staff member, while the other staff member changed a child’s clothes. In space #5 (103) a group of twelve (12) children, two (2) and three (3) years of age, were present with two (2) staff members. During observation, children played with pretend cars, housekeeping materials and manipulatives. Two (2) children asked for morning snacks and had them at the table. One (1) staff member took seven (7) children to the playground while one (1) staff member kept five (5) children in the classroom until two (2) of them finished the snacks. In space #6 (203), a group of nine (9) children, all two (2) years old, were present with two (2) staff members. In space #7 (202), a group of seven (7) children, one (1) and two (2) years of age, were present with two (2) staff members. Children from space #6 and #7 played together on the infant/toddler playground. Children engaged in gross motor play with balls, slides, riding toys. In space #8 (201), a group of seven (7) children, all one (1) year of age, were present with two (2) staff members. In space #9 (111), a group of twelve (12) children, three (3) and four (4) years of age, were present with two (2) staff members. During observation, one (1) staff member took three (3) children to the bathroom, while the other staff member cared for nine (9) children. Children played with camp accessories, such as pretend s’mores, pretend camp hire, grill, etc., playdough, manipulatives, sand and other materials. There is a small patio area outside between space #9 and #10. During today’s visit, I noticed that children’s drawings were on the concrete and there were some equipment, such as children’s chair, table, pretend kitchen, car track, etc. Per staff member in space #9, some children in #9 and #10 sometimes play in the area. Per Ms. Loria, a small group of children had played in space. A narrow walkway connects the front entrance of the building and the patio. Two (2) air-conditioning units were accessible to the children by the walkway. Top areas of the air-conditioning units were not covered with protectors. In space #10 (113), a group of fifteen (15) children, three-to-five year of age, were present with two (2) staff members. The children sat at the tables and had morning snacks – blueberry muffins and milk were served. After snacks, children cleaned up food, washed their hands and joined group time. Diaper creams, sunscreens, emergency medications and over-the-counter medications were maintained in the classrooms, and all of their product’s expiration, permission forms, action plans were valid. Interaction and supervision were adequate. Two (2) playgrounds were monitored. No safety hazards were found on the infant/toddler playground. On preschool playground, mulch under the climber tunnel was measured for six (6) inches. However, it may need to be fluffed in some sections. There is a shed on the preschool playground where play equipment was maintained. There was a lock on the shed. Due to damaged doors, it created opening between two (2) doors. The opening was as wide as 4 ½ inches. During observation, twelve (12) children from room 103, fourteen (14) children from room 102 were present on the preschool playground. Children ran on the bike tracks, climbed on a climber, played pretend house with mulch and pretend kitchen equipment and a slide. Later, twelve (12) children from room 111 joined the playground. One (1) of the children asked one (1) of the staff members for a truck. The staff member unlocked the shed and pulled three (3) riding/push toys, three (3) tricycles, one (1) scooter, some blocks and two (2) small toy vehicles. Staff files: Four (4) new staff files were monitored in full and Twenty-three (23) existing staff files were monitored partially for criminal background letters, CPR/First Aid certificates and ITS/SIDS certificates. Staff and training worksheet was submitted by Ms. Loria for new staff members during today's visit. The following discrepancies were noted. G. Noell (sub): HQ: 3/22/26 EI: 3/22/26 Application: 3/16/26 EMC/EPR review: 3/23/26 M. Kucin (floater): Application- 4/1/26 EPR/EMC review – 4/21/26 J. Chambers (T): EMC/EPR review – 3/10/26 HQ – 3/5/26 EI: 3/5/26 Medical exam – 3/6/26 Application – 3/5/26 Existing staff members files were monitored for the followings: CBC expiration date: F. Norton (Fl) – 3/16/27 F. Noell (Lt) – 2/24/28 V. Milner (LT) – 4/19/26* Per ABCMS, qualification letter is valid through 5/26/31. Application process started on 5/18/26. C. McCormick – 2/9/28 T) N. Loria- 3/17/27 P. Jones (LT)- 12/22/27 H. Hensley (T) - 12/3/29 K. Greene (T) -2/24/31 C. Green (T)– 5/21/26* Per ABCMS, qualification letter is valid through 5/26/31. CBC application started on 5/18/26. D. Castillo (LT)- 9/5/30 R. Bishop (T) - 8/1/30 M. Bennett (K, FL)- 8/7/29 H. Beck (T) - 6/3/26* Per ABCMS, qualification letter is valid through 6/3/26. Application process was started on 5/22/26. A. Bair (LT) - 8/17/27 C. Whittemore (sub)- 5/1/30 K. Warren (K, Front Desk)- 2/3/27 B. Swatzell (LT) - 5/4/27 C. Smith (sub)- 5/21/26* Per ABCMS, the qualification letter is expired and no application process has been started. L. Smathers (LT) -4/17/30 R. Rutherford (LT)– 2/23/31 J. Riddle (T)a - 8/7/30 M. Rice (LT)- 10/21/27 M. Peach (LT)- 6/10/26* Per ABCMS, no application process has been started. CPR/First Aid expiration date: F. Norton - 8/13/26 F. Noell - 3/22/27 V. Milner – 9/2027 C. McCormick - 6/21/27 N. Loria – 08/2026 P. Jones – 8/13/26 H. Hensley – 02/2027 K. Greene – no certificates on file* CPR/First Aid training scheduled on June 5, 2026. C. Green – 8/13/26 D. Castillo – 8/13/26 R. Bishop - 09/2027 M. Bennett - 8/13/26 H. Beck- 8/13/26 A. Bair- 2/22/27 C. Whittemore- 09/2027 K. Warren- 8/13/26 B. Swatzell – 8/13/26 C. Smith - 08/2026 L. Smathers – 8/13/26 J. Herman - 09/2027 R. Rutherford – 8/13/26 J. Riddle – 09/2027 M. Rice -8/26/27 M. Peach - 09/2027 ITS/SIDS expiration date: F. Norton – 8/5/28 F. Noell – 8/5/28 V. Milner – 8/5/28 C. McCormick – 2/27/26* N. Loria – 8/5/28 P. Jones – 8/5/28 C. Green – 8/5/28 D. Castillo-8/5/28 M. Bennett - 8/5/26 H. Beck- 8/5/26 A. Bair-8/5/26 K. Warren - 8/5/26 B. Swatzell – 8/5/26 L. Smathers - 8/5/25 R. Rutherford - 8/8/25 M. Rice - 1/29/28 M. Peach -8/5/26 R. Bishop – 8/5/28 J. Sherman – 3/19/27 N. Loria: EPR training – 8/19 and 8/21/24 Playground Safety training -11/20/24 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 434 The materials and equipment indoors and outdoors were not sufficient to provide a variety of play experiences to promote the children's emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development. One (1) slide structure, (1) climber tunnel, pretend kitchen with a few pretend dishes were available on the playground for twenty-six (26) children. When additional twelve (12) children joined, two (2) riding/pushing toys, three (3) tricycles, one (1) scooter, some blocks and two (2) small vehicle toys were pulled for children in addition to the permanent structure. Sufficient materials were not available for the thirty-eight (38) children present on the playground. 10A NCAC 09 .0509(2) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. The lock for the shed on the preschool playground created openings between doors as wide as 4 1/2 inches. .0605(g) 828 Air conditioning units were accessible or did not have a guard to keep objects from being thrown into the unit. Two (2) air-conditioning units in the walk path that connects the outside patio between room 111 and 113 were accessible to the children, and the top fans were not covered by guards. .0604 (m) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). Four (4) staff members did not complete the criminal background renewal process prior to the expiration dates of their qualification letters. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. Valid qualification letters were not on file for four (4) staff members. G.S. 110-90.2(b) & (d) & .2703(e) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Ten (10) existing staff members had not been added to the roster, and the seven (7) staff members who were separated from the program had not been removed from the roster. G.S. 110-90.2 & .2703(r) Technical assistance was provided as follows: 434: sufficient material and equipment for variety of learning experience The materials and equipment indoors and outdoors must be sufficient to provide a variety of play experiences to promote the children's emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development. Few equipment and materials lead to conflicts among children and safety concerns as most children gather in the same area on the playground. Sufficient quantities of materials and equipment must be available for children to promote not only gross motor development but also health emotional/social development, approaches to play and learning, language/communication and other areas. To comply, either reduce the number of children on the playground at the same time by creating a playground rotation schedule or bring variety of materials to the playground. 714: Entrapment hazards Openings in equipment, steps, decks, handrails, and fencing shall be less than 3 1/2” or greater than 9”. The shed for playground equipment in preschool playground had a lock, but the door was not closed all the way, creating openings, as wide as 4 ½ inches. To comply, the shed must be closed all the way. In your compliance letter, please state the action you took to meet the compliance. 828: air-conditioning unit The air conditioning units were accessible to children and were not fitted with guards to prevent objects from being thrown into them. Two (2) air conditioning units were located along the walkway leading to classrooms 113 and 111. To comply, air conditioning units must be located so they are not accessible to children or must be fitted with a mesh guard that prevents objects from being thrown into the units. To address this issue, you may install barriers or fencing around the air conditioning units to restrict children's access along the walkway. Alternatively, you may choose not to use the auxiliary outdoor space adjacent to classrooms 113 and 111 as part of the children's activity area. In your compliance letter, please state the action you took to achieve compliance. 1044: CBC process Prior to expiration date of the qualification letter, the child care provider must complete and submit required forms to complete a criminal background check. The following staff member did not complete the criminal background process prior to expiration dates of the qualification letter: C. Smith, H. Beck, C. Green and V. Milner To comply, staff members must start the criminal background renewal process weeks in advance to make sure that their qualifications letters are renewed prior to expiration date. In your compliance letter, please state how you will prevent this violation in detail. 1757: Criminal background check Valid qualification letter must be on file for each staff member at all times. To comply, the following staff members’ qualification letters must be printed and filed: C. Green and V. Milner Additionally, the following staff member must complete the criminal background application process, print the qualification letter and file: C. Smith and H. Beck C. Smith and H. Beck have fifteen (15) days (through the end of June 17, 2026, to complete the criminal background process. If the process is not completed and the staff members’ criminal background letters are not on file by the end of June 17, 2026, above staff members may not be present on-site until valid qualification letters are issued. In your compliance letter, please verify the completion of task that include printing qualification letters for C. Green, V. Milner, C. Smith and H. Beck and filing them in their staff files. 1805: ABCMS roster New employees, including all staff members including cooks, floaters and substitutes must be listed on the ABCMS system within five (5) days of employment. All employees who are separated from the program must also be reported to the system within five (5) business days. To comply, The following staff members must be listed on the ABCMS system: M. Kucin J. Chambers F. Norton V. Milner K. Greene M. Bennett A. Bair H. Beck C. Smith J. Sherman Additionally, please remove the following staff members from the roster: A. Hendryx D. Little C. Mashburn M. McDonald T. Oliver M. Swaney L. Wooten 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 6/16/26. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Reminder: M. Peach– criminal background letter will expire on 6/10/26. Please renew the qualification letter without delays. Auxiliary space: Some Auxiliary space can be accessed by children, even though it is not licensed if children are permitted by parents to be outside of the fenced area. However, this shall not be frequently done, as regulatory accessed space must be licensed. Auxiliary space can be visited a few times/years for special events or occasional special lessons. QIRS discussion: Per conversation with Ms. Loria, she disclosed that the program is considering renewing the Rated License Assessment with pathway 2- Instructional and Classroom Quality Pathway. The program is still going through NECAP Accreditation. In order to receive on-site visits required for NECAP accreditation, the program is required to submit the request for on-site visit by the end of June 2026. Ms. Loria does not think that the program will be ready to do so yet. The program is considering purchasing Teaching Strategies Gold. Growing Meal: Starting next school year, the program will not cook on-site. Parents can choose to pack their children’s lunch or order through Growing Meal. Ms. Loria will work with Growing Meal to discuss nutrition requirements. Administrative Action: A repeat violation of the criminal background check requirement for two consecutive visits may result in an administrative action warrant. 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 .3222 (c) If employment-related changes occur at a facility that result in noncompliance with or failure to meet the standards in the Section for the star rating issued, the operator shall correct the noncompliance within six months. If the operator does not correct the noncompliance within six months, 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 6/2/2026 Number Present: 104 Completed Date: 6/2/2026 Age: From 0 To 6 Total Minutes: 437 Time In: 09:20 AM Time Out: 04:37 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 Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to you. Today, Ms. Loria was available during the visit. 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-one (81) percent as of today prior to this visit. Permit type – four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space, children under 2 ½ years old in rooms with direct exits only, meets reduced ratios. The last annual compliance visit was conducted on 10/30/25. The last fire drill was practiced on 5/28/26. The last lockdown drill was practiced on 4/13/26. The last playground inspection was documented on 5/8/26. The last fire inspection was approved on 3/13/26 but was completed on the wrong form. I requested Ms. Loria to obtain fire inspection on the correct form. The last sanitation inspection was conducted on 3/11/26 with seven (7) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum is Creative Curriculum. Lead water testing was completed on 1/8/24 without hazards. Lead paint has no records. Asbestos testing was completed on 4/9/26. Twenty-six (26) staff members were listed on the Automated Criminal Background Check Management System (ABCMS). Upon arrival, I announced my presence and the purpose of the visit. Walk-through: In space #1 (117), a group of seven (7) children, infants and one (1) year of age, were present with two (2) staff members. Five (5) children, all one (1) were strapped on the Bye-Bye Buggy and went for a walk while, two (2) infants remained in the classroom with one (1) staff member. One (1) child’s diaper was changed while the other child crawled in the classroom. In space #2 (114), a group of thirteen (13) children, four-to-six year of age, were present with two (2) staff members. The child who was six (6) had not started elementary school. Children transitioned from bathroom to the classroom. Upon arrival in the classroom, children were instructed to join the group discussion. A permission form for Benadryl was on file for a child, but medicine was not brought in, according to a staff member. The same child had allergy to a food item, but not severe enough for epi-pen. In space #3 (101), a group of seven (7) children, two (2) to three (3) years of age, were present with one (1) staff member. The children transitioned from playground to inside. They held a walking rope and followed the staff member. Upon arrival in the classroom, children took turns and washed their hands before transitioning to free play. In space #4 (102) a group of fourteen (14) children, two (2) and three (3) years of age, were present with two (2) staff members. Children participated in group dance/song led by a staff member, while the other staff member changed a child’s clothes. In space #5 (103) a group of twelve (12) children, two (2) and three (3) years of age, were present with two (2) staff members. During observation, children played with pretend cars, housekeeping materials and manipulatives. Two (2) children asked for morning snacks and had them at the table. One (1) staff member took seven (7) children to the playground while one (1) staff member kept five (5) children in the classroom until two (2) of them finished the snacks. In space #6 (203), a group of nine (9) children, all two (2) years old, were present with two (2) staff members. In space #7 (202), a group of seven (7) children, one (1) and two (2) years of age, were present with two (2) staff members. Children from space #6 and #7 played together on the infant/toddler playground. Children engaged in gross motor play with balls, slides, riding toys. In space #8 (201), a group of seven (7) children, all one (1) year of age, were present with two (2) staff members. In space #9 (111), a group of twelve (12) children, three (3) and four (4) years of age, were present with two (2) staff members. During observation, one (1) staff member took three (3) children to the bathroom, while the other staff member cared for nine (9) children. Children played with camp accessories, such as pretend s’mores, pretend camp hire, grill, etc., playdough, manipulatives, sand and other materials. There is a small patio area outside between space #9 and #10. During today’s visit, I noticed that children’s drawings were on the concrete and there were some equipment, such as children’s chair, table, pretend kitchen, car track, etc. Per staff member in space #9, some children in #9 and #10 sometimes play in the area. Per Ms. Loria, a small group of children had played in space. A narrow walkway connects the front entrance of the building and the patio. Two (2) air-conditioning units were accessible to the children by the walkway. Top areas of the air-conditioning units were not covered with protectors. In space #10 (113), a group of fifteen (15) children, three-to-five year of age, were present with two (2) staff members. The children sat at the tables and had morning snacks – blueberry muffins and milk were served. After snacks, children cleaned up food, washed their hands and joined group time. Diaper creams, sunscreens, emergency medications and over-the-counter medications were maintained in the classrooms, and all of their product’s expiration, permission forms, action plans were valid. Interaction and supervision were adequate. Two (2) playgrounds were monitored. No safety hazards were found on the infant/toddler playground. On preschool playground, mulch under the climber tunnel was measured for six (6) inches. However, it may need to be fluffed in some sections. There is a shed on the preschool playground where play equipment was maintained. There was a lock on the shed. Due to damaged doors, it created opening between two (2) doors. The opening was as wide as 4 ½ inches. During observation, twelve (12) children from room 103, fourteen (14) children from room 102 were present on the preschool playground. Children ran on the bike tracks, climbed on a climber, played pretend house with mulch and pretend kitchen equipment and a slide. Later, twelve (12) children from room 111 joined the playground. One (1) of the children asked one (1) of the staff members for a truck. The staff member unlocked the shed and pulled three (3) riding/push toys, three (3) tricycles, one (1) scooter, some blocks and two (2) small toy vehicles. Staff files: Four (4) new staff files were monitored in full and Twenty-three (23) existing staff files were monitored partially for criminal background letters, CPR/First Aid certificates and ITS/SIDS certificates. Staff and training worksheet was submitted by Ms. Loria for new staff members during today's visit. The following discrepancies were noted. G. Noell (sub): HQ: 3/22/26 EI: 3/22/26 Application: 3/16/26 EMC/EPR review: 3/23/26 M. Kucin (floater): Application- 4/1/26 EPR/EMC review – 4/21/26 J. Chambers (T): EMC/EPR review – 3/10/26 HQ – 3/5/26 EI: 3/5/26 Medical exam – 3/6/26 Application – 3/5/26 Existing staff members files were monitored for the followings: CBC expiration date: F. Norton (Fl) – 3/16/27 F. Noell (Lt) – 2/24/28 V. Milner (LT) – 4/19/26* Per ABCMS, qualification letter is valid through 5/26/31. Application process started on 5/18/26. C. McCormick – 2/9/28 T) N. Loria- 3/17/27 P. Jones (LT)- 12/22/27 H. Hensley (T) - 12/3/29 K. Greene (T) -2/24/31 C. Green (T)– 5/21/26* Per ABCMS, qualification letter is valid through 5/26/31. CBC application started on 5/18/26. D. Castillo (LT)- 9/5/30 R. Bishop (T) - 8/1/30 M. Bennett (K, FL)- 8/7/29 H. Beck (T) - 6/3/26* Per ABCMS, qualification letter is valid through 6/3/26. Application process was started on 5/22/26. A. Bair (LT) - 8/17/27 C. Whittemore (sub)- 5/1/30 K. Warren (K, Front Desk)- 2/3/27 B. Swatzell (LT) - 5/4/27 C. Smith (sub)- 5/21/26* Per ABCMS, the qualification letter is expired and no application process has been started. L. Smathers (LT) -4/17/30 R. Rutherford (LT)– 2/23/31 J. Riddle (T)a - 8/7/30 M. Rice (LT)- 10/21/27 M. Peach (LT)- 6/10/26* Per ABCMS, no application process has been started. CPR/First Aid expiration date: F. Norton - 8/13/26 F. Noell - 3/22/27 V. Milner – 9/2027 C. McCormick - 6/21/27 N. Loria – 08/2026 P. Jones – 8/13/26 H. Hensley – 02/2027 K. Greene – no certificates on file* CPR/First Aid training scheduled on June 5, 2026. C. Green – 8/13/26 D. Castillo – 8/13/26 R. Bishop - 09/2027 M. Bennett - 8/13/26 H. Beck- 8/13/26 A. Bair- 2/22/27 C. Whittemore- 09/2027 K. Warren- 8/13/26 B. Swatzell – 8/13/26 C. Smith - 08/2026 L. Smathers – 8/13/26 J. Herman - 09/2027 R. Rutherford – 8/13/26 J. Riddle – 09/2027 M. Rice -8/26/27 M. Peach - 09/2027 ITS/SIDS expiration date: F. Norton – 8/5/28 F. Noell – 8/5/28 V. Milner – 8/5/28 C. McCormick – 2/27/26* N. Loria – 8/5/28 P. Jones – 8/5/28 C. Green – 8/5/28 D. Castillo-8/5/28 M. Bennett - 8/5/26 H. Beck- 8/5/26 A. Bair-8/5/26 K. Warren - 8/5/26 B. Swatzell – 8/5/26 L. Smathers - 8/5/25 R. Rutherford - 8/8/25 M. Rice - 1/29/28 M. Peach -8/5/26 R. Bishop – 8/5/28 J. Sherman – 3/19/27 N. Loria: EPR training – 8/19 and 8/21/24 Playground Safety training -11/20/24 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 434 The materials and equipment indoors and outdoors were not sufficient to provide a variety of play experiences to promote the children's emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development. One (1) slide structure, (1) climber tunnel, pretend kitchen with a few pretend dishes were available on the playground for twenty-six (26) children. When additional twelve (12) children joined, two (2) riding/pushing toys, three (3) tricycles, one (1) scooter, some blocks and two (2) small vehicle toys were pulled for children in addition to the permanent structure. Sufficient materials were not available for the thirty-eight (38) children present on the playground. 10A NCAC 09 .0509(2) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. The lock for the shed on the preschool playground created openings between doors as wide as 4 1/2 inches. .0605(g) 828 Air conditioning units were accessible or did not have a guard to keep objects from being thrown into the unit. Two (2) air-conditioning units in the walk path that connects the outside patio between room 111 and 113 were accessible to the children, and the top fans were not covered by guards. .0604 (m) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). Four (4) staff members did not complete the criminal background renewal process prior to the expiration dates of their qualification letters. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. Valid qualification letters were not on file for four (4) staff members. G.S. 110-90.2(b) & (d) & .2703(e) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Ten (10) existing staff members had not been added to the roster, and the seven (7) staff members who were separated from the program had not been removed from the roster. G.S. 110-90.2 & .2703(r) Technical assistance was provided as follows: 434: sufficient material and equipment for variety of learning experience The materials and equipment indoors and outdoors must be sufficient to provide a variety of play experiences to promote the children's emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development. Few equipment and materials lead to conflicts among children and safety concerns as most children gather in the same area on the playground. Sufficient quantities of materials and equipment must be available for children to promote not only gross motor development but also health emotional/social development, approaches to play and learning, language/communication and other areas. To comply, either reduce the number of children on the playground at the same time by creating a playground rotation schedule or bring variety of materials to the playground. 714: Entrapment hazards Openings in equipment, steps, decks, handrails, and fencing shall be less than 3 1/2” or greater than 9”. The shed for playground equipment in preschool playground had a lock, but the door was not closed all the way, creating openings, as wide as 4 ½ inches. To comply, the shed must be closed all the way. In your compliance letter, please state the action you took to meet the compliance. 828: air-conditioning unit The air conditioning units were accessible to children and were not fitted with guards to prevent objects from being thrown into them. Two (2) air conditioning units were located along the walkway leading to classrooms 113 and 111. To comply, air conditioning units must be located so they are not accessible to children or must be fitted with a mesh guard that prevents objects from being thrown into the units. To address this issue, you may install barriers or fencing around the air conditioning units to restrict children's access along the walkway. Alternatively, you may choose not to use the auxiliary outdoor space adjacent to classrooms 113 and 111 as part of the children's activity area. In your compliance letter, please state the action you took to achieve compliance. 1044: CBC process Prior to expiration date of the qualification letter, the child care provider must complete and submit required forms to complete a criminal background check. The following staff member did not complete the criminal background process prior to expiration dates of the qualification letter: C. Smith, H. Beck, C. Green and V. Milner To comply, staff members must start the criminal background renewal process weeks in advance to make sure that their qualifications letters are renewed prior to expiration date. In your compliance letter, please state how you will prevent this violation in detail. 1757: Criminal background check Valid qualification letter must be on file for each staff member at all times. To comply, the following staff members’ qualification letters must be printed and filed: C. Green and V. Milner Additionally, the following staff member must complete the criminal background application process, print the qualification letter and file: C. Smith and H. Beck C. Smith and H. Beck have fifteen (15) days (through the end of June 17, 2026, to complete the criminal background process. If the process is not completed and the staff members’ criminal background letters are not on file by the end of June 17, 2026, above staff members may not be present on-site until valid qualification letters are issued. In your compliance letter, please verify the completion of task that include printing qualification letters for C. Green, V. Milner, C. Smith and H. Beck and filing them in their staff files. 1805: ABCMS roster New employees, including all staff members including cooks, floaters and substitutes must be listed on the ABCMS system within five (5) days of employment. All employees who are separated from the program must also be reported to the system within five (5) business days. To comply, The following staff members must be listed on the ABCMS system: M. Kucin J. Chambers F. Norton V. Milner K. Greene M. Bennett A. Bair H. Beck C. Smith J. Sherman Additionally, please remove the following staff members from the roster: A. Hendryx D. Little C. Mashburn M. McDonald T. Oliver M. Swaney L. Wooten 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 6/16/26. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Reminder: M. Peach– criminal background letter will expire on 6/10/26. Please renew the qualification letter without delays. Auxiliary space: Some Auxiliary space can be accessed by children, even though it is not licensed if children are permitted by parents to be outside of the fenced area. However, this shall not be frequently done, as regulatory accessed space must be licensed. Auxiliary space can be visited a few times/years for special events or occasional special lessons. QIRS discussion: Per conversation with Ms. Loria, she disclosed that the program is considering renewing the Rated License Assessment with pathway 2- Instructional and Classroom Quality Pathway. The program is still going through NECAP Accreditation. In order to receive on-site visits required for NECAP accreditation, the program is required to submit the request for on-site visit by the end of June 2026. Ms. Loria does not think that the program will be ready to do so yet. The program is considering purchasing Teaching Strategies Gold. Growing Meal: Starting next school year, the program will not cook on-site. Parents can choose to pack their children’s lunch or order through Growing Meal. Ms. Loria will work with Growing Meal to discuss nutrition requirements. Administrative Action: A repeat violation of the criminal background check requirement for two consecutive visits may result in an administrative action warrant. 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 .3222 (c) If employment-related changes occur at a facility that result in noncompliance with or failure to meet the standards in the Section for the star rating issued, the operator shall correct the noncompliance within six months. If the operator does not correct the noncompliance within six months, 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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 .1801 · Violation

Name of Operation: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: 0326-144L Visit Date: 3/17/2026 Number Present: 97 Completed Date: 3/17/2026 Age: From 0 To 5 Total Minutes: 275 Time In: 10:18 AM Time Out: 02:53 PM Time In: Time Out: List to Use: Center Type Of Visit: Self Report Announced/Unannounced: Unannounced The purpose of today’s visit was to obtain information related to a self-report received by the Division. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to you. During today’s visit, Ms. Loria accompanied me during a walk through the facility I discussed the information with Ms. Loria and one (1) staff member. Emmanuel Lutheran School operates with four-star center license issued on 6/20/19 with restrictions: daytime care, meets enhanced space and reduced ratios. Limited monitoring of child care requirements was conducted today to include supervision, general safety, permit restrictions, staff/child ratios and program record. There is a concern of inadequate supervision. Walk-through of the facility: License was posted and permit restrictions were maintained. No safety hazards were observed. • Space #1 (117) A group of five (5) infants with two (2) staff members were present. Two (2) infants sat/laid on the floor next to the lead teacher and held toys. One (1) sat near the lead teacher and mouthed a toy, and the other two (2) children sat with the teacher and explored the environment. • Space #2 (114) A group of fourteen (14) children, four-to-five years of age, were present with two (2) staff members. The group transitioned to music class in the sanctuary. The children lined up in front of the classroom and walked in line to the sanctuary. • Space #3 (101) Eleven (11) children, two-to-three years of age, were present with two (2) staff members. The children engaged in free play with puzzles, toy vehicles and tracks and other materials. One (1) staff member supervised the group while the other staff member aided two (2) children in the bathroom. • Space #4 (102) A group of ten (10) children, two-to-three years of age, were present with two (2) staff members. The group transitioned to the gym during observation. The children gathered and lined up by the back door. One (1) child was asked to hold the door for the group. One (1) staff member lead the group and the other staff member was the last person in line. • Space #5 (103) A total of eleven (11) children, two-to-three years of age, were present with two (2) staff members. The children used the gym to play as the playgrounds were partly covered by snow. • Space #6 (203) A total of seven (7) children, all two (2) years of age, were present with two (2) staff members. One (1) child’s diaper was changed, and the other children explored the classroom. One (1) staff member read a book to the group • Space #7 (202) A group of eight (8) children, all one (1) year of age, were present with two (2) staff members. The children attempted to clean up with teacher prompts and got ready for lunch. Today, chicken patties, rolls, green beans, mandarin oranges and milk were served for lunch. Food was cut into smaller pieces before serving children. Supervision during meal was adequate. • Space #8 (201) Eight (8) children, all one (1) year of age, were present with two (2) staff members. One (1) child’s diaper was changed during observation, while the other children gathered around the other staff member and played with rattles and other materials. • Space #9 (111) A group of ten (10) children, three-to-four years of age, were present with two (2) staff members. The group transitioned to use the bathroom in the hallway. One (1) staff member supervised the girl’s bathroom while the other staff member supervised the boy’s. • Space #10 (113) A group of thirteen (13) children, four-to-five years of age, were present with two (2) staff members today. When I visited the classroom, twelve (12) children and one (1) staff member was present as one (1) child was temporarily moved to space #2 while one (1) staff member used the bathroom. Some children in space #2, #3 #4, #5, #9, #10, participated in Soccer Shots today. Classroom staff members stayed with the group of children to maintain the staff/child ratios. Supervision and interaction were adequate during today’s visit. Video Footage Review: Video footage of the incident that occurred on March 11, 2026, was reviewed. The footage was captured from the camera facing the infant/toddler playground. At 4:46 p.m., seven (7) children and three (3) adults were present on the playground. According to Ms. Loria, one (1) of the adults was the grandparent of one (1) child present on the playground. At 4:48 p.m., one (1) staff member was observed conversing with the grandparent. At the same time, another staff member escorted four (4) children out of the fenced area and loaded them onto a buggy. At 4:50 p.m., the grandparent and one (1) child left the playground. One (1) additional child exited the playground gate and was loaded onto the buggy by the staff members who were already there. The second staff member exited the playground shortly thereafter. A total of five (5) children and two (2) staff members left the playground area at 4:50 p.m. As the two (2) staff members and five (5) children departed on the buggy, one (1) child remained on the playground and walked toward the tree structure. The child was several feet away from one (1) staff member, positioned diagonally behind the child on the left side. The staff member did not notice the child’s presence and left with the group. From 4:50 p.m. to 4:53 p.m., the child remained alone on the playground, standing and walking near the tree structure while looking around. At 4:53 p.m., a parent and two (2) children exited the cafeteria and noticed the child on the playground. The parent looked around briefly and then returned to the building. At 4:55 p.m., a staff member from the K–8 after-school program exited the building, entered the playground, took the child by the hand, and returned inside. Interviews: Ms. Loria was interviewed. She stated that some children from Space #6 and Space #7 were combined on the playground for the last hour on the day of the incident. One (1) teacher from Space #6 and one (1) teacher from Space #7 were supervising the group. When asked about the sequence of events after the child was taken inside, Ms. Loria stated that the after-school staff member reported the incident to the principal and returned the child to Space #6. While on the way to the classroom, the teacher from Space #7 encountered the staff member and the child as the teacher was clocking out for the day. This was how teachers in space #6 and #7 became aware of the child being left behind on the playground. The teacher from Space #7 clocked out because he/she believed that five (5) children, ages one to two years, were present. When the child who had been left on the playground was brought inside, the teacher from Space #7 remained in the classroom to maintain the appropriate staff-to-child ratios. At approximately the same time, the parent who observed the child alone on the playground emailed Ms. Loria, at which point she became aware of the incident. Teacher interview: One (1) of the teachers involved in the incident was not present due to inclement weather. One (1) teacher from Space #6 was interviewed. The staff member stated that he/she had been working in one (1) of the pre-K classrooms until approximately 4:30 p.m. on the day of the incident and then joined the other teacher and children from Space #6 and Space #7 on the playground. The staff member stated that he/she did not have a clear awareness of which children were present and did not realize that one (1) child had been left on the playground unattended. After the incident: Per Ms. Loria, disciplinary action was considered but was not taken, as both staff members took the incident seriously and were extremely upset. Both staff members completed the “Supervision in Early Childhood Programs” training through the iPD Portfolio on the Head Start website. The teacher from Space #6 completed the training on March 11, 2026, and the teacher from Space #7 completed the training on March 12, 2026. Training certificates were maintained on file and reviewed during today’s visit. Ms. Loria stated that a staff meeting is planned for the Teacher Workday on March 20, 2026, during which supervision protocols will be reviewed. The protocol requires staff members to review the check-in/check-out list in the Brightwheel app prior to leaving an area and upon arrival in the classroom. No additional documentation will be required, as the sign-in/out data in the Brightwheel app will be used for reference purposes only. At the time of the visit, no written supervision or transition policies were in place. However, the program is in the process of obtaining National Early Childhood Program Accreditation (NECPA). As part of the NECPA requirements, detailed supervision policies must be developed and submitted. Ms. Loria plans to include all supervision and transition protocols in the written policy. Program Record Review: The attendance records, including sign-in and sign-out times on Brightwheel, for children in Space #6 and Space #7 on March 9, 2026, were reviewed. According to the records, seven (7) children remained in care at 4:50 p.m., at the time of the incident. Video footage shows five (5) children being loaded onto the buggies and taken inside, while one (1) child remained on the playground. The records indicate that one (1) child was signed out at 4:51 p.m., representing a discrepancy that was further investigated. The staff member from Space #6 stated that the child signed out at 4:51 p.m. was the child whose grandparent was present on the playground in the video footage. The teacher further stated that the child was signed out by him/her in the classroom after the group of five (5) children and two (2) staff members returned to the classroom. This reflected that sign-in/out records may not always be accurate for staff members to rely on without further actions. Based on information obtained, the following was determined. On March 9, 2026, at approximately 4:50 pm, a child, two (2) years of age, was left unattended on the infant/toddler playground for approximately three (3) minutes until a parent found the child on the playground and reported it to a staff on site. Based on self-report and interviews, the concern regarding supervision is confirmed. The following violations were documented during today’s visit: Violation Number Comment Rule 303 Children were not adequately supervised at all times. On March 9, 2026, at approximately 4:50 pm, a child, two (2) years of age, was left unattended on the infant/toddler playground for approximately three (3) minutes until a parent found the child on the playground and reported it to a staff on site. .1801(a)(1-5) Technical assistance was provided as follows: 303: adequate supervision – transition to/from playground Children must be adequately supervised at all times to keep children safe. Some sections of the playground were not easily visible. It is important to walk the perimeter of the playground to ensure all children are with the group prior to going indoors. Strategies for supervision of children are available on National Resource Center under 2.2 Supervision and Discipline guideline at https://nrckids.org/CFOC/Database/2.2.0.1. Active and positive supervision involves knowing each child’s abilities, establishing clear and simple safety rules, being aware of potential hazards, standing in strategic positions, and scanning play areas and circulating around space. There are multiple safeguards and procedures needed for adequate supervision during transitions. • Accurate data are essential—without them, staff cannot ensure that all children are accounted for. Relying on a single record may not be sufficient. Examples to prevent errors include recording accurate departure times, not relying solely on parent/guardian sign-out, developing procedures to ensure children are signed out before any informal conferences or meetings, taking head counts throughout the day by multiple staff members, and consistently communicating the counts to each other. • Threshold counts – Children shall be counted as they cross all thresholds. If a door closes and any children are left in a separate space, it is considered a supervision error. Therefore, one staff member should manage the threshold while another supervises the entire group to ensure no child is left behind. During transitions, staff members shall remain vigilant to make sure no children wander away from the group. • Sweeping of space – Staff members shall be aware of hard-to-see or hiding places and ensure the area is thoroughly checked before any transition. • Teacher communication – Communication between staff members is critical for preventing mistakes. Staff shall actively talk with each other and share head counts, using clear statements such as, “I counted 10 children, how about you?” or “I am verifying that two children left the classroom with the therapist. Can you take a head count? I will do the same.” Consistent verbal communication helps ensure all children are accounted for during transitions. • Name-to-face counts – Staff members shall conduct name-to-face counts to ensure each child is accounted for, especially during transitions or when children leave a group for therapy, restroom breaks, or other activities. This practice requires staff to visually verify each child against the roster rather than relying solely on memory or sign-in/out records. Name-to-face counts should be performed multiple times by different staff members, with results communicated clearly to the team to prevent errors and ensure the safety of every child. • Administrative oversight – No policy can be adequately implemented without administrative oversight. Administrators are responsible for ensuring staff consistently follow procedures, providing guidance and clarification when needed, and monitoring compliance during daily operations. Regular observations, reviews of transition practices, and follow-up on any incidents help identify areas for improvement. Administrators should also provide ongoing training, model best practices, and encourage open communication among staff to maintain a culture of safety and accountability. Refer to 10A NCAC 09 .1801(a)(1-5). A consult follow-up visit must be completed to verify the compliance. Review of the supervision policy and center’s transition protocols with staff members involved in the incident are strongly recommended. If you find transition protocol to be insufficient, plan to improve the plan and share it with all staff members. Administrative oversight is critical in implementing new protocols. Achieving Compliance: The facility received a violation regarding supervision today. A follow-up visit will be conducted in the near future to determine if staff are adequately supervising children per Child Care Rule 10A NCAC 09 .1801(a)(1-5). Due to additional visit is required to verify compliance, a compliance letter is not required for item 303. Consultation is provided as follows: QIRS discussion – Ms. Loria and I discussed the progress of QIRS. The program is in the process of obtaining NECPA accreditation. We discussed the need for additional education evaluation for staff members for 4-star level. Ms. Loria thought that at least 50% of lead teachers and other staff members would meet the 4-star level education standards. NECPA standards: I reviewed chapter 2 – supervision of NECPA standards. The chapter include general supervision, child-staff ratios, daily attendance records of children, pick up and drop off procedures and active and positive supervision. 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. 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 to 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 can be a resource for you while you strive to provide a safe and healthy environment for the well-being of young children. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: 0326-144L Visit Date: 3/17/2026 Number Present: 97 Completed Date: 3/17/2026 Age: From 0 To 5 Total Minutes: 275 Time In: 10:18 AM Time Out: 02:53 PM Time In: Time Out: List to Use: Center Type Of Visit: Self Report Announced/Unannounced: Unannounced The purpose of today’s visit was to obtain information related to a self-report received by the Division. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to you. During today’s visit, Ms. Loria accompanied me during a walk through the facility I discussed the information with Ms. Loria and one (1) staff member. Emmanuel Lutheran School operates with four-star center license issued on 6/20/19 with restrictions: daytime care, meets enhanced space and reduced ratios. Limited monitoring of child care requirements was conducted today to include supervision, general safety, permit restrictions, staff/child ratios and program record. There is a concern of inadequate supervision. Walk-through of the facility: License was posted and permit restrictions were maintained. No safety hazards were observed. • Space #1 (117) A group of five (5) infants with two (2) staff members were present. Two (2) infants sat/laid on the floor next to the lead teacher and held toys. One (1) sat near the lead teacher and mouthed a toy, and the other two (2) children sat with the teacher and explored the environment. • Space #2 (114) A group of fourteen (14) children, four-to-five years of age, were present with two (2) staff members. The group transitioned to music class in the sanctuary. The children lined up in front of the classroom and walked in line to the sanctuary. • Space #3 (101) Eleven (11) children, two-to-three years of age, were present with two (2) staff members. The children engaged in free play with puzzles, toy vehicles and tracks and other materials. One (1) staff member supervised the group while the other staff member aided two (2) children in the bathroom. • Space #4 (102) A group of ten (10) children, two-to-three years of age, were present with two (2) staff members. The group transitioned to the gym during observation. The children gathered and lined up by the back door. One (1) child was asked to hold the door for the group. One (1) staff member lead the group and the other staff member was the last person in line. • Space #5 (103) A total of eleven (11) children, two-to-three years of age, were present with two (2) staff members. The children used the gym to play as the playgrounds were partly covered by snow. • Space #6 (203) A total of seven (7) children, all two (2) years of age, were present with two (2) staff members. One (1) child’s diaper was changed, and the other children explored the classroom. One (1) staff member read a book to the group • Space #7 (202) A group of eight (8) children, all one (1) year of age, were present with two (2) staff members. The children attempted to clean up with teacher prompts and got ready for lunch. Today, chicken patties, rolls, green beans, mandarin oranges and milk were served for lunch. Food was cut into smaller pieces before serving children. Supervision during meal was adequate. • Space #8 (201) Eight (8) children, all one (1) year of age, were present with two (2) staff members. One (1) child’s diaper was changed during observation, while the other children gathered around the other staff member and played with rattles and other materials. • Space #9 (111) A group of ten (10) children, three-to-four years of age, were present with two (2) staff members. The group transitioned to use the bathroom in the hallway. One (1) staff member supervised the girl’s bathroom while the other staff member supervised the boy’s. • Space #10 (113) A group of thirteen (13) children, four-to-five years of age, were present with two (2) staff members today. When I visited the classroom, twelve (12) children and one (1) staff member was present as one (1) child was temporarily moved to space #2 while one (1) staff member used the bathroom. Some children in space #2, #3 #4, #5, #9, #10, participated in Soccer Shots today. Classroom staff members stayed with the group of children to maintain the staff/child ratios. Supervision and interaction were adequate during today’s visit. Video Footage Review: Video footage of the incident that occurred on March 11, 2026, was reviewed. The footage was captured from the camera facing the infant/toddler playground. At 4:46 p.m., seven (7) children and three (3) adults were present on the playground. According to Ms. Loria, one (1) of the adults was the grandparent of one (1) child present on the playground. At 4:48 p.m., one (1) staff member was observed conversing with the grandparent. At the same time, another staff member escorted four (4) children out of the fenced area and loaded them onto a buggy. At 4:50 p.m., the grandparent and one (1) child left the playground. One (1) additional child exited the playground gate and was loaded onto the buggy by the staff members who were already there. The second staff member exited the playground shortly thereafter. A total of five (5) children and two (2) staff members left the playground area at 4:50 p.m. As the two (2) staff members and five (5) children departed on the buggy, one (1) child remained on the playground and walked toward the tree structure. The child was several feet away from one (1) staff member, positioned diagonally behind the child on the left side. The staff member did not notice the child’s presence and left with the group. From 4:50 p.m. to 4:53 p.m., the child remained alone on the playground, standing and walking near the tree structure while looking around. At 4:53 p.m., a parent and two (2) children exited the cafeteria and noticed the child on the playground. The parent looked around briefly and then returned to the building. At 4:55 p.m., a staff member from the K–8 after-school program exited the building, entered the playground, took the child by the hand, and returned inside. Interviews: Ms. Loria was interviewed. She stated that some children from Space #6 and Space #7 were combined on the playground for the last hour on the day of the incident. One (1) teacher from Space #6 and one (1) teacher from Space #7 were supervising the group. When asked about the sequence of events after the child was taken inside, Ms. Loria stated that the after-school staff member reported the incident to the principal and returned the child to Space #6. While on the way to the classroom, the teacher from Space #7 encountered the staff member and the child as the teacher was clocking out for the day. This was how teachers in space #6 and #7 became aware of the child being left behind on the playground. The teacher from Space #7 clocked out because he/she believed that five (5) children, ages one to two years, were present. When the child who had been left on the playground was brought inside, the teacher from Space #7 remained in the classroom to maintain the appropriate staff-to-child ratios. At approximately the same time, the parent who observed the child alone on the playground emailed Ms. Loria, at which point she became aware of the incident. Teacher interview: One (1) of the teachers involved in the incident was not present due to inclement weather. One (1) teacher from Space #6 was interviewed. The staff member stated that he/she had been working in one (1) of the pre-K classrooms until approximately 4:30 p.m. on the day of the incident and then joined the other teacher and children from Space #6 and Space #7 on the playground. The staff member stated that he/she did not have a clear awareness of which children were present and did not realize that one (1) child had been left on the playground unattended. After the incident: Per Ms. Loria, disciplinary action was considered but was not taken, as both staff members took the incident seriously and were extremely upset. Both staff members completed the “Supervision in Early Childhood Programs” training through the iPD Portfolio on the Head Start website. The teacher from Space #6 completed the training on March 11, 2026, and the teacher from Space #7 completed the training on March 12, 2026. Training certificates were maintained on file and reviewed during today’s visit. Ms. Loria stated that a staff meeting is planned for the Teacher Workday on March 20, 2026, during which supervision protocols will be reviewed. The protocol requires staff members to review the check-in/check-out list in the Brightwheel app prior to leaving an area and upon arrival in the classroom. No additional documentation will be required, as the sign-in/out data in the Brightwheel app will be used for reference purposes only. At the time of the visit, no written supervision or transition policies were in place. However, the program is in the process of obtaining National Early Childhood Program Accreditation (NECPA). As part of the NECPA requirements, detailed supervision policies must be developed and submitted. Ms. Loria plans to include all supervision and transition protocols in the written policy. Program Record Review: The attendance records, including sign-in and sign-out times on Brightwheel, for children in Space #6 and Space #7 on March 9, 2026, were reviewed. According to the records, seven (7) children remained in care at 4:50 p.m., at the time of the incident. Video footage shows five (5) children being loaded onto the buggies and taken inside, while one (1) child remained on the playground. The records indicate that one (1) child was signed out at 4:51 p.m., representing a discrepancy that was further investigated. The staff member from Space #6 stated that the child signed out at 4:51 p.m. was the child whose grandparent was present on the playground in the video footage. The teacher further stated that the child was signed out by him/her in the classroom after the group of five (5) children and two (2) staff members returned to the classroom. This reflected that sign-in/out records may not always be accurate for staff members to rely on without further actions. Based on information obtained, the following was determined. On March 9, 2026, at approximately 4:50 pm, a child, two (2) years of age, was left unattended on the infant/toddler playground for approximately three (3) minutes until a parent found the child on the playground and reported it to a staff on site. Based on self-report and interviews, the concern regarding supervision is confirmed. The following violations were documented during today’s visit: Violation Number Comment Rule 303 Children were not adequately supervised at all times. On March 9, 2026, at approximately 4:50 pm, a child, two (2) years of age, was left unattended on the infant/toddler playground for approximately three (3) minutes until a parent found the child on the playground and reported it to a staff on site. .1801(a)(1-5) Technical assistance was provided as follows: 303: adequate supervision – transition to/from playground Children must be adequately supervised at all times to keep children safe. Some sections of the playground were not easily visible. It is important to walk the perimeter of the playground to ensure all children are with the group prior to going indoors. Strategies for supervision of children are available on National Resource Center under 2.2 Supervision and Discipline guideline at https://nrckids.org/CFOC/Database/2.2.0.1. Active and positive supervision involves knowing each child’s abilities, establishing clear and simple safety rules, being aware of potential hazards, standing in strategic positions, and scanning play areas and circulating around space. There are multiple safeguards and procedures needed for adequate supervision during transitions. • Accurate data are essential—without them, staff cannot ensure that all children are accounted for. Relying on a single record may not be sufficient. Examples to prevent errors include recording accurate departure times, not relying solely on parent/guardian sign-out, developing procedures to ensure children are signed out before any informal conferences or meetings, taking head counts throughout the day by multiple staff members, and consistently communicating the counts to each other. • Threshold counts – Children shall be counted as they cross all thresholds. If a door closes and any children are left in a separate space, it is considered a supervision error. Therefore, one staff member should manage the threshold while another supervises the entire group to ensure no child is left behind. During transitions, staff members shall remain vigilant to make sure no children wander away from the group. • Sweeping of space – Staff members shall be aware of hard-to-see or hiding places and ensure the area is thoroughly checked before any transition. • Teacher communication – Communication between staff members is critical for preventing mistakes. Staff shall actively talk with each other and share head counts, using clear statements such as, “I counted 10 children, how about you?” or “I am verifying that two children left the classroom with the therapist. Can you take a head count? I will do the same.” Consistent verbal communication helps ensure all children are accounted for during transitions. • Name-to-face counts – Staff members shall conduct name-to-face counts to ensure each child is accounted for, especially during transitions or when children leave a group for therapy, restroom breaks, or other activities. This practice requires staff to visually verify each child against the roster rather than relying solely on memory or sign-in/out records. Name-to-face counts should be performed multiple times by different staff members, with results communicated clearly to the team to prevent errors and ensure the safety of every child. • Administrative oversight – No policy can be adequately implemented without administrative oversight. Administrators are responsible for ensuring staff consistently follow procedures, providing guidance and clarification when needed, and monitoring compliance during daily operations. Regular observations, reviews of transition practices, and follow-up on any incidents help identify areas for improvement. Administrators should also provide ongoing training, model best practices, and encourage open communication among staff to maintain a culture of safety and accountability. Refer to 10A NCAC 09 .1801(a)(1-5). A consult follow-up visit must be completed to verify the compliance. Review of the supervision policy and center’s transition protocols with staff members involved in the incident are strongly recommended. If you find transition protocol to be insufficient, plan to improve the plan and share it with all staff members. Administrative oversight is critical in implementing new protocols. Achieving Compliance: The facility received a violation regarding supervision today. A follow-up visit will be conducted in the near future to determine if staff are adequately supervising children per Child Care Rule 10A NCAC 09 .1801(a)(1-5). Due to additional visit is required to verify compliance, a compliance letter is not required for item 303. Consultation is provided as follows: QIRS discussion – Ms. Loria and I discussed the progress of QIRS. The program is in the process of obtaining NECPA accreditation. We discussed the need for additional education evaluation for staff members for 4-star level. Ms. Loria thought that at least 50% of lead teachers and other staff members would meet the 4-star level education standards. NECPA standards: I reviewed chapter 2 – supervision of NECPA standards. The chapter include general supervision, child-staff ratios, daily attendance records of children, pick up and drop off procedures and active and positive supervision. 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. 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 to 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 can be a resource for you while you strive to provide a safe and healthy environment for the well-being of young children. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 10/30/2025 Number Present: 113 Completed Date: 10/30/2025 Age: From 0 To 5 Total Minutes: 452 Time In: 09:30 AM Time Out: 05:02 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, Kaoru Eddins Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to you. Today, Ms. Loria was available during the visit. 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-five (85) percent as of today prior to this visit. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Emmanuel Lutheran Church of Asheville, N.C., Inc., is current/active as of 10/27/25. Permit type – four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/7/25. The last fire drill was practiced on 10/21/25. The last shelter-in-place drill was practiced on 10/21/25. The last playground inspection was documented on 10/17/25. The last fire inspection was approved on 3/28/25. The last sanitation inspection was conducted on 2/28/25 with nineteen (19) demerits for an approved classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 1/8/24 without hazards. Lead paint and asbestos testing were under review. On 8/25/25, visual inspection for remediation for lead and asbestos was completed, and the facility did not pass Staff roster on the ABCMS is in progress. Upon arrival, I announced my presence and the purpose of the visit. In space #1, six (6) infants with two (2) staff members were present. One (1) was held by a staff member and fed a bottle, two (2) were in the seat bouncer, one (1) was in the upright bouncer and one (1) was in a seating device and one (1) was in the crib. The child in the crib cried for a few minutes and fell asleep. Bottles were labeled with each child’s name and today’s date. Feeding plan for each child was signed and posted. Interaction and supervision were adequate. Each child had a sleep sack to sleep. In space #6, eight (8) children, infants and one (1) were present with two (2) staff members. Two (2) children, an infant and one (1) year old were laying down on the floor on boppy pillows feeding themselves bottles as they fell asleep. Both children finished the bottles and fell asleep on the boppy. They were moved to cribs several minutes later. A total of five (5) children were in the crib. Two (2) children were on the crib awake for more than twenty (20) minutes. Staff members stated that they were put in the cribs for nap time and the children typically fall asleep on their own. One (1) of the children in the crib cried over several minutes attempting to pull himself/herself out of the crib looking at staff members. I instructed staff members to remove the child from the crib after several minutes. Twelve (12) children transitioned from outside to inside in space #5 (103). Some of the children used the bathroom in the hallway and the other children came inside to wash their hands in the sink in the classroom. BBQ meatballs, green beans, diced pears, hush puppies and milk were served for lunch. Nap time was observed in space #10 (113), some cots were placed in the group area very closely, but they used matts as dividers. Space #9 was occupied with thirteen (13) children, three (3) to four (4) years old with two (2) staff members. The playground were monitored, and no safety hazards were observed. Permission forms, action plan and storage of medication were in compliance for all over-the-counter products and emergency medications. I reviewed three (3) existing staff files in full, nine (9) new staff members’ files. Staff and Training Worksheet was submitted by Ms. Loria, but each staff member’s on-going training information may not be accurate. Therefore, a few additional staff members files were reviewed for on-going training information and other missing information. Thirteen (13) children’s files were monitored. 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 491 Caregiver did not respond at the earliest opportunity to an infant or toddler’s physical and emotional needs. One (1) child was left crying in the crib for several minutes in space #6. The child spent over twenty (20) minutes awake in the crib and cried for several minutes at the end. The child was alert and awake, standing up in the crib, reaching for adult to pick him/her up. .0511(b)(1) 532 All children were not held or placed in feeding chairs or other appropriate apparatus to be fed. Two (2) children fed themselves a bottle on the floor as they laid on the boppy. The children fell asleep on the boppy as they fed themselves in room 203. 10A NCAC 09 .0902(b) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. several packets/boxes of batteries were stored in the cabinet by the entrance door in room 102. A baby proof device was on the cabinet. .2820(b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In room 203, an Auvi-Q was maintained without an original box with a pharmacy label. .0803(2)(a) 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 following diaper creams and over-the-counter products were expired: • Boudreaux’s Butt Past expired in 07/2025 in space #6 (203) • After Bite Liquid expired in 09/2023 in space #6 (203) • Boudreaux’s Butt Past expired in 05/2025 in space # (117) • Aquaphor 3-in-1 Diaper Rash Cream expired in 05/2025 in space #4 (102) .0803(12) 1030 Application for employment and date of birth was not on file for all staff. An application for staff member employed on 3/8/21 was not on file. .0302(d)(1)(A) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Orientation information was not found for FR (DOE - 9/8/25). Most of the orientation form are missing information for new staff members. .1101(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. At least two (2) staff members did not complete the required training hours. F.N (DOE- 4/15/08) completed six (6) hours of training between 4/15/24 - 4/14/25 while the requirement was ten (10) hours. C.M (DOE-2/14/23) completed 1.5 hours of training between 2/14/24 - 2/13/25. The requirement was twenty (20) hours. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Many of the new staff member's orientation hours were not logged. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Twenty-nine (29) staff members did not have annual evaluation on files. 10A NCAC 09 .0514(f) 1898 Staff did not complete the health and safety training within one year of employment. C.M (DOE -2/14/23), K.D (DOE-2/26/25), and J.S. (DOE-2/26/24) have not completed the Health and Safety Training. .1102(a) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. C.G. (DOE-3/21/18) completed Health and Safety training on 10/25/20 but did not complete the fifth year training. .1103(b) Technical assistance was provided as follows: 491: meeting needs for infants and toddlers Staff members must meet the needs of infants and toddlers at the earliest opportunity. Building routines is important for young children. However, staff members shall not force routines on infants and toddlers but flexibly deal with each situation considering the needs of each child. It is permitted to place a child in the crib to encourage him/her to put himself/herself to sleep. However, different approaches may be needed based on the child’s mood, environment and other factors. Children should not be left crying without attending for extended period of time. In your compliance letter, please state what types of discussions/training you had with the staff members. 532: Designated feeding area Children must be fed in the designated areas, such as tables/chairs, high chairs. Young children can be held during bottle feeding. However, play area shall not be used as feeding areas. In your compliance letter, please state what types of discussions/training you had with the staff members. 840: Potentially hazardous products Batteries are considered corrosive agent; therefore, they must be stored in locked storage. Baby-proof devices are not sufficient. Please remove all alkaline batteries in the cabinet by the entrance door in space #4 (102) and store them in a locked storage. 844: pharmacy box Prescription medication must be in its original box with a pharmacy label. Auvi-Q in space # 6 (203) was not in its original box with a pharmacy label. To comply, you can ask the parent to provide the original box or ask for a pharmacy label. Each time staff member administers the medication, right child, right dosage, right route, right time and right medication must be verified. 849: Expired medication and over-the-counter products Expired medication and products must be returned to the family or discarded within seventy-two (72) hours of their expiration dates. To comply, please send the following products. • Boudreaux’s Butt Past expired in 07/2025 in space #6 (203) • After Bite Liquid expired in 09/2023 in space #6 (203) • Boudreaux’s Butt Past expired in 05/2025 in space # (117) • Aquaphor 3-in-1 Diaper Rash Cream expired in 05/2025 in space #4 (102) 1030: Application for Employment Application for employment and verification of date of birth must be maintained in the staff file. R. Rutherford’s application was not maintained in the staff file. Please locate the application and file them. If original application is not found, you may create the new one. 1045 & 1067: Orientation The program is required to provide minimum of six (6) hours of orientation and cover required topics within the first two (2) weeks of employment. Minimum of ten (10) hours of orientation and covering required topics within the first six (6) weeks of employment is also required. Make sure to cover all required topics, hours of orientation and initials. Most of the new staff orientation form are issing information, such as hours and initials. All topics on the orientation form must be reviewed. Please remember to use the most updated orientation form. The form was printed and shared with Ms. Loria during the visit. 1052: On-going training Each staff member must complete required hours of training starting the second year of employment. The training period is determined based on each member of staff’s hiring date. The required hours are determined based on the education listed on his/her WORKS letter. It is important for each staff member and administrators to understand the accurate training period and required hours for each member of staff. F. Norton’s completed training period is 4/15/24 through 4/14/25. During the period, he/she completed six (6) hours of training. C. McCormick’s completed training period is 2/14/24 through 2/13/25. During the period, he/she completed 1.5 hours of training. To comply, F. Norton must complete four (4) hours of training within the next two (2) weeks. These training is to make up for the last training period. Therefore, the hours will not count for the current period. C. McCormick needs 18.5 hours of training within the next two (2) weeks based on the understanding that he/she needs twenty (20) hours of training. Although I did not have time to review all staff members’ ongoing training hours, any staff who are short from the previous training period should complete additional training to make up the deficit. 1232: Annual evaluation Each staff member must have staff development plan and annual evaluation. Both documents must be renewed annually. No staff member except for one (1), had annual evaluation on the Staff and Training Worksheet. To comply, please complete the annual evaluation for all staff members and file them in their personal files. 1898 & 1899: Health and Safety Training Health and Safety training must be completed within one (1) year of employment and every five (5) years thereafter. Staff members and substitutes who work more than ten (10) days must complete health and safety training. K. Dorn, C. McCormick, J. Sherman did not complete their Health and Safety training within the first year of employment. C. Green did not complete the fifth year renewal training. To comply, those staff members listed above must complete the Health and Safety Training including “Medication in Child Care” training within the next two (2) weeks. Recognizing and Responding to Suspicions of Child Maltreatment training is not part of the renewal requirement. Print all certificates and file them behind the training log. 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 11/13/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Please fille out all sections for Staff and Training Worksheet before submitting them to me. Rated License Assessment: Pathways: Ms. Loria was interested in pathway 2 initially. The program is currently using Bright Wheel program where Ms. Loria customized the assessment tools to align with the NC FELD. However, Bright Wheel curriculum is not currently on the approved formative assessment list. We discussed that teachers need ample time to be trained, practice and understand the formative assessment tools. It is not something they can learn overnight. Due to this reason, it may be challenging to choose pathway 2 for upcoming assessment. For the renewal in 2029, it may be possible to choose pathway 2. I encouraged Ms. Loria to review accreditation options. I explained the requirements for CQI, Family and Community Engagement, education, staff/child ratios, self-study, mentoring and coaching options. Ms. Loria would like to look into several resources before determining the pathway. Timeline The next routine unannounced visit will be conducted in spring 2026 and the annual compliance visit prior to October 30, 2026. We discussed applying for the Rated License Assessment in late September 2026. This timeline will provide Ms. Loria to complete researches on accreditation and formative assessment as well as work on the Outreach assessment and self-study depending on her choice. Resources needed: I will periodically check on you to discuss your options. 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 .3222 (c) If employment-related changes occur at a facility that result in noncompliance with or failure to meet the standards in the Section for the star rating issued, the operator shall correct the noncompliance within six months. If the operator does not correct the noncompliance within six months, 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 10/30/2025 Number Present: 113 Completed Date: 10/30/2025 Age: From 0 To 5 Total Minutes: 452 Time In: 09:30 AM Time Out: 05:02 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, Kaoru Eddins Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to you. Today, Ms. Loria was available during the visit. 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-five (85) percent as of today prior to this visit. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Emmanuel Lutheran Church of Asheville, N.C., Inc., is current/active as of 10/27/25. Permit type – four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/7/25. The last fire drill was practiced on 10/21/25. The last shelter-in-place drill was practiced on 10/21/25. The last playground inspection was documented on 10/17/25. The last fire inspection was approved on 3/28/25. The last sanitation inspection was conducted on 2/28/25 with nineteen (19) demerits for an approved classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 1/8/24 without hazards. Lead paint and asbestos testing were under review. On 8/25/25, visual inspection for remediation for lead and asbestos was completed, and the facility did not pass Staff roster on the ABCMS is in progress. Upon arrival, I announced my presence and the purpose of the visit. In space #1, six (6) infants with two (2) staff members were present. One (1) was held by a staff member and fed a bottle, two (2) were in the seat bouncer, one (1) was in the upright bouncer and one (1) was in a seating device and one (1) was in the crib. The child in the crib cried for a few minutes and fell asleep. Bottles were labeled with each child’s name and today’s date. Feeding plan for each child was signed and posted. Interaction and supervision were adequate. Each child had a sleep sack to sleep. In space #6, eight (8) children, infants and one (1) were present with two (2) staff members. Two (2) children, an infant and one (1) year old were laying down on the floor on boppy pillows feeding themselves bottles as they fell asleep. Both children finished the bottles and fell asleep on the boppy. They were moved to cribs several minutes later. A total of five (5) children were in the crib. Two (2) children were on the crib awake for more than twenty (20) minutes. Staff members stated that they were put in the cribs for nap time and the children typically fall asleep on their own. One (1) of the children in the crib cried over several minutes attempting to pull himself/herself out of the crib looking at staff members. I instructed staff members to remove the child from the crib after several minutes. Twelve (12) children transitioned from outside to inside in space #5 (103). Some of the children used the bathroom in the hallway and the other children came inside to wash their hands in the sink in the classroom. BBQ meatballs, green beans, diced pears, hush puppies and milk were served for lunch. Nap time was observed in space #10 (113), some cots were placed in the group area very closely, but they used matts as dividers. Space #9 was occupied with thirteen (13) children, three (3) to four (4) years old with two (2) staff members. The playground were monitored, and no safety hazards were observed. Permission forms, action plan and storage of medication were in compliance for all over-the-counter products and emergency medications. I reviewed three (3) existing staff files in full, nine (9) new staff members’ files. Staff and Training Worksheet was submitted by Ms. Loria, but each staff member’s on-going training information may not be accurate. Therefore, a few additional staff members files were reviewed for on-going training information and other missing information. Thirteen (13) children’s files were monitored. 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 491 Caregiver did not respond at the earliest opportunity to an infant or toddler’s physical and emotional needs. One (1) child was left crying in the crib for several minutes in space #6. The child spent over twenty (20) minutes awake in the crib and cried for several minutes at the end. The child was alert and awake, standing up in the crib, reaching for adult to pick him/her up. .0511(b)(1) 532 All children were not held or placed in feeding chairs or other appropriate apparatus to be fed. Two (2) children fed themselves a bottle on the floor as they laid on the boppy. The children fell asleep on the boppy as they fed themselves in room 203. 10A NCAC 09 .0902(b) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. several packets/boxes of batteries were stored in the cabinet by the entrance door in room 102. A baby proof device was on the cabinet. .2820(b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In room 203, an Auvi-Q was maintained without an original box with a pharmacy label. .0803(2)(a) 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 following diaper creams and over-the-counter products were expired: • Boudreaux’s Butt Past expired in 07/2025 in space #6 (203) • After Bite Liquid expired in 09/2023 in space #6 (203) • Boudreaux’s Butt Past expired in 05/2025 in space # (117) • Aquaphor 3-in-1 Diaper Rash Cream expired in 05/2025 in space #4 (102) .0803(12) 1030 Application for employment and date of birth was not on file for all staff. An application for staff member employed on 3/8/21 was not on file. .0302(d)(1)(A) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Orientation information was not found for FR (DOE - 9/8/25). Most of the orientation form are missing information for new staff members. .1101(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. At least two (2) staff members did not complete the required training hours. F.N (DOE- 4/15/08) completed six (6) hours of training between 4/15/24 - 4/14/25 while the requirement was ten (10) hours. C.M (DOE-2/14/23) completed 1.5 hours of training between 2/14/24 - 2/13/25. The requirement was twenty (20) hours. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Many of the new staff member's orientation hours were not logged. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Twenty-nine (29) staff members did not have annual evaluation on files. 10A NCAC 09 .0514(f) 1898 Staff did not complete the health and safety training within one year of employment. C.M (DOE -2/14/23), K.D (DOE-2/26/25), and J.S. (DOE-2/26/24) have not completed the Health and Safety Training. .1102(a) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. C.G. (DOE-3/21/18) completed Health and Safety training on 10/25/20 but did not complete the fifth year training. .1103(b) Technical assistance was provided as follows: 491: meeting needs for infants and toddlers Staff members must meet the needs of infants and toddlers at the earliest opportunity. Building routines is important for young children. However, staff members shall not force routines on infants and toddlers but flexibly deal with each situation considering the needs of each child. It is permitted to place a child in the crib to encourage him/her to put himself/herself to sleep. However, different approaches may be needed based on the child’s mood, environment and other factors. Children should not be left crying without attending for extended period of time. In your compliance letter, please state what types of discussions/training you had with the staff members. 532: Designated feeding area Children must be fed in the designated areas, such as tables/chairs, high chairs. Young children can be held during bottle feeding. However, play area shall not be used as feeding areas. In your compliance letter, please state what types of discussions/training you had with the staff members. 840: Potentially hazardous products Batteries are considered corrosive agent; therefore, they must be stored in locked storage. Baby-proof devices are not sufficient. Please remove all alkaline batteries in the cabinet by the entrance door in space #4 (102) and store them in a locked storage. 844: pharmacy box Prescription medication must be in its original box with a pharmacy label. Auvi-Q in space # 6 (203) was not in its original box with a pharmacy label. To comply, you can ask the parent to provide the original box or ask for a pharmacy label. Each time staff member administers the medication, right child, right dosage, right route, right time and right medication must be verified. 849: Expired medication and over-the-counter products Expired medication and products must be returned to the family or discarded within seventy-two (72) hours of their expiration dates. To comply, please send the following products. • Boudreaux’s Butt Past expired in 07/2025 in space #6 (203) • After Bite Liquid expired in 09/2023 in space #6 (203) • Boudreaux’s Butt Past expired in 05/2025 in space # (117) • Aquaphor 3-in-1 Diaper Rash Cream expired in 05/2025 in space #4 (102) 1030: Application for Employment Application for employment and verification of date of birth must be maintained in the staff file. R. Rutherford’s application was not maintained in the staff file. Please locate the application and file them. If original application is not found, you may create the new one. 1045 & 1067: Orientation The program is required to provide minimum of six (6) hours of orientation and cover required topics within the first two (2) weeks of employment. Minimum of ten (10) hours of orientation and covering required topics within the first six (6) weeks of employment is also required. Make sure to cover all required topics, hours of orientation and initials. Most of the new staff orientation form are issing information, such as hours and initials. All topics on the orientation form must be reviewed. Please remember to use the most updated orientation form. The form was printed and shared with Ms. Loria during the visit. 1052: On-going training Each staff member must complete required hours of training starting the second year of employment. The training period is determined based on each member of staff’s hiring date. The required hours are determined based on the education listed on his/her WORKS letter. It is important for each staff member and administrators to understand the accurate training period and required hours for each member of staff. F. Norton’s completed training period is 4/15/24 through 4/14/25. During the period, he/she completed six (6) hours of training. C. McCormick’s completed training period is 2/14/24 through 2/13/25. During the period, he/she completed 1.5 hours of training. To comply, F. Norton must complete four (4) hours of training within the next two (2) weeks. These training is to make up for the last training period. Therefore, the hours will not count for the current period. C. McCormick needs 18.5 hours of training within the next two (2) weeks based on the understanding that he/she needs twenty (20) hours of training. Although I did not have time to review all staff members’ ongoing training hours, any staff who are short from the previous training period should complete additional training to make up the deficit. 1232: Annual evaluation Each staff member must have staff development plan and annual evaluation. Both documents must be renewed annually. No staff member except for one (1), had annual evaluation on the Staff and Training Worksheet. To comply, please complete the annual evaluation for all staff members and file them in their personal files. 1898 & 1899: Health and Safety Training Health and Safety training must be completed within one (1) year of employment and every five (5) years thereafter. Staff members and substitutes who work more than ten (10) days must complete health and safety training. K. Dorn, C. McCormick, J. Sherman did not complete their Health and Safety training within the first year of employment. C. Green did not complete the fifth year renewal training. To comply, those staff members listed above must complete the Health and Safety Training including “Medication in Child Care” training within the next two (2) weeks. Recognizing and Responding to Suspicions of Child Maltreatment training is not part of the renewal requirement. Print all certificates and file them behind the training log. 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 11/13/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Please fille out all sections for Staff and Training Worksheet before submitting them to me. Rated License Assessment: Pathways: Ms. Loria was interested in pathway 2 initially. The program is currently using Bright Wheel program where Ms. Loria customized the assessment tools to align with the NC FELD. However, Bright Wheel curriculum is not currently on the approved formative assessment list. We discussed that teachers need ample time to be trained, practice and understand the formative assessment tools. It is not something they can learn overnight. Due to this reason, it may be challenging to choose pathway 2 for upcoming assessment. For the renewal in 2029, it may be possible to choose pathway 2. I encouraged Ms. Loria to review accreditation options. I explained the requirements for CQI, Family and Community Engagement, education, staff/child ratios, self-study, mentoring and coaching options. Ms. Loria would like to look into several resources before determining the pathway. Timeline The next routine unannounced visit will be conducted in spring 2026 and the annual compliance visit prior to October 30, 2026. We discussed applying for the Rated License Assessment in late September 2026. This timeline will provide Ms. Loria to complete researches on accreditation and formative assessment as well as work on the Outreach assessment and self-study depending on her choice. Resources needed: I will periodically check on you to discuss your options. 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 .3222 (c) If employment-related changes occur at a facility that result in noncompliance with or failure to meet the standards in the Section for the star rating issued, the operator shall correct the noncompliance within six months. If the operator does not correct the noncompliance within six months, 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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 .0514 · Violation

Name of Operation: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 10/30/2025 Number Present: 113 Completed Date: 10/30/2025 Age: From 0 To 5 Total Minutes: 452 Time In: 09:30 AM Time Out: 05:02 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, Kaoru Eddins Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to you. Today, Ms. Loria was available during the visit. 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-five (85) percent as of today prior to this visit. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Emmanuel Lutheran Church of Asheville, N.C., Inc., is current/active as of 10/27/25. Permit type – four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/7/25. The last fire drill was practiced on 10/21/25. The last shelter-in-place drill was practiced on 10/21/25. The last playground inspection was documented on 10/17/25. The last fire inspection was approved on 3/28/25. The last sanitation inspection was conducted on 2/28/25 with nineteen (19) demerits for an approved classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 1/8/24 without hazards. Lead paint and asbestos testing were under review. On 8/25/25, visual inspection for remediation for lead and asbestos was completed, and the facility did not pass Staff roster on the ABCMS is in progress. Upon arrival, I announced my presence and the purpose of the visit. In space #1, six (6) infants with two (2) staff members were present. One (1) was held by a staff member and fed a bottle, two (2) were in the seat bouncer, one (1) was in the upright bouncer and one (1) was in a seating device and one (1) was in the crib. The child in the crib cried for a few minutes and fell asleep. Bottles were labeled with each child’s name and today’s date. Feeding plan for each child was signed and posted. Interaction and supervision were adequate. Each child had a sleep sack to sleep. In space #6, eight (8) children, infants and one (1) were present with two (2) staff members. Two (2) children, an infant and one (1) year old were laying down on the floor on boppy pillows feeding themselves bottles as they fell asleep. Both children finished the bottles and fell asleep on the boppy. They were moved to cribs several minutes later. A total of five (5) children were in the crib. Two (2) children were on the crib awake for more than twenty (20) minutes. Staff members stated that they were put in the cribs for nap time and the children typically fall asleep on their own. One (1) of the children in the crib cried over several minutes attempting to pull himself/herself out of the crib looking at staff members. I instructed staff members to remove the child from the crib after several minutes. Twelve (12) children transitioned from outside to inside in space #5 (103). Some of the children used the bathroom in the hallway and the other children came inside to wash their hands in the sink in the classroom. BBQ meatballs, green beans, diced pears, hush puppies and milk were served for lunch. Nap time was observed in space #10 (113), some cots were placed in the group area very closely, but they used matts as dividers. Space #9 was occupied with thirteen (13) children, three (3) to four (4) years old with two (2) staff members. The playground were monitored, and no safety hazards were observed. Permission forms, action plan and storage of medication were in compliance for all over-the-counter products and emergency medications. I reviewed three (3) existing staff files in full, nine (9) new staff members’ files. Staff and Training Worksheet was submitted by Ms. Loria, but each staff member’s on-going training information may not be accurate. Therefore, a few additional staff members files were reviewed for on-going training information and other missing information. Thirteen (13) children’s files were monitored. 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 491 Caregiver did not respond at the earliest opportunity to an infant or toddler’s physical and emotional needs. One (1) child was left crying in the crib for several minutes in space #6. The child spent over twenty (20) minutes awake in the crib and cried for several minutes at the end. The child was alert and awake, standing up in the crib, reaching for adult to pick him/her up. .0511(b)(1) 532 All children were not held or placed in feeding chairs or other appropriate apparatus to be fed. Two (2) children fed themselves a bottle on the floor as they laid on the boppy. The children fell asleep on the boppy as they fed themselves in room 203. 10A NCAC 09 .0902(b) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. several packets/boxes of batteries were stored in the cabinet by the entrance door in room 102. A baby proof device was on the cabinet. .2820(b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In room 203, an Auvi-Q was maintained without an original box with a pharmacy label. .0803(2)(a) 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 following diaper creams and over-the-counter products were expired: • Boudreaux’s Butt Past expired in 07/2025 in space #6 (203) • After Bite Liquid expired in 09/2023 in space #6 (203) • Boudreaux’s Butt Past expired in 05/2025 in space # (117) • Aquaphor 3-in-1 Diaper Rash Cream expired in 05/2025 in space #4 (102) .0803(12) 1030 Application for employment and date of birth was not on file for all staff. An application for staff member employed on 3/8/21 was not on file. .0302(d)(1)(A) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Orientation information was not found for FR (DOE - 9/8/25). Most of the orientation form are missing information for new staff members. .1101(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. At least two (2) staff members did not complete the required training hours. F.N (DOE- 4/15/08) completed six (6) hours of training between 4/15/24 - 4/14/25 while the requirement was ten (10) hours. C.M (DOE-2/14/23) completed 1.5 hours of training between 2/14/24 - 2/13/25. The requirement was twenty (20) hours. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Many of the new staff member's orientation hours were not logged. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Twenty-nine (29) staff members did not have annual evaluation on files. 10A NCAC 09 .0514(f) 1898 Staff did not complete the health and safety training within one year of employment. C.M (DOE -2/14/23), K.D (DOE-2/26/25), and J.S. (DOE-2/26/24) have not completed the Health and Safety Training. .1102(a) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. C.G. (DOE-3/21/18) completed Health and Safety training on 10/25/20 but did not complete the fifth year training. .1103(b) Technical assistance was provided as follows: 491: meeting needs for infants and toddlers Staff members must meet the needs of infants and toddlers at the earliest opportunity. Building routines is important for young children. However, staff members shall not force routines on infants and toddlers but flexibly deal with each situation considering the needs of each child. It is permitted to place a child in the crib to encourage him/her to put himself/herself to sleep. However, different approaches may be needed based on the child’s mood, environment and other factors. Children should not be left crying without attending for extended period of time. In your compliance letter, please state what types of discussions/training you had with the staff members. 532: Designated feeding area Children must be fed in the designated areas, such as tables/chairs, high chairs. Young children can be held during bottle feeding. However, play area shall not be used as feeding areas. In your compliance letter, please state what types of discussions/training you had with the staff members. 840: Potentially hazardous products Batteries are considered corrosive agent; therefore, they must be stored in locked storage. Baby-proof devices are not sufficient. Please remove all alkaline batteries in the cabinet by the entrance door in space #4 (102) and store them in a locked storage. 844: pharmacy box Prescription medication must be in its original box with a pharmacy label. Auvi-Q in space # 6 (203) was not in its original box with a pharmacy label. To comply, you can ask the parent to provide the original box or ask for a pharmacy label. Each time staff member administers the medication, right child, right dosage, right route, right time and right medication must be verified. 849: Expired medication and over-the-counter products Expired medication and products must be returned to the family or discarded within seventy-two (72) hours of their expiration dates. To comply, please send the following products. • Boudreaux’s Butt Past expired in 07/2025 in space #6 (203) • After Bite Liquid expired in 09/2023 in space #6 (203) • Boudreaux’s Butt Past expired in 05/2025 in space # (117) • Aquaphor 3-in-1 Diaper Rash Cream expired in 05/2025 in space #4 (102) 1030: Application for Employment Application for employment and verification of date of birth must be maintained in the staff file. R. Rutherford’s application was not maintained in the staff file. Please locate the application and file them. If original application is not found, you may create the new one. 1045 & 1067: Orientation The program is required to provide minimum of six (6) hours of orientation and cover required topics within the first two (2) weeks of employment. Minimum of ten (10) hours of orientation and covering required topics within the first six (6) weeks of employment is also required. Make sure to cover all required topics, hours of orientation and initials. Most of the new staff orientation form are issing information, such as hours and initials. All topics on the orientation form must be reviewed. Please remember to use the most updated orientation form. The form was printed and shared with Ms. Loria during the visit. 1052: On-going training Each staff member must complete required hours of training starting the second year of employment. The training period is determined based on each member of staff’s hiring date. The required hours are determined based on the education listed on his/her WORKS letter. It is important for each staff member and administrators to understand the accurate training period and required hours for each member of staff. F. Norton’s completed training period is 4/15/24 through 4/14/25. During the period, he/she completed six (6) hours of training. C. McCormick’s completed training period is 2/14/24 through 2/13/25. During the period, he/she completed 1.5 hours of training. To comply, F. Norton must complete four (4) hours of training within the next two (2) weeks. These training is to make up for the last training period. Therefore, the hours will not count for the current period. C. McCormick needs 18.5 hours of training within the next two (2) weeks based on the understanding that he/she needs twenty (20) hours of training. Although I did not have time to review all staff members’ ongoing training hours, any staff who are short from the previous training period should complete additional training to make up the deficit. 1232: Annual evaluation Each staff member must have staff development plan and annual evaluation. Both documents must be renewed annually. No staff member except for one (1), had annual evaluation on the Staff and Training Worksheet. To comply, please complete the annual evaluation for all staff members and file them in their personal files. 1898 & 1899: Health and Safety Training Health and Safety training must be completed within one (1) year of employment and every five (5) years thereafter. Staff members and substitutes who work more than ten (10) days must complete health and safety training. K. Dorn, C. McCormick, J. Sherman did not complete their Health and Safety training within the first year of employment. C. Green did not complete the fifth year renewal training. To comply, those staff members listed above must complete the Health and Safety Training including “Medication in Child Care” training within the next two (2) weeks. Recognizing and Responding to Suspicions of Child Maltreatment training is not part of the renewal requirement. Print all certificates and file them behind the training log. 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 11/13/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Please fille out all sections for Staff and Training Worksheet before submitting them to me. Rated License Assessment: Pathways: Ms. Loria was interested in pathway 2 initially. The program is currently using Bright Wheel program where Ms. Loria customized the assessment tools to align with the NC FELD. However, Bright Wheel curriculum is not currently on the approved formative assessment list. We discussed that teachers need ample time to be trained, practice and understand the formative assessment tools. It is not something they can learn overnight. Due to this reason, it may be challenging to choose pathway 2 for upcoming assessment. For the renewal in 2029, it may be possible to choose pathway 2. I encouraged Ms. Loria to review accreditation options. I explained the requirements for CQI, Family and Community Engagement, education, staff/child ratios, self-study, mentoring and coaching options. Ms. Loria would like to look into several resources before determining the pathway. Timeline The next routine unannounced visit will be conducted in spring 2026 and the annual compliance visit prior to October 30, 2026. We discussed applying for the Rated License Assessment in late September 2026. This timeline will provide Ms. Loria to complete researches on accreditation and formative assessment as well as work on the Outreach assessment and self-study depending on her choice. Resources needed: I will periodically check on you to discuss your options. 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 .3222 (c) If employment-related changes occur at a facility that result in noncompliance with or failure to meet the standards in the Section for the star rating issued, the operator shall correct the noncompliance within six months. If the operator does not correct the noncompliance within six months, 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 10/30/2025 Number Present: 113 Completed Date: 10/30/2025 Age: From 0 To 5 Total Minutes: 452 Time In: 09:30 AM Time Out: 05:02 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, Kaoru Eddins Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to you. Today, Ms. Loria was available during the visit. 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-five (85) percent as of today prior to this visit. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Emmanuel Lutheran Church of Asheville, N.C., Inc., is current/active as of 10/27/25. Permit type – four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/7/25. The last fire drill was practiced on 10/21/25. The last shelter-in-place drill was practiced on 10/21/25. The last playground inspection was documented on 10/17/25. The last fire inspection was approved on 3/28/25. The last sanitation inspection was conducted on 2/28/25 with nineteen (19) demerits for an approved classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 1/8/24 without hazards. Lead paint and asbestos testing were under review. On 8/25/25, visual inspection for remediation for lead and asbestos was completed, and the facility did not pass Staff roster on the ABCMS is in progress. Upon arrival, I announced my presence and the purpose of the visit. In space #1, six (6) infants with two (2) staff members were present. One (1) was held by a staff member and fed a bottle, two (2) were in the seat bouncer, one (1) was in the upright bouncer and one (1) was in a seating device and one (1) was in the crib. The child in the crib cried for a few minutes and fell asleep. Bottles were labeled with each child’s name and today’s date. Feeding plan for each child was signed and posted. Interaction and supervision were adequate. Each child had a sleep sack to sleep. In space #6, eight (8) children, infants and one (1) were present with two (2) staff members. Two (2) children, an infant and one (1) year old were laying down on the floor on boppy pillows feeding themselves bottles as they fell asleep. Both children finished the bottles and fell asleep on the boppy. They were moved to cribs several minutes later. A total of five (5) children were in the crib. Two (2) children were on the crib awake for more than twenty (20) minutes. Staff members stated that they were put in the cribs for nap time and the children typically fall asleep on their own. One (1) of the children in the crib cried over several minutes attempting to pull himself/herself out of the crib looking at staff members. I instructed staff members to remove the child from the crib after several minutes. Twelve (12) children transitioned from outside to inside in space #5 (103). Some of the children used the bathroom in the hallway and the other children came inside to wash their hands in the sink in the classroom. BBQ meatballs, green beans, diced pears, hush puppies and milk were served for lunch. Nap time was observed in space #10 (113), some cots were placed in the group area very closely, but they used matts as dividers. Space #9 was occupied with thirteen (13) children, three (3) to four (4) years old with two (2) staff members. The playground were monitored, and no safety hazards were observed. Permission forms, action plan and storage of medication were in compliance for all over-the-counter products and emergency medications. I reviewed three (3) existing staff files in full, nine (9) new staff members’ files. Staff and Training Worksheet was submitted by Ms. Loria, but each staff member’s on-going training information may not be accurate. Therefore, a few additional staff members files were reviewed for on-going training information and other missing information. Thirteen (13) children’s files were monitored. 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 491 Caregiver did not respond at the earliest opportunity to an infant or toddler’s physical and emotional needs. One (1) child was left crying in the crib for several minutes in space #6. The child spent over twenty (20) minutes awake in the crib and cried for several minutes at the end. The child was alert and awake, standing up in the crib, reaching for adult to pick him/her up. .0511(b)(1) 532 All children were not held or placed in feeding chairs or other appropriate apparatus to be fed. Two (2) children fed themselves a bottle on the floor as they laid on the boppy. The children fell asleep on the boppy as they fed themselves in room 203. 10A NCAC 09 .0902(b) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. several packets/boxes of batteries were stored in the cabinet by the entrance door in room 102. A baby proof device was on the cabinet. .2820(b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In room 203, an Auvi-Q was maintained without an original box with a pharmacy label. .0803(2)(a) 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 following diaper creams and over-the-counter products were expired: • Boudreaux’s Butt Past expired in 07/2025 in space #6 (203) • After Bite Liquid expired in 09/2023 in space #6 (203) • Boudreaux’s Butt Past expired in 05/2025 in space # (117) • Aquaphor 3-in-1 Diaper Rash Cream expired in 05/2025 in space #4 (102) .0803(12) 1030 Application for employment and date of birth was not on file for all staff. An application for staff member employed on 3/8/21 was not on file. .0302(d)(1)(A) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Orientation information was not found for FR (DOE - 9/8/25). Most of the orientation form are missing information for new staff members. .1101(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. At least two (2) staff members did not complete the required training hours. F.N (DOE- 4/15/08) completed six (6) hours of training between 4/15/24 - 4/14/25 while the requirement was ten (10) hours. C.M (DOE-2/14/23) completed 1.5 hours of training between 2/14/24 - 2/13/25. The requirement was twenty (20) hours. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Many of the new staff member's orientation hours were not logged. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Twenty-nine (29) staff members did not have annual evaluation on files. 10A NCAC 09 .0514(f) 1898 Staff did not complete the health and safety training within one year of employment. C.M (DOE -2/14/23), K.D (DOE-2/26/25), and J.S. (DOE-2/26/24) have not completed the Health and Safety Training. .1102(a) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. C.G. (DOE-3/21/18) completed Health and Safety training on 10/25/20 but did not complete the fifth year training. .1103(b) Technical assistance was provided as follows: 491: meeting needs for infants and toddlers Staff members must meet the needs of infants and toddlers at the earliest opportunity. Building routines is important for young children. However, staff members shall not force routines on infants and toddlers but flexibly deal with each situation considering the needs of each child. It is permitted to place a child in the crib to encourage him/her to put himself/herself to sleep. However, different approaches may be needed based on the child’s mood, environment and other factors. Children should not be left crying without attending for extended period of time. In your compliance letter, please state what types of discussions/training you had with the staff members. 532: Designated feeding area Children must be fed in the designated areas, such as tables/chairs, high chairs. Young children can be held during bottle feeding. However, play area shall not be used as feeding areas. In your compliance letter, please state what types of discussions/training you had with the staff members. 840: Potentially hazardous products Batteries are considered corrosive agent; therefore, they must be stored in locked storage. Baby-proof devices are not sufficient. Please remove all alkaline batteries in the cabinet by the entrance door in space #4 (102) and store them in a locked storage. 844: pharmacy box Prescription medication must be in its original box with a pharmacy label. Auvi-Q in space # 6 (203) was not in its original box with a pharmacy label. To comply, you can ask the parent to provide the original box or ask for a pharmacy label. Each time staff member administers the medication, right child, right dosage, right route, right time and right medication must be verified. 849: Expired medication and over-the-counter products Expired medication and products must be returned to the family or discarded within seventy-two (72) hours of their expiration dates. To comply, please send the following products. • Boudreaux’s Butt Past expired in 07/2025 in space #6 (203) • After Bite Liquid expired in 09/2023 in space #6 (203) • Boudreaux’s Butt Past expired in 05/2025 in space # (117) • Aquaphor 3-in-1 Diaper Rash Cream expired in 05/2025 in space #4 (102) 1030: Application for Employment Application for employment and verification of date of birth must be maintained in the staff file. R. Rutherford’s application was not maintained in the staff file. Please locate the application and file them. If original application is not found, you may create the new one. 1045 & 1067: Orientation The program is required to provide minimum of six (6) hours of orientation and cover required topics within the first two (2) weeks of employment. Minimum of ten (10) hours of orientation and covering required topics within the first six (6) weeks of employment is also required. Make sure to cover all required topics, hours of orientation and initials. Most of the new staff orientation form are issing information, such as hours and initials. All topics on the orientation form must be reviewed. Please remember to use the most updated orientation form. The form was printed and shared with Ms. Loria during the visit. 1052: On-going training Each staff member must complete required hours of training starting the second year of employment. The training period is determined based on each member of staff’s hiring date. The required hours are determined based on the education listed on his/her WORKS letter. It is important for each staff member and administrators to understand the accurate training period and required hours for each member of staff. F. Norton’s completed training period is 4/15/24 through 4/14/25. During the period, he/she completed six (6) hours of training. C. McCormick’s completed training period is 2/14/24 through 2/13/25. During the period, he/she completed 1.5 hours of training. To comply, F. Norton must complete four (4) hours of training within the next two (2) weeks. These training is to make up for the last training period. Therefore, the hours will not count for the current period. C. McCormick needs 18.5 hours of training within the next two (2) weeks based on the understanding that he/she needs twenty (20) hours of training. Although I did not have time to review all staff members’ ongoing training hours, any staff who are short from the previous training period should complete additional training to make up the deficit. 1232: Annual evaluation Each staff member must have staff development plan and annual evaluation. Both documents must be renewed annually. No staff member except for one (1), had annual evaluation on the Staff and Training Worksheet. To comply, please complete the annual evaluation for all staff members and file them in their personal files. 1898 & 1899: Health and Safety Training Health and Safety training must be completed within one (1) year of employment and every five (5) years thereafter. Staff members and substitutes who work more than ten (10) days must complete health and safety training. K. Dorn, C. McCormick, J. Sherman did not complete their Health and Safety training within the first year of employment. C. Green did not complete the fifth year renewal training. To comply, those staff members listed above must complete the Health and Safety Training including “Medication in Child Care” training within the next two (2) weeks. Recognizing and Responding to Suspicions of Child Maltreatment training is not part of the renewal requirement. Print all certificates and file them behind the training log. 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 11/13/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Please fille out all sections for Staff and Training Worksheet before submitting them to me. Rated License Assessment: Pathways: Ms. Loria was interested in pathway 2 initially. The program is currently using Bright Wheel program where Ms. Loria customized the assessment tools to align with the NC FELD. However, Bright Wheel curriculum is not currently on the approved formative assessment list. We discussed that teachers need ample time to be trained, practice and understand the formative assessment tools. It is not something they can learn overnight. Due to this reason, it may be challenging to choose pathway 2 for upcoming assessment. For the renewal in 2029, it may be possible to choose pathway 2. I encouraged Ms. Loria to review accreditation options. I explained the requirements for CQI, Family and Community Engagement, education, staff/child ratios, self-study, mentoring and coaching options. Ms. Loria would like to look into several resources before determining the pathway. Timeline The next routine unannounced visit will be conducted in spring 2026 and the annual compliance visit prior to October 30, 2026. We discussed applying for the Rated License Assessment in late September 2026. This timeline will provide Ms. Loria to complete researches on accreditation and formative assessment as well as work on the Outreach assessment and self-study depending on her choice. Resources needed: I will periodically check on you to discuss your options. 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 .3222 (c) If employment-related changes occur at a facility that result in noncompliance with or failure to meet the standards in the Section for the star rating issued, the operator shall correct the noncompliance within six months. If the operator does not correct the noncompliance within six months, 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 10/30/2025 Number Present: 113 Completed Date: 10/30/2025 Age: From 0 To 5 Total Minutes: 452 Time In: 09:30 AM Time Out: 05:02 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, Kaoru Eddins Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to you. Today, Ms. Loria was available during the visit. 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-five (85) percent as of today prior to this visit. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Emmanuel Lutheran Church of Asheville, N.C., Inc., is current/active as of 10/27/25. Permit type – four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/7/25. The last fire drill was practiced on 10/21/25. The last shelter-in-place drill was practiced on 10/21/25. The last playground inspection was documented on 10/17/25. The last fire inspection was approved on 3/28/25. The last sanitation inspection was conducted on 2/28/25 with nineteen (19) demerits for an approved classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 1/8/24 without hazards. Lead paint and asbestos testing were under review. On 8/25/25, visual inspection for remediation for lead and asbestos was completed, and the facility did not pass Staff roster on the ABCMS is in progress. Upon arrival, I announced my presence and the purpose of the visit. In space #1, six (6) infants with two (2) staff members were present. One (1) was held by a staff member and fed a bottle, two (2) were in the seat bouncer, one (1) was in the upright bouncer and one (1) was in a seating device and one (1) was in the crib. The child in the crib cried for a few minutes and fell asleep. Bottles were labeled with each child’s name and today’s date. Feeding plan for each child was signed and posted. Interaction and supervision were adequate. Each child had a sleep sack to sleep. In space #6, eight (8) children, infants and one (1) were present with two (2) staff members. Two (2) children, an infant and one (1) year old were laying down on the floor on boppy pillows feeding themselves bottles as they fell asleep. Both children finished the bottles and fell asleep on the boppy. They were moved to cribs several minutes later. A total of five (5) children were in the crib. Two (2) children were on the crib awake for more than twenty (20) minutes. Staff members stated that they were put in the cribs for nap time and the children typically fall asleep on their own. One (1) of the children in the crib cried over several minutes attempting to pull himself/herself out of the crib looking at staff members. I instructed staff members to remove the child from the crib after several minutes. Twelve (12) children transitioned from outside to inside in space #5 (103). Some of the children used the bathroom in the hallway and the other children came inside to wash their hands in the sink in the classroom. BBQ meatballs, green beans, diced pears, hush puppies and milk were served for lunch. Nap time was observed in space #10 (113), some cots were placed in the group area very closely, but they used matts as dividers. Space #9 was occupied with thirteen (13) children, three (3) to four (4) years old with two (2) staff members. The playground were monitored, and no safety hazards were observed. Permission forms, action plan and storage of medication were in compliance for all over-the-counter products and emergency medications. I reviewed three (3) existing staff files in full, nine (9) new staff members’ files. Staff and Training Worksheet was submitted by Ms. Loria, but each staff member’s on-going training information may not be accurate. Therefore, a few additional staff members files were reviewed for on-going training information and other missing information. Thirteen (13) children’s files were monitored. 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 491 Caregiver did not respond at the earliest opportunity to an infant or toddler’s physical and emotional needs. One (1) child was left crying in the crib for several minutes in space #6. The child spent over twenty (20) minutes awake in the crib and cried for several minutes at the end. The child was alert and awake, standing up in the crib, reaching for adult to pick him/her up. .0511(b)(1) 532 All children were not held or placed in feeding chairs or other appropriate apparatus to be fed. Two (2) children fed themselves a bottle on the floor as they laid on the boppy. The children fell asleep on the boppy as they fed themselves in room 203. 10A NCAC 09 .0902(b) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. several packets/boxes of batteries were stored in the cabinet by the entrance door in room 102. A baby proof device was on the cabinet. .2820(b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In room 203, an Auvi-Q was maintained without an original box with a pharmacy label. .0803(2)(a) 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 following diaper creams and over-the-counter products were expired: • Boudreaux’s Butt Past expired in 07/2025 in space #6 (203) • After Bite Liquid expired in 09/2023 in space #6 (203) • Boudreaux’s Butt Past expired in 05/2025 in space # (117) • Aquaphor 3-in-1 Diaper Rash Cream expired in 05/2025 in space #4 (102) .0803(12) 1030 Application for employment and date of birth was not on file for all staff. An application for staff member employed on 3/8/21 was not on file. .0302(d)(1)(A) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Orientation information was not found for FR (DOE - 9/8/25). Most of the orientation form are missing information for new staff members. .1101(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. At least two (2) staff members did not complete the required training hours. F.N (DOE- 4/15/08) completed six (6) hours of training between 4/15/24 - 4/14/25 while the requirement was ten (10) hours. C.M (DOE-2/14/23) completed 1.5 hours of training between 2/14/24 - 2/13/25. The requirement was twenty (20) hours. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Many of the new staff member's orientation hours were not logged. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Twenty-nine (29) staff members did not have annual evaluation on files. 10A NCAC 09 .0514(f) 1898 Staff did not complete the health and safety training within one year of employment. C.M (DOE -2/14/23), K.D (DOE-2/26/25), and J.S. (DOE-2/26/24) have not completed the Health and Safety Training. .1102(a) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. C.G. (DOE-3/21/18) completed Health and Safety training on 10/25/20 but did not complete the fifth year training. .1103(b) Technical assistance was provided as follows: 491: meeting needs for infants and toddlers Staff members must meet the needs of infants and toddlers at the earliest opportunity. Building routines is important for young children. However, staff members shall not force routines on infants and toddlers but flexibly deal with each situation considering the needs of each child. It is permitted to place a child in the crib to encourage him/her to put himself/herself to sleep. However, different approaches may be needed based on the child’s mood, environment and other factors. Children should not be left crying without attending for extended period of time. In your compliance letter, please state what types of discussions/training you had with the staff members. 532: Designated feeding area Children must be fed in the designated areas, such as tables/chairs, high chairs. Young children can be held during bottle feeding. However, play area shall not be used as feeding areas. In your compliance letter, please state what types of discussions/training you had with the staff members. 840: Potentially hazardous products Batteries are considered corrosive agent; therefore, they must be stored in locked storage. Baby-proof devices are not sufficient. Please remove all alkaline batteries in the cabinet by the entrance door in space #4 (102) and store them in a locked storage. 844: pharmacy box Prescription medication must be in its original box with a pharmacy label. Auvi-Q in space # 6 (203) was not in its original box with a pharmacy label. To comply, you can ask the parent to provide the original box or ask for a pharmacy label. Each time staff member administers the medication, right child, right dosage, right route, right time and right medication must be verified. 849: Expired medication and over-the-counter products Expired medication and products must be returned to the family or discarded within seventy-two (72) hours of their expiration dates. To comply, please send the following products. • Boudreaux’s Butt Past expired in 07/2025 in space #6 (203) • After Bite Liquid expired in 09/2023 in space #6 (203) • Boudreaux’s Butt Past expired in 05/2025 in space # (117) • Aquaphor 3-in-1 Diaper Rash Cream expired in 05/2025 in space #4 (102) 1030: Application for Employment Application for employment and verification of date of birth must be maintained in the staff file. R. Rutherford’s application was not maintained in the staff file. Please locate the application and file them. If original application is not found, you may create the new one. 1045 & 1067: Orientation The program is required to provide minimum of six (6) hours of orientation and cover required topics within the first two (2) weeks of employment. Minimum of ten (10) hours of orientation and covering required topics within the first six (6) weeks of employment is also required. Make sure to cover all required topics, hours of orientation and initials. Most of the new staff orientation form are issing information, such as hours and initials. All topics on the orientation form must be reviewed. Please remember to use the most updated orientation form. The form was printed and shared with Ms. Loria during the visit. 1052: On-going training Each staff member must complete required hours of training starting the second year of employment. The training period is determined based on each member of staff’s hiring date. The required hours are determined based on the education listed on his/her WORKS letter. It is important for each staff member and administrators to understand the accurate training period and required hours for each member of staff. F. Norton’s completed training period is 4/15/24 through 4/14/25. During the period, he/she completed six (6) hours of training. C. McCormick’s completed training period is 2/14/24 through 2/13/25. During the period, he/she completed 1.5 hours of training. To comply, F. Norton must complete four (4) hours of training within the next two (2) weeks. These training is to make up for the last training period. Therefore, the hours will not count for the current period. C. McCormick needs 18.5 hours of training within the next two (2) weeks based on the understanding that he/she needs twenty (20) hours of training. Although I did not have time to review all staff members’ ongoing training hours, any staff who are short from the previous training period should complete additional training to make up the deficit. 1232: Annual evaluation Each staff member must have staff development plan and annual evaluation. Both documents must be renewed annually. No staff member except for one (1), had annual evaluation on the Staff and Training Worksheet. To comply, please complete the annual evaluation for all staff members and file them in their personal files. 1898 & 1899: Health and Safety Training Health and Safety training must be completed within one (1) year of employment and every five (5) years thereafter. Staff members and substitutes who work more than ten (10) days must complete health and safety training. K. Dorn, C. McCormick, J. Sherman did not complete their Health and Safety training within the first year of employment. C. Green did not complete the fifth year renewal training. To comply, those staff members listed above must complete the Health and Safety Training including “Medication in Child Care” training within the next two (2) weeks. Recognizing and Responding to Suspicions of Child Maltreatment training is not part of the renewal requirement. Print all certificates and file them behind the training log. 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 11/13/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Please fille out all sections for Staff and Training Worksheet before submitting them to me. Rated License Assessment: Pathways: Ms. Loria was interested in pathway 2 initially. The program is currently using Bright Wheel program where Ms. Loria customized the assessment tools to align with the NC FELD. However, Bright Wheel curriculum is not currently on the approved formative assessment list. We discussed that teachers need ample time to be trained, practice and understand the formative assessment tools. It is not something they can learn overnight. Due to this reason, it may be challenging to choose pathway 2 for upcoming assessment. For the renewal in 2029, it may be possible to choose pathway 2. I encouraged Ms. Loria to review accreditation options. I explained the requirements for CQI, Family and Community Engagement, education, staff/child ratios, self-study, mentoring and coaching options. Ms. Loria would like to look into several resources before determining the pathway. Timeline The next routine unannounced visit will be conducted in spring 2026 and the annual compliance visit prior to October 30, 2026. We discussed applying for the Rated License Assessment in late September 2026. This timeline will provide Ms. Loria to complete researches on accreditation and formative assessment as well as work on the Outreach assessment and self-study depending on her choice. Resources needed: I will periodically check on you to discuss your options. 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 .3222 (c) If employment-related changes occur at a facility that result in noncompliance with or failure to meet the standards in the Section for the star rating issued, the operator shall correct the noncompliance within six months. If the operator does not correct the noncompliance within six months, 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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 .3222 · Violation

Name of Operation: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 10/30/2025 Number Present: 113 Completed Date: 10/30/2025 Age: From 0 To 5 Total Minutes: 452 Time In: 09:30 AM Time Out: 05:02 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, Kaoru Eddins Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to you. Today, Ms. Loria was available during the visit. 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-five (85) percent as of today prior to this visit. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Emmanuel Lutheran Church of Asheville, N.C., Inc., is current/active as of 10/27/25. Permit type – four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/7/25. The last fire drill was practiced on 10/21/25. The last shelter-in-place drill was practiced on 10/21/25. The last playground inspection was documented on 10/17/25. The last fire inspection was approved on 3/28/25. The last sanitation inspection was conducted on 2/28/25 with nineteen (19) demerits for an approved classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 1/8/24 without hazards. Lead paint and asbestos testing were under review. On 8/25/25, visual inspection for remediation for lead and asbestos was completed, and the facility did not pass Staff roster on the ABCMS is in progress. Upon arrival, I announced my presence and the purpose of the visit. In space #1, six (6) infants with two (2) staff members were present. One (1) was held by a staff member and fed a bottle, two (2) were in the seat bouncer, one (1) was in the upright bouncer and one (1) was in a seating device and one (1) was in the crib. The child in the crib cried for a few minutes and fell asleep. Bottles were labeled with each child’s name and today’s date. Feeding plan for each child was signed and posted. Interaction and supervision were adequate. Each child had a sleep sack to sleep. In space #6, eight (8) children, infants and one (1) were present with two (2) staff members. Two (2) children, an infant and one (1) year old were laying down on the floor on boppy pillows feeding themselves bottles as they fell asleep. Both children finished the bottles and fell asleep on the boppy. They were moved to cribs several minutes later. A total of five (5) children were in the crib. Two (2) children were on the crib awake for more than twenty (20) minutes. Staff members stated that they were put in the cribs for nap time and the children typically fall asleep on their own. One (1) of the children in the crib cried over several minutes attempting to pull himself/herself out of the crib looking at staff members. I instructed staff members to remove the child from the crib after several minutes. Twelve (12) children transitioned from outside to inside in space #5 (103). Some of the children used the bathroom in the hallway and the other children came inside to wash their hands in the sink in the classroom. BBQ meatballs, green beans, diced pears, hush puppies and milk were served for lunch. Nap time was observed in space #10 (113), some cots were placed in the group area very closely, but they used matts as dividers. Space #9 was occupied with thirteen (13) children, three (3) to four (4) years old with two (2) staff members. The playground were monitored, and no safety hazards were observed. Permission forms, action plan and storage of medication were in compliance for all over-the-counter products and emergency medications. I reviewed three (3) existing staff files in full, nine (9) new staff members’ files. Staff and Training Worksheet was submitted by Ms. Loria, but each staff member’s on-going training information may not be accurate. Therefore, a few additional staff members files were reviewed for on-going training information and other missing information. Thirteen (13) children’s files were monitored. 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 491 Caregiver did not respond at the earliest opportunity to an infant or toddler’s physical and emotional needs. One (1) child was left crying in the crib for several minutes in space #6. The child spent over twenty (20) minutes awake in the crib and cried for several minutes at the end. The child was alert and awake, standing up in the crib, reaching for adult to pick him/her up. .0511(b)(1) 532 All children were not held or placed in feeding chairs or other appropriate apparatus to be fed. Two (2) children fed themselves a bottle on the floor as they laid on the boppy. The children fell asleep on the boppy as they fed themselves in room 203. 10A NCAC 09 .0902(b) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. several packets/boxes of batteries were stored in the cabinet by the entrance door in room 102. A baby proof device was on the cabinet. .2820(b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In room 203, an Auvi-Q was maintained without an original box with a pharmacy label. .0803(2)(a) 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 following diaper creams and over-the-counter products were expired: • Boudreaux’s Butt Past expired in 07/2025 in space #6 (203) • After Bite Liquid expired in 09/2023 in space #6 (203) • Boudreaux’s Butt Past expired in 05/2025 in space # (117) • Aquaphor 3-in-1 Diaper Rash Cream expired in 05/2025 in space #4 (102) .0803(12) 1030 Application for employment and date of birth was not on file for all staff. An application for staff member employed on 3/8/21 was not on file. .0302(d)(1)(A) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Orientation information was not found for FR (DOE - 9/8/25). Most of the orientation form are missing information for new staff members. .1101(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. At least two (2) staff members did not complete the required training hours. F.N (DOE- 4/15/08) completed six (6) hours of training between 4/15/24 - 4/14/25 while the requirement was ten (10) hours. C.M (DOE-2/14/23) completed 1.5 hours of training between 2/14/24 - 2/13/25. The requirement was twenty (20) hours. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Many of the new staff member's orientation hours were not logged. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Twenty-nine (29) staff members did not have annual evaluation on files. 10A NCAC 09 .0514(f) 1898 Staff did not complete the health and safety training within one year of employment. C.M (DOE -2/14/23), K.D (DOE-2/26/25), and J.S. (DOE-2/26/24) have not completed the Health and Safety Training. .1102(a) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. C.G. (DOE-3/21/18) completed Health and Safety training on 10/25/20 but did not complete the fifth year training. .1103(b) Technical assistance was provided as follows: 491: meeting needs for infants and toddlers Staff members must meet the needs of infants and toddlers at the earliest opportunity. Building routines is important for young children. However, staff members shall not force routines on infants and toddlers but flexibly deal with each situation considering the needs of each child. It is permitted to place a child in the crib to encourage him/her to put himself/herself to sleep. However, different approaches may be needed based on the child’s mood, environment and other factors. Children should not be left crying without attending for extended period of time. In your compliance letter, please state what types of discussions/training you had with the staff members. 532: Designated feeding area Children must be fed in the designated areas, such as tables/chairs, high chairs. Young children can be held during bottle feeding. However, play area shall not be used as feeding areas. In your compliance letter, please state what types of discussions/training you had with the staff members. 840: Potentially hazardous products Batteries are considered corrosive agent; therefore, they must be stored in locked storage. Baby-proof devices are not sufficient. Please remove all alkaline batteries in the cabinet by the entrance door in space #4 (102) and store them in a locked storage. 844: pharmacy box Prescription medication must be in its original box with a pharmacy label. Auvi-Q in space # 6 (203) was not in its original box with a pharmacy label. To comply, you can ask the parent to provide the original box or ask for a pharmacy label. Each time staff member administers the medication, right child, right dosage, right route, right time and right medication must be verified. 849: Expired medication and over-the-counter products Expired medication and products must be returned to the family or discarded within seventy-two (72) hours of their expiration dates. To comply, please send the following products. • Boudreaux’s Butt Past expired in 07/2025 in space #6 (203) • After Bite Liquid expired in 09/2023 in space #6 (203) • Boudreaux’s Butt Past expired in 05/2025 in space # (117) • Aquaphor 3-in-1 Diaper Rash Cream expired in 05/2025 in space #4 (102) 1030: Application for Employment Application for employment and verification of date of birth must be maintained in the staff file. R. Rutherford’s application was not maintained in the staff file. Please locate the application and file them. If original application is not found, you may create the new one. 1045 & 1067: Orientation The program is required to provide minimum of six (6) hours of orientation and cover required topics within the first two (2) weeks of employment. Minimum of ten (10) hours of orientation and covering required topics within the first six (6) weeks of employment is also required. Make sure to cover all required topics, hours of orientation and initials. Most of the new staff orientation form are issing information, such as hours and initials. All topics on the orientation form must be reviewed. Please remember to use the most updated orientation form. The form was printed and shared with Ms. Loria during the visit. 1052: On-going training Each staff member must complete required hours of training starting the second year of employment. The training period is determined based on each member of staff’s hiring date. The required hours are determined based on the education listed on his/her WORKS letter. It is important for each staff member and administrators to understand the accurate training period and required hours for each member of staff. F. Norton’s completed training period is 4/15/24 through 4/14/25. During the period, he/she completed six (6) hours of training. C. McCormick’s completed training period is 2/14/24 through 2/13/25. During the period, he/she completed 1.5 hours of training. To comply, F. Norton must complete four (4) hours of training within the next two (2) weeks. These training is to make up for the last training period. Therefore, the hours will not count for the current period. C. McCormick needs 18.5 hours of training within the next two (2) weeks based on the understanding that he/she needs twenty (20) hours of training. Although I did not have time to review all staff members’ ongoing training hours, any staff who are short from the previous training period should complete additional training to make up the deficit. 1232: Annual evaluation Each staff member must have staff development plan and annual evaluation. Both documents must be renewed annually. No staff member except for one (1), had annual evaluation on the Staff and Training Worksheet. To comply, please complete the annual evaluation for all staff members and file them in their personal files. 1898 & 1899: Health and Safety Training Health and Safety training must be completed within one (1) year of employment and every five (5) years thereafter. Staff members and substitutes who work more than ten (10) days must complete health and safety training. K. Dorn, C. McCormick, J. Sherman did not complete their Health and Safety training within the first year of employment. C. Green did not complete the fifth year renewal training. To comply, those staff members listed above must complete the Health and Safety Training including “Medication in Child Care” training within the next two (2) weeks. Recognizing and Responding to Suspicions of Child Maltreatment training is not part of the renewal requirement. Print all certificates and file them behind the training log. 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 11/13/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Please fille out all sections for Staff and Training Worksheet before submitting them to me. Rated License Assessment: Pathways: Ms. Loria was interested in pathway 2 initially. The program is currently using Bright Wheel program where Ms. Loria customized the assessment tools to align with the NC FELD. However, Bright Wheel curriculum is not currently on the approved formative assessment list. We discussed that teachers need ample time to be trained, practice and understand the formative assessment tools. It is not something they can learn overnight. Due to this reason, it may be challenging to choose pathway 2 for upcoming assessment. For the renewal in 2029, it may be possible to choose pathway 2. I encouraged Ms. Loria to review accreditation options. I explained the requirements for CQI, Family and Community Engagement, education, staff/child ratios, self-study, mentoring and coaching options. Ms. Loria would like to look into several resources before determining the pathway. Timeline The next routine unannounced visit will be conducted in spring 2026 and the annual compliance visit prior to October 30, 2026. We discussed applying for the Rated License Assessment in late September 2026. This timeline will provide Ms. Loria to complete researches on accreditation and formative assessment as well as work on the Outreach assessment and self-study depending on her choice. Resources needed: I will periodically check on you to discuss your options. 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 .3222 (c) If employment-related changes occur at a facility that result in noncompliance with or failure to meet the standards in the Section for the star rating issued, the operator shall correct the noncompliance within six months. If the operator does not correct the noncompliance within six months, 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 10/30/2025 Number Present: 113 Completed Date: 10/30/2025 Age: From 0 To 5 Total Minutes: 452 Time In: 09:30 AM Time Out: 05:02 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, Kaoru Eddins Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to you. Today, Ms. Loria was available during the visit. 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-five (85) percent as of today prior to this visit. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Emmanuel Lutheran Church of Asheville, N.C., Inc., is current/active as of 10/27/25. Permit type – four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/7/25. The last fire drill was practiced on 10/21/25. The last shelter-in-place drill was practiced on 10/21/25. The last playground inspection was documented on 10/17/25. The last fire inspection was approved on 3/28/25. The last sanitation inspection was conducted on 2/28/25 with nineteen (19) demerits for an approved classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 1/8/24 without hazards. Lead paint and asbestos testing were under review. On 8/25/25, visual inspection for remediation for lead and asbestos was completed, and the facility did not pass Staff roster on the ABCMS is in progress. Upon arrival, I announced my presence and the purpose of the visit. In space #1, six (6) infants with two (2) staff members were present. One (1) was held by a staff member and fed a bottle, two (2) were in the seat bouncer, one (1) was in the upright bouncer and one (1) was in a seating device and one (1) was in the crib. The child in the crib cried for a few minutes and fell asleep. Bottles were labeled with each child’s name and today’s date. Feeding plan for each child was signed and posted. Interaction and supervision were adequate. Each child had a sleep sack to sleep. In space #6, eight (8) children, infants and one (1) were present with two (2) staff members. Two (2) children, an infant and one (1) year old were laying down on the floor on boppy pillows feeding themselves bottles as they fell asleep. Both children finished the bottles and fell asleep on the boppy. They were moved to cribs several minutes later. A total of five (5) children were in the crib. Two (2) children were on the crib awake for more than twenty (20) minutes. Staff members stated that they were put in the cribs for nap time and the children typically fall asleep on their own. One (1) of the children in the crib cried over several minutes attempting to pull himself/herself out of the crib looking at staff members. I instructed staff members to remove the child from the crib after several minutes. Twelve (12) children transitioned from outside to inside in space #5 (103). Some of the children used the bathroom in the hallway and the other children came inside to wash their hands in the sink in the classroom. BBQ meatballs, green beans, diced pears, hush puppies and milk were served for lunch. Nap time was observed in space #10 (113), some cots were placed in the group area very closely, but they used matts as dividers. Space #9 was occupied with thirteen (13) children, three (3) to four (4) years old with two (2) staff members. The playground were monitored, and no safety hazards were observed. Permission forms, action plan and storage of medication were in compliance for all over-the-counter products and emergency medications. I reviewed three (3) existing staff files in full, nine (9) new staff members’ files. Staff and Training Worksheet was submitted by Ms. Loria, but each staff member’s on-going training information may not be accurate. Therefore, a few additional staff members files were reviewed for on-going training information and other missing information. Thirteen (13) children’s files were monitored. 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 491 Caregiver did not respond at the earliest opportunity to an infant or toddler’s physical and emotional needs. One (1) child was left crying in the crib for several minutes in space #6. The child spent over twenty (20) minutes awake in the crib and cried for several minutes at the end. The child was alert and awake, standing up in the crib, reaching for adult to pick him/her up. .0511(b)(1) 532 All children were not held or placed in feeding chairs or other appropriate apparatus to be fed. Two (2) children fed themselves a bottle on the floor as they laid on the boppy. The children fell asleep on the boppy as they fed themselves in room 203. 10A NCAC 09 .0902(b) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. several packets/boxes of batteries were stored in the cabinet by the entrance door in room 102. A baby proof device was on the cabinet. .2820(b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In room 203, an Auvi-Q was maintained without an original box with a pharmacy label. .0803(2)(a) 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 following diaper creams and over-the-counter products were expired: • Boudreaux’s Butt Past expired in 07/2025 in space #6 (203) • After Bite Liquid expired in 09/2023 in space #6 (203) • Boudreaux’s Butt Past expired in 05/2025 in space # (117) • Aquaphor 3-in-1 Diaper Rash Cream expired in 05/2025 in space #4 (102) .0803(12) 1030 Application for employment and date of birth was not on file for all staff. An application for staff member employed on 3/8/21 was not on file. .0302(d)(1)(A) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Orientation information was not found for FR (DOE - 9/8/25). Most of the orientation form are missing information for new staff members. .1101(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. At least two (2) staff members did not complete the required training hours. F.N (DOE- 4/15/08) completed six (6) hours of training between 4/15/24 - 4/14/25 while the requirement was ten (10) hours. C.M (DOE-2/14/23) completed 1.5 hours of training between 2/14/24 - 2/13/25. The requirement was twenty (20) hours. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Many of the new staff member's orientation hours were not logged. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Twenty-nine (29) staff members did not have annual evaluation on files. 10A NCAC 09 .0514(f) 1898 Staff did not complete the health and safety training within one year of employment. C.M (DOE -2/14/23), K.D (DOE-2/26/25), and J.S. (DOE-2/26/24) have not completed the Health and Safety Training. .1102(a) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. C.G. (DOE-3/21/18) completed Health and Safety training on 10/25/20 but did not complete the fifth year training. .1103(b) Technical assistance was provided as follows: 491: meeting needs for infants and toddlers Staff members must meet the needs of infants and toddlers at the earliest opportunity. Building routines is important for young children. However, staff members shall not force routines on infants and toddlers but flexibly deal with each situation considering the needs of each child. It is permitted to place a child in the crib to encourage him/her to put himself/herself to sleep. However, different approaches may be needed based on the child’s mood, environment and other factors. Children should not be left crying without attending for extended period of time. In your compliance letter, please state what types of discussions/training you had with the staff members. 532: Designated feeding area Children must be fed in the designated areas, such as tables/chairs, high chairs. Young children can be held during bottle feeding. However, play area shall not be used as feeding areas. In your compliance letter, please state what types of discussions/training you had with the staff members. 840: Potentially hazardous products Batteries are considered corrosive agent; therefore, they must be stored in locked storage. Baby-proof devices are not sufficient. Please remove all alkaline batteries in the cabinet by the entrance door in space #4 (102) and store them in a locked storage. 844: pharmacy box Prescription medication must be in its original box with a pharmacy label. Auvi-Q in space # 6 (203) was not in its original box with a pharmacy label. To comply, you can ask the parent to provide the original box or ask for a pharmacy label. Each time staff member administers the medication, right child, right dosage, right route, right time and right medication must be verified. 849: Expired medication and over-the-counter products Expired medication and products must be returned to the family or discarded within seventy-two (72) hours of their expiration dates. To comply, please send the following products. • Boudreaux’s Butt Past expired in 07/2025 in space #6 (203) • After Bite Liquid expired in 09/2023 in space #6 (203) • Boudreaux’s Butt Past expired in 05/2025 in space # (117) • Aquaphor 3-in-1 Diaper Rash Cream expired in 05/2025 in space #4 (102) 1030: Application for Employment Application for employment and verification of date of birth must be maintained in the staff file. R. Rutherford’s application was not maintained in the staff file. Please locate the application and file them. If original application is not found, you may create the new one. 1045 & 1067: Orientation The program is required to provide minimum of six (6) hours of orientation and cover required topics within the first two (2) weeks of employment. Minimum of ten (10) hours of orientation and covering required topics within the first six (6) weeks of employment is also required. Make sure to cover all required topics, hours of orientation and initials. Most of the new staff orientation form are issing information, such as hours and initials. All topics on the orientation form must be reviewed. Please remember to use the most updated orientation form. The form was printed and shared with Ms. Loria during the visit. 1052: On-going training Each staff member must complete required hours of training starting the second year of employment. The training period is determined based on each member of staff’s hiring date. The required hours are determined based on the education listed on his/her WORKS letter. It is important for each staff member and administrators to understand the accurate training period and required hours for each member of staff. F. Norton’s completed training period is 4/15/24 through 4/14/25. During the period, he/she completed six (6) hours of training. C. McCormick’s completed training period is 2/14/24 through 2/13/25. During the period, he/she completed 1.5 hours of training. To comply, F. Norton must complete four (4) hours of training within the next two (2) weeks. These training is to make up for the last training period. Therefore, the hours will not count for the current period. C. McCormick needs 18.5 hours of training within the next two (2) weeks based on the understanding that he/she needs twenty (20) hours of training. Although I did not have time to review all staff members’ ongoing training hours, any staff who are short from the previous training period should complete additional training to make up the deficit. 1232: Annual evaluation Each staff member must have staff development plan and annual evaluation. Both documents must be renewed annually. No staff member except for one (1), had annual evaluation on the Staff and Training Worksheet. To comply, please complete the annual evaluation for all staff members and file them in their personal files. 1898 & 1899: Health and Safety Training Health and Safety training must be completed within one (1) year of employment and every five (5) years thereafter. Staff members and substitutes who work more than ten (10) days must complete health and safety training. K. Dorn, C. McCormick, J. Sherman did not complete their Health and Safety training within the first year of employment. C. Green did not complete the fifth year renewal training. To comply, those staff members listed above must complete the Health and Safety Training including “Medication in Child Care” training within the next two (2) weeks. Recognizing and Responding to Suspicions of Child Maltreatment training is not part of the renewal requirement. Print all certificates and file them behind the training log. 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 11/13/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Please fille out all sections for Staff and Training Worksheet before submitting them to me. Rated License Assessment: Pathways: Ms. Loria was interested in pathway 2 initially. The program is currently using Bright Wheel program where Ms. Loria customized the assessment tools to align with the NC FELD. However, Bright Wheel curriculum is not currently on the approved formative assessment list. We discussed that teachers need ample time to be trained, practice and understand the formative assessment tools. It is not something they can learn overnight. Due to this reason, it may be challenging to choose pathway 2 for upcoming assessment. For the renewal in 2029, it may be possible to choose pathway 2. I encouraged Ms. Loria to review accreditation options. I explained the requirements for CQI, Family and Community Engagement, education, staff/child ratios, self-study, mentoring and coaching options. Ms. Loria would like to look into several resources before determining the pathway. Timeline The next routine unannounced visit will be conducted in spring 2026 and the annual compliance visit prior to October 30, 2026. We discussed applying for the Rated License Assessment in late September 2026. This timeline will provide Ms. Loria to complete researches on accreditation and formative assessment as well as work on the Outreach assessment and self-study depending on her choice. Resources needed: I will periodically check on you to discuss your options. 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 .3222 (c) If employment-related changes occur at a facility that result in noncompliance with or failure to meet the standards in the Section for the star rating issued, the operator shall correct the noncompliance within six months. If the operator does not correct the noncompliance within six months, 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 5/1/2025 Number Present: 93 Completed Date: 5/1/2025 Age: From 0 To 6 Total Minutes: 205 Time In: 09:15 AM Time Out: 12:40 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 Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. Kaitlyn Marshall, Child Care Consultant, accompanied me for this visit. A signed copy of the visit summary was left on-site with you. Ms. Loria was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was eight-six (86) percent as of today prior to this visit. Permit type – four- star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/7/24. The last fire drill was practiced on 4/28/25. The last shelter-in-place drill was practiced on 4/28/25. The last playground inspection was documented on 3/13/25. The last fire inspection was approved on 3/28/25. The last sanitation inspection was conducted on 2/28/25 with nineteen (19) demerits for an approved classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 1/8/24 without hazards. Lead paint and asbestos testing has not been completed yet. Upon arrival, we announced our presence and the purpose of the visit. In space #1, a group of six (6) infants and one-year-old children were present with two (2) staff members. Three (3) children were on high chairs and had a snack. Small pieces of English muffins were served. Other three (3) children explored the environment and mouthed some toys. Two (2) evacuation cribs were available, sleep checks were filled out for previous days, feeding plans were signed and posted. Diaper creams were in compliance. In space #2, a group of ten (10) children, four-to-six years of age, were present with two (2) staff members. They participated in group time, listening to a story and sang songs. No medications were maintained in this classroom. In space #3, a group of eleven (11) children, two-to-three years of age returned from playground. The children washed their hands and sat at the tables. One (1) prescription medication and diaper creams were maintained in this classroom. The lock to the medication box was not secured, though the pad lock was on the box. In space #4, a group of twelve (12) children, two -to-four years of age were present with two (2) teachers. The children participated in group time then transitioned to the playground. Some easily torn plastics were accessible to children. In space #5, a group of thirteen (13) children, four-to-five years of age, were present with two (2) staff members. The children engaged in various activities, such as listening to stories, working on worksheet and art activity and building Duplo blocks. No medications were maintained in the classroom. In space #6, a group of ten (10) children, one-to-two years of age, were present with two (2) staff members. The children played with cardboard blocks, stuffed animals and other materials. The children in space #7 went for a walk in the buggies. A group of eight (8) children, infants and one (1) year old children were present with two (2) staff members. In space #8, a group of seven (7) children, all one (1) year of age, were present with two (2) staff members. The children explored the environment, picked up rattles and moved around. Space #9 was not used during the visit. Space #10, a group of sixteen (16) children had morning snacks. The children had English muffin with Jelly. Some students brought food from home. One (1) child had crackers and apple sauce. Supervision and interaction were adequate in all classrooms. All existing staff files were monitored and six (6) new staff files were monitored in full. No children’s files were monitored during today’s visit. The playgrounds were inspected. On the younger children’s playground, the children played with riding toys, tree house structure and accessories. On the older children’s playground, the children played with a climber, a slide structure, sandbox and riding toys. Astroturf is placed around the slide structure. Mulch was measured for seven (7) inches around the climber. No safety hazards were observed. 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 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. In space #4, three (3) outlets on the extension cord located under a teacher desk were not covered with safety covers. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #4, a can of Febreeze Luxe Air aerosol spray was stored in the cabinet. The cabinet had baby proof device. In space #5, a can of Barbasol shaving cream and two (2) packs of Energizer AA batteries were stored on the top shelf. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #3, Nystatin was maintained in a medication box along with diaper creams. The medication box had a padlock, but the lock was not secured. 15A NCAC 18A .2820(d) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #3, Nystatin was maintained in a medication box without its original box with a pharmacy label. .0803(2)(a) 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 space #4, several plastic materials were accessible to the a child, two (2) years of age. Under the changing table, there were six (6) packs of diapers in plastic wrappers. On the shelf on the desk, there was a bag of tree cut outs and leaves. There was mesh bags in a plastic bag. There was a bag of wooden beads and strings in a plastic bag on top of the desk. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The last playground inspection was conducted on 3/13/25. .0605(q) Technical assistance was provided as follows: 812: Electrical outlets Electrical outlets must be covered with safety covers. This requirement applies to all outlets including extension cords unless the outlet itself is tamper resistant. Refer to 10A NCAC 09 .0604(c). 840: Hazardous products Potentially hazardous products including chemicals and aerosol products must be stored in locked storage. Padlock with keys, combination locks, magnetic locks are common examples. Baby proofing devices are not typically considered sufficient. Please maintain shaving creams in a locked storage in space #4. Additionally, batteries are also considered corrosive agents and need to be maintained in locked storage. Please refer to 15A NCAC 18A.2820(b). 841: Storage of medication Prescription medication shall be stored in locked storage. In space #3, the medication box had a padlock, but it was not secured. Please train the staff members to be aware what kinds of medications are maintained in the classroom. Diaper creams must be inaccessible to the children, but in locked storage, but any medications, prescription and over-the-counter, such as Nystatin, children’s Benadryl must be stored in locked storage. Refer to 15A NCAC 18A.2820(d). 844: Prescription medication Prescription medication must be in its original box with a pharmacy label. This is to prevent mistakes by verifying the right medication, right route, right dosage, right child and right time. Please ask the parent to provide the original box for Nystatin cream in space #3. Additionally, please use the medication authorization form for prescription medications. Refer to 10A NCAC 09 .0803(2)(a) 858: Easily torn plastics Any easily torn plastics, such as plastic wrappers must be inaccessible to children under three. (3). This is to prevent choking or suffocation. Please remove plastics from the products and maintain them in the containers, such as shoebox containers as needed. When all children in the group turns three (3), this rule does not apply. Refer to 10A NCAC 09 .0604(q). 859: Playground Inspection: Playground inspections must be conducted monthly. In your letter of compliance, include a statement that indicates how you will ensure playground inspections are conducted on a monthly basis. Refer to 10A NCAC 09 .0605(q). The following items were not cited as violations during the visit today. Due to Tropical Storm Helene, our area is currently under a state of emergency. Additional time and guidance is given to reach compliance with certain items. Please note, violations may be cited during future visits if compliance is not met: Orientation Training: The orientation training record for Staff AH is blank. This staff was hired 3/10/25. To reach compliance, plan to complete the required 16 hours of orientation training with the staff member and document the training on the orientation training log. Health and Safety Training: Staff FN was initially hired 3/1/23 as a substitute. They transitioned to a lead teacher on 1/3/25. The Health and Safety Training topics were completed on 4/4/25. Moving forward, please note any substitutes that work more than 10 days in a 12 month period must complete Health and Safety training within the first year of hire. Recognizing and Responding to Suspicions of Child Maltreatment Training: Staff CC, hire date 1/6/25 did not have a certificate for the training on file. The training was due on 4/6/25. Plan to have this staff member complete the training immediately. Plan to print the certificate and place in the staff member’s file immediately upon completion. First Aid Training: Staff CC, hire date 4/6/25, had a certificate for BLS Provider training that expires 1/23/26. The training certificate stated that the training covered CPR and AED. The training certificate did not state that First Aid was part of the training. Plan to locate a First Aid training for this staff member. Please note, most First Aid trainings are paired with the CPR component and are rarely offered as standalone trainings. 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 5/15/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Expired medication: Destin Maximum Strength in space #6 (room 203) expired at the end of April. Please return the medication within next 48 hours. The following staff members will have Criminal Background Check qualifying letters expire soon: B. Brock- 10/5/25 D. Castillo- 9/1/25 We recommend staff begin the process to renew Criminal Background Checks up to six months prior to the expiration of the previous letter. Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: 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. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. 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. 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 5/1/2025 Number Present: 93 Completed Date: 5/1/2025 Age: From 0 To 6 Total Minutes: 205 Time In: 09:15 AM Time Out: 12:40 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 Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. Kaitlyn Marshall, Child Care Consultant, accompanied me for this visit. A signed copy of the visit summary was left on-site with you. Ms. Loria was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was eight-six (86) percent as of today prior to this visit. Permit type – four- star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/7/24. The last fire drill was practiced on 4/28/25. The last shelter-in-place drill was practiced on 4/28/25. The last playground inspection was documented on 3/13/25. The last fire inspection was approved on 3/28/25. The last sanitation inspection was conducted on 2/28/25 with nineteen (19) demerits for an approved classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 1/8/24 without hazards. Lead paint and asbestos testing has not been completed yet. Upon arrival, we announced our presence and the purpose of the visit. In space #1, a group of six (6) infants and one-year-old children were present with two (2) staff members. Three (3) children were on high chairs and had a snack. Small pieces of English muffins were served. Other three (3) children explored the environment and mouthed some toys. Two (2) evacuation cribs were available, sleep checks were filled out for previous days, feeding plans were signed and posted. Diaper creams were in compliance. In space #2, a group of ten (10) children, four-to-six years of age, were present with two (2) staff members. They participated in group time, listening to a story and sang songs. No medications were maintained in this classroom. In space #3, a group of eleven (11) children, two-to-three years of age returned from playground. The children washed their hands and sat at the tables. One (1) prescription medication and diaper creams were maintained in this classroom. The lock to the medication box was not secured, though the pad lock was on the box. In space #4, a group of twelve (12) children, two -to-four years of age were present with two (2) teachers. The children participated in group time then transitioned to the playground. Some easily torn plastics were accessible to children. In space #5, a group of thirteen (13) children, four-to-five years of age, were present with two (2) staff members. The children engaged in various activities, such as listening to stories, working on worksheet and art activity and building Duplo blocks. No medications were maintained in the classroom. In space #6, a group of ten (10) children, one-to-two years of age, were present with two (2) staff members. The children played with cardboard blocks, stuffed animals and other materials. The children in space #7 went for a walk in the buggies. A group of eight (8) children, infants and one (1) year old children were present with two (2) staff members. In space #8, a group of seven (7) children, all one (1) year of age, were present with two (2) staff members. The children explored the environment, picked up rattles and moved around. Space #9 was not used during the visit. Space #10, a group of sixteen (16) children had morning snacks. The children had English muffin with Jelly. Some students brought food from home. One (1) child had crackers and apple sauce. Supervision and interaction were adequate in all classrooms. All existing staff files were monitored and six (6) new staff files were monitored in full. No children’s files were monitored during today’s visit. The playgrounds were inspected. On the younger children’s playground, the children played with riding toys, tree house structure and accessories. On the older children’s playground, the children played with a climber, a slide structure, sandbox and riding toys. Astroturf is placed around the slide structure. Mulch was measured for seven (7) inches around the climber. No safety hazards were observed. 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 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. In space #4, three (3) outlets on the extension cord located under a teacher desk were not covered with safety covers. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #4, a can of Febreeze Luxe Air aerosol spray was stored in the cabinet. The cabinet had baby proof device. In space #5, a can of Barbasol shaving cream and two (2) packs of Energizer AA batteries were stored on the top shelf. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #3, Nystatin was maintained in a medication box along with diaper creams. The medication box had a padlock, but the lock was not secured. 15A NCAC 18A .2820(d) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #3, Nystatin was maintained in a medication box without its original box with a pharmacy label. .0803(2)(a) 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 space #4, several plastic materials were accessible to the a child, two (2) years of age. Under the changing table, there were six (6) packs of diapers in plastic wrappers. On the shelf on the desk, there was a bag of tree cut outs and leaves. There was mesh bags in a plastic bag. There was a bag of wooden beads and strings in a plastic bag on top of the desk. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The last playground inspection was conducted on 3/13/25. .0605(q) Technical assistance was provided as follows: 812: Electrical outlets Electrical outlets must be covered with safety covers. This requirement applies to all outlets including extension cords unless the outlet itself is tamper resistant. Refer to 10A NCAC 09 .0604(c). 840: Hazardous products Potentially hazardous products including chemicals and aerosol products must be stored in locked storage. Padlock with keys, combination locks, magnetic locks are common examples. Baby proofing devices are not typically considered sufficient. Please maintain shaving creams in a locked storage in space #4. Additionally, batteries are also considered corrosive agents and need to be maintained in locked storage. Please refer to 15A NCAC 18A.2820(b). 841: Storage of medication Prescription medication shall be stored in locked storage. In space #3, the medication box had a padlock, but it was not secured. Please train the staff members to be aware what kinds of medications are maintained in the classroom. Diaper creams must be inaccessible to the children, but in locked storage, but any medications, prescription and over-the-counter, such as Nystatin, children’s Benadryl must be stored in locked storage. Refer to 15A NCAC 18A.2820(d). 844: Prescription medication Prescription medication must be in its original box with a pharmacy label. This is to prevent mistakes by verifying the right medication, right route, right dosage, right child and right time. Please ask the parent to provide the original box for Nystatin cream in space #3. Additionally, please use the medication authorization form for prescription medications. Refer to 10A NCAC 09 .0803(2)(a) 858: Easily torn plastics Any easily torn plastics, such as plastic wrappers must be inaccessible to children under three. (3). This is to prevent choking or suffocation. Please remove plastics from the products and maintain them in the containers, such as shoebox containers as needed. When all children in the group turns three (3), this rule does not apply. Refer to 10A NCAC 09 .0604(q). 859: Playground Inspection: Playground inspections must be conducted monthly. In your letter of compliance, include a statement that indicates how you will ensure playground inspections are conducted on a monthly basis. Refer to 10A NCAC 09 .0605(q). The following items were not cited as violations during the visit today. Due to Tropical Storm Helene, our area is currently under a state of emergency. Additional time and guidance is given to reach compliance with certain items. Please note, violations may be cited during future visits if compliance is not met: Orientation Training: The orientation training record for Staff AH is blank. This staff was hired 3/10/25. To reach compliance, plan to complete the required 16 hours of orientation training with the staff member and document the training on the orientation training log. Health and Safety Training: Staff FN was initially hired 3/1/23 as a substitute. They transitioned to a lead teacher on 1/3/25. The Health and Safety Training topics were completed on 4/4/25. Moving forward, please note any substitutes that work more than 10 days in a 12 month period must complete Health and Safety training within the first year of hire. Recognizing and Responding to Suspicions of Child Maltreatment Training: Staff CC, hire date 1/6/25 did not have a certificate for the training on file. The training was due on 4/6/25. Plan to have this staff member complete the training immediately. Plan to print the certificate and place in the staff member’s file immediately upon completion. First Aid Training: Staff CC, hire date 4/6/25, had a certificate for BLS Provider training that expires 1/23/26. The training certificate stated that the training covered CPR and AED. The training certificate did not state that First Aid was part of the training. Plan to locate a First Aid training for this staff member. Please note, most First Aid trainings are paired with the CPR component and are rarely offered as standalone trainings. 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 5/15/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Expired medication: Destin Maximum Strength in space #6 (room 203) expired at the end of April. Please return the medication within next 48 hours. The following staff members will have Criminal Background Check qualifying letters expire soon: B. Brock- 10/5/25 D. Castillo- 9/1/25 We recommend staff begin the process to renew Criminal Background Checks up to six months prior to the expiration of the previous letter. Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: 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. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. 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. 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 5/1/2025 Number Present: 93 Completed Date: 5/1/2025 Age: From 0 To 6 Total Minutes: 205 Time In: 09:15 AM Time Out: 12:40 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 Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. Kaitlyn Marshall, Child Care Consultant, accompanied me for this visit. A signed copy of the visit summary was left on-site with you. Ms. Loria was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was eight-six (86) percent as of today prior to this visit. Permit type – four- star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/7/24. The last fire drill was practiced on 4/28/25. The last shelter-in-place drill was practiced on 4/28/25. The last playground inspection was documented on 3/13/25. The last fire inspection was approved on 3/28/25. The last sanitation inspection was conducted on 2/28/25 with nineteen (19) demerits for an approved classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 1/8/24 without hazards. Lead paint and asbestos testing has not been completed yet. Upon arrival, we announced our presence and the purpose of the visit. In space #1, a group of six (6) infants and one-year-old children were present with two (2) staff members. Three (3) children were on high chairs and had a snack. Small pieces of English muffins were served. Other three (3) children explored the environment and mouthed some toys. Two (2) evacuation cribs were available, sleep checks were filled out for previous days, feeding plans were signed and posted. Diaper creams were in compliance. In space #2, a group of ten (10) children, four-to-six years of age, were present with two (2) staff members. They participated in group time, listening to a story and sang songs. No medications were maintained in this classroom. In space #3, a group of eleven (11) children, two-to-three years of age returned from playground. The children washed their hands and sat at the tables. One (1) prescription medication and diaper creams were maintained in this classroom. The lock to the medication box was not secured, though the pad lock was on the box. In space #4, a group of twelve (12) children, two -to-four years of age were present with two (2) teachers. The children participated in group time then transitioned to the playground. Some easily torn plastics were accessible to children. In space #5, a group of thirteen (13) children, four-to-five years of age, were present with two (2) staff members. The children engaged in various activities, such as listening to stories, working on worksheet and art activity and building Duplo blocks. No medications were maintained in the classroom. In space #6, a group of ten (10) children, one-to-two years of age, were present with two (2) staff members. The children played with cardboard blocks, stuffed animals and other materials. The children in space #7 went for a walk in the buggies. A group of eight (8) children, infants and one (1) year old children were present with two (2) staff members. In space #8, a group of seven (7) children, all one (1) year of age, were present with two (2) staff members. The children explored the environment, picked up rattles and moved around. Space #9 was not used during the visit. Space #10, a group of sixteen (16) children had morning snacks. The children had English muffin with Jelly. Some students brought food from home. One (1) child had crackers and apple sauce. Supervision and interaction were adequate in all classrooms. All existing staff files were monitored and six (6) new staff files were monitored in full. No children’s files were monitored during today’s visit. The playgrounds were inspected. On the younger children’s playground, the children played with riding toys, tree house structure and accessories. On the older children’s playground, the children played with a climber, a slide structure, sandbox and riding toys. Astroturf is placed around the slide structure. Mulch was measured for seven (7) inches around the climber. No safety hazards were observed. 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 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. In space #4, three (3) outlets on the extension cord located under a teacher desk were not covered with safety covers. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #4, a can of Febreeze Luxe Air aerosol spray was stored in the cabinet. The cabinet had baby proof device. In space #5, a can of Barbasol shaving cream and two (2) packs of Energizer AA batteries were stored on the top shelf. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #3, Nystatin was maintained in a medication box along with diaper creams. The medication box had a padlock, but the lock was not secured. 15A NCAC 18A .2820(d) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #3, Nystatin was maintained in a medication box without its original box with a pharmacy label. .0803(2)(a) 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 space #4, several plastic materials were accessible to the a child, two (2) years of age. Under the changing table, there were six (6) packs of diapers in plastic wrappers. On the shelf on the desk, there was a bag of tree cut outs and leaves. There was mesh bags in a plastic bag. There was a bag of wooden beads and strings in a plastic bag on top of the desk. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The last playground inspection was conducted on 3/13/25. .0605(q) Technical assistance was provided as follows: 812: Electrical outlets Electrical outlets must be covered with safety covers. This requirement applies to all outlets including extension cords unless the outlet itself is tamper resistant. Refer to 10A NCAC 09 .0604(c). 840: Hazardous products Potentially hazardous products including chemicals and aerosol products must be stored in locked storage. Padlock with keys, combination locks, magnetic locks are common examples. Baby proofing devices are not typically considered sufficient. Please maintain shaving creams in a locked storage in space #4. Additionally, batteries are also considered corrosive agents and need to be maintained in locked storage. Please refer to 15A NCAC 18A.2820(b). 841: Storage of medication Prescription medication shall be stored in locked storage. In space #3, the medication box had a padlock, but it was not secured. Please train the staff members to be aware what kinds of medications are maintained in the classroom. Diaper creams must be inaccessible to the children, but in locked storage, but any medications, prescription and over-the-counter, such as Nystatin, children’s Benadryl must be stored in locked storage. Refer to 15A NCAC 18A.2820(d). 844: Prescription medication Prescription medication must be in its original box with a pharmacy label. This is to prevent mistakes by verifying the right medication, right route, right dosage, right child and right time. Please ask the parent to provide the original box for Nystatin cream in space #3. Additionally, please use the medication authorization form for prescription medications. Refer to 10A NCAC 09 .0803(2)(a) 858: Easily torn plastics Any easily torn plastics, such as plastic wrappers must be inaccessible to children under three. (3). This is to prevent choking or suffocation. Please remove plastics from the products and maintain them in the containers, such as shoebox containers as needed. When all children in the group turns three (3), this rule does not apply. Refer to 10A NCAC 09 .0604(q). 859: Playground Inspection: Playground inspections must be conducted monthly. In your letter of compliance, include a statement that indicates how you will ensure playground inspections are conducted on a monthly basis. Refer to 10A NCAC 09 .0605(q). The following items were not cited as violations during the visit today. Due to Tropical Storm Helene, our area is currently under a state of emergency. Additional time and guidance is given to reach compliance with certain items. Please note, violations may be cited during future visits if compliance is not met: Orientation Training: The orientation training record for Staff AH is blank. This staff was hired 3/10/25. To reach compliance, plan to complete the required 16 hours of orientation training with the staff member and document the training on the orientation training log. Health and Safety Training: Staff FN was initially hired 3/1/23 as a substitute. They transitioned to a lead teacher on 1/3/25. The Health and Safety Training topics were completed on 4/4/25. Moving forward, please note any substitutes that work more than 10 days in a 12 month period must complete Health and Safety training within the first year of hire. Recognizing and Responding to Suspicions of Child Maltreatment Training: Staff CC, hire date 1/6/25 did not have a certificate for the training on file. The training was due on 4/6/25. Plan to have this staff member complete the training immediately. Plan to print the certificate and place in the staff member’s file immediately upon completion. First Aid Training: Staff CC, hire date 4/6/25, had a certificate for BLS Provider training that expires 1/23/26. The training certificate stated that the training covered CPR and AED. The training certificate did not state that First Aid was part of the training. Plan to locate a First Aid training for this staff member. Please note, most First Aid trainings are paired with the CPR component and are rarely offered as standalone trainings. 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 5/15/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Expired medication: Destin Maximum Strength in space #6 (room 203) expired at the end of April. Please return the medication within next 48 hours. The following staff members will have Criminal Background Check qualifying letters expire soon: B. Brock- 10/5/25 D. Castillo- 9/1/25 We recommend staff begin the process to renew Criminal Background Checks up to six months prior to the expiration of the previous letter. Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: 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. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. 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. 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 5/1/2025 Number Present: 93 Completed Date: 5/1/2025 Age: From 0 To 6 Total Minutes: 205 Time In: 09:15 AM Time Out: 12:40 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 Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. Kaitlyn Marshall, Child Care Consultant, accompanied me for this visit. A signed copy of the visit summary was left on-site with you. Ms. Loria was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was eight-six (86) percent as of today prior to this visit. Permit type – four- star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/7/24. The last fire drill was practiced on 4/28/25. The last shelter-in-place drill was practiced on 4/28/25. The last playground inspection was documented on 3/13/25. The last fire inspection was approved on 3/28/25. The last sanitation inspection was conducted on 2/28/25 with nineteen (19) demerits for an approved classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 1/8/24 without hazards. Lead paint and asbestos testing has not been completed yet. Upon arrival, we announced our presence and the purpose of the visit. In space #1, a group of six (6) infants and one-year-old children were present with two (2) staff members. Three (3) children were on high chairs and had a snack. Small pieces of English muffins were served. Other three (3) children explored the environment and mouthed some toys. Two (2) evacuation cribs were available, sleep checks were filled out for previous days, feeding plans were signed and posted. Diaper creams were in compliance. In space #2, a group of ten (10) children, four-to-six years of age, were present with two (2) staff members. They participated in group time, listening to a story and sang songs. No medications were maintained in this classroom. In space #3, a group of eleven (11) children, two-to-three years of age returned from playground. The children washed their hands and sat at the tables. One (1) prescription medication and diaper creams were maintained in this classroom. The lock to the medication box was not secured, though the pad lock was on the box. In space #4, a group of twelve (12) children, two -to-four years of age were present with two (2) teachers. The children participated in group time then transitioned to the playground. Some easily torn plastics were accessible to children. In space #5, a group of thirteen (13) children, four-to-five years of age, were present with two (2) staff members. The children engaged in various activities, such as listening to stories, working on worksheet and art activity and building Duplo blocks. No medications were maintained in the classroom. In space #6, a group of ten (10) children, one-to-two years of age, were present with two (2) staff members. The children played with cardboard blocks, stuffed animals and other materials. The children in space #7 went for a walk in the buggies. A group of eight (8) children, infants and one (1) year old children were present with two (2) staff members. In space #8, a group of seven (7) children, all one (1) year of age, were present with two (2) staff members. The children explored the environment, picked up rattles and moved around. Space #9 was not used during the visit. Space #10, a group of sixteen (16) children had morning snacks. The children had English muffin with Jelly. Some students brought food from home. One (1) child had crackers and apple sauce. Supervision and interaction were adequate in all classrooms. All existing staff files were monitored and six (6) new staff files were monitored in full. No children’s files were monitored during today’s visit. The playgrounds were inspected. On the younger children’s playground, the children played with riding toys, tree house structure and accessories. On the older children’s playground, the children played with a climber, a slide structure, sandbox and riding toys. Astroturf is placed around the slide structure. Mulch was measured for seven (7) inches around the climber. No safety hazards were observed. 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 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. In space #4, three (3) outlets on the extension cord located under a teacher desk were not covered with safety covers. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #4, a can of Febreeze Luxe Air aerosol spray was stored in the cabinet. The cabinet had baby proof device. In space #5, a can of Barbasol shaving cream and two (2) packs of Energizer AA batteries were stored on the top shelf. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #3, Nystatin was maintained in a medication box along with diaper creams. The medication box had a padlock, but the lock was not secured. 15A NCAC 18A .2820(d) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #3, Nystatin was maintained in a medication box without its original box with a pharmacy label. .0803(2)(a) 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 space #4, several plastic materials were accessible to the a child, two (2) years of age. Under the changing table, there were six (6) packs of diapers in plastic wrappers. On the shelf on the desk, there was a bag of tree cut outs and leaves. There was mesh bags in a plastic bag. There was a bag of wooden beads and strings in a plastic bag on top of the desk. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The last playground inspection was conducted on 3/13/25. .0605(q) Technical assistance was provided as follows: 812: Electrical outlets Electrical outlets must be covered with safety covers. This requirement applies to all outlets including extension cords unless the outlet itself is tamper resistant. Refer to 10A NCAC 09 .0604(c). 840: Hazardous products Potentially hazardous products including chemicals and aerosol products must be stored in locked storage. Padlock with keys, combination locks, magnetic locks are common examples. Baby proofing devices are not typically considered sufficient. Please maintain shaving creams in a locked storage in space #4. Additionally, batteries are also considered corrosive agents and need to be maintained in locked storage. Please refer to 15A NCAC 18A.2820(b). 841: Storage of medication Prescription medication shall be stored in locked storage. In space #3, the medication box had a padlock, but it was not secured. Please train the staff members to be aware what kinds of medications are maintained in the classroom. Diaper creams must be inaccessible to the children, but in locked storage, but any medications, prescription and over-the-counter, such as Nystatin, children’s Benadryl must be stored in locked storage. Refer to 15A NCAC 18A.2820(d). 844: Prescription medication Prescription medication must be in its original box with a pharmacy label. This is to prevent mistakes by verifying the right medication, right route, right dosage, right child and right time. Please ask the parent to provide the original box for Nystatin cream in space #3. Additionally, please use the medication authorization form for prescription medications. Refer to 10A NCAC 09 .0803(2)(a) 858: Easily torn plastics Any easily torn plastics, such as plastic wrappers must be inaccessible to children under three. (3). This is to prevent choking or suffocation. Please remove plastics from the products and maintain them in the containers, such as shoebox containers as needed. When all children in the group turns three (3), this rule does not apply. Refer to 10A NCAC 09 .0604(q). 859: Playground Inspection: Playground inspections must be conducted monthly. In your letter of compliance, include a statement that indicates how you will ensure playground inspections are conducted on a monthly basis. Refer to 10A NCAC 09 .0605(q). The following items were not cited as violations during the visit today. Due to Tropical Storm Helene, our area is currently under a state of emergency. Additional time and guidance is given to reach compliance with certain items. Please note, violations may be cited during future visits if compliance is not met: Orientation Training: The orientation training record for Staff AH is blank. This staff was hired 3/10/25. To reach compliance, plan to complete the required 16 hours of orientation training with the staff member and document the training on the orientation training log. Health and Safety Training: Staff FN was initially hired 3/1/23 as a substitute. They transitioned to a lead teacher on 1/3/25. The Health and Safety Training topics were completed on 4/4/25. Moving forward, please note any substitutes that work more than 10 days in a 12 month period must complete Health and Safety training within the first year of hire. Recognizing and Responding to Suspicions of Child Maltreatment Training: Staff CC, hire date 1/6/25 did not have a certificate for the training on file. The training was due on 4/6/25. Plan to have this staff member complete the training immediately. Plan to print the certificate and place in the staff member’s file immediately upon completion. First Aid Training: Staff CC, hire date 4/6/25, had a certificate for BLS Provider training that expires 1/23/26. The training certificate stated that the training covered CPR and AED. The training certificate did not state that First Aid was part of the training. Plan to locate a First Aid training for this staff member. Please note, most First Aid trainings are paired with the CPR component and are rarely offered as standalone trainings. 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 5/15/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Expired medication: Destin Maximum Strength in space #6 (room 203) expired at the end of April. Please return the medication within next 48 hours. The following staff members will have Criminal Background Check qualifying letters expire soon: B. Brock- 10/5/25 D. Castillo- 9/1/25 We recommend staff begin the process to renew Criminal Background Checks up to six months prior to the expiration of the previous letter. Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: 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. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. 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. 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 5/1/2025 Number Present: 93 Completed Date: 5/1/2025 Age: From 0 To 6 Total Minutes: 205 Time In: 09:15 AM Time Out: 12:40 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 Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. Kaitlyn Marshall, Child Care Consultant, accompanied me for this visit. A signed copy of the visit summary was left on-site with you. Ms. Loria was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was eight-six (86) percent as of today prior to this visit. Permit type – four- star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/7/24. The last fire drill was practiced on 4/28/25. The last shelter-in-place drill was practiced on 4/28/25. The last playground inspection was documented on 3/13/25. The last fire inspection was approved on 3/28/25. The last sanitation inspection was conducted on 2/28/25 with nineteen (19) demerits for an approved classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 1/8/24 without hazards. Lead paint and asbestos testing has not been completed yet. Upon arrival, we announced our presence and the purpose of the visit. In space #1, a group of six (6) infants and one-year-old children were present with two (2) staff members. Three (3) children were on high chairs and had a snack. Small pieces of English muffins were served. Other three (3) children explored the environment and mouthed some toys. Two (2) evacuation cribs were available, sleep checks were filled out for previous days, feeding plans were signed and posted. Diaper creams were in compliance. In space #2, a group of ten (10) children, four-to-six years of age, were present with two (2) staff members. They participated in group time, listening to a story and sang songs. No medications were maintained in this classroom. In space #3, a group of eleven (11) children, two-to-three years of age returned from playground. The children washed their hands and sat at the tables. One (1) prescription medication and diaper creams were maintained in this classroom. The lock to the medication box was not secured, though the pad lock was on the box. In space #4, a group of twelve (12) children, two -to-four years of age were present with two (2) teachers. The children participated in group time then transitioned to the playground. Some easily torn plastics were accessible to children. In space #5, a group of thirteen (13) children, four-to-five years of age, were present with two (2) staff members. The children engaged in various activities, such as listening to stories, working on worksheet and art activity and building Duplo blocks. No medications were maintained in the classroom. In space #6, a group of ten (10) children, one-to-two years of age, were present with two (2) staff members. The children played with cardboard blocks, stuffed animals and other materials. The children in space #7 went for a walk in the buggies. A group of eight (8) children, infants and one (1) year old children were present with two (2) staff members. In space #8, a group of seven (7) children, all one (1) year of age, were present with two (2) staff members. The children explored the environment, picked up rattles and moved around. Space #9 was not used during the visit. Space #10, a group of sixteen (16) children had morning snacks. The children had English muffin with Jelly. Some students brought food from home. One (1) child had crackers and apple sauce. Supervision and interaction were adequate in all classrooms. All existing staff files were monitored and six (6) new staff files were monitored in full. No children’s files were monitored during today’s visit. The playgrounds were inspected. On the younger children’s playground, the children played with riding toys, tree house structure and accessories. On the older children’s playground, the children played with a climber, a slide structure, sandbox and riding toys. Astroturf is placed around the slide structure. Mulch was measured for seven (7) inches around the climber. No safety hazards were observed. 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 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. In space #4, three (3) outlets on the extension cord located under a teacher desk were not covered with safety covers. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #4, a can of Febreeze Luxe Air aerosol spray was stored in the cabinet. The cabinet had baby proof device. In space #5, a can of Barbasol shaving cream and two (2) packs of Energizer AA batteries were stored on the top shelf. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #3, Nystatin was maintained in a medication box along with diaper creams. The medication box had a padlock, but the lock was not secured. 15A NCAC 18A .2820(d) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #3, Nystatin was maintained in a medication box without its original box with a pharmacy label. .0803(2)(a) 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 space #4, several plastic materials were accessible to the a child, two (2) years of age. Under the changing table, there were six (6) packs of diapers in plastic wrappers. On the shelf on the desk, there was a bag of tree cut outs and leaves. There was mesh bags in a plastic bag. There was a bag of wooden beads and strings in a plastic bag on top of the desk. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The last playground inspection was conducted on 3/13/25. .0605(q) Technical assistance was provided as follows: 812: Electrical outlets Electrical outlets must be covered with safety covers. This requirement applies to all outlets including extension cords unless the outlet itself is tamper resistant. Refer to 10A NCAC 09 .0604(c). 840: Hazardous products Potentially hazardous products including chemicals and aerosol products must be stored in locked storage. Padlock with keys, combination locks, magnetic locks are common examples. Baby proofing devices are not typically considered sufficient. Please maintain shaving creams in a locked storage in space #4. Additionally, batteries are also considered corrosive agents and need to be maintained in locked storage. Please refer to 15A NCAC 18A.2820(b). 841: Storage of medication Prescription medication shall be stored in locked storage. In space #3, the medication box had a padlock, but it was not secured. Please train the staff members to be aware what kinds of medications are maintained in the classroom. Diaper creams must be inaccessible to the children, but in locked storage, but any medications, prescription and over-the-counter, such as Nystatin, children’s Benadryl must be stored in locked storage. Refer to 15A NCAC 18A.2820(d). 844: Prescription medication Prescription medication must be in its original box with a pharmacy label. This is to prevent mistakes by verifying the right medication, right route, right dosage, right child and right time. Please ask the parent to provide the original box for Nystatin cream in space #3. Additionally, please use the medication authorization form for prescription medications. Refer to 10A NCAC 09 .0803(2)(a) 858: Easily torn plastics Any easily torn plastics, such as plastic wrappers must be inaccessible to children under three. (3). This is to prevent choking or suffocation. Please remove plastics from the products and maintain them in the containers, such as shoebox containers as needed. When all children in the group turns three (3), this rule does not apply. Refer to 10A NCAC 09 .0604(q). 859: Playground Inspection: Playground inspections must be conducted monthly. In your letter of compliance, include a statement that indicates how you will ensure playground inspections are conducted on a monthly basis. Refer to 10A NCAC 09 .0605(q). The following items were not cited as violations during the visit today. Due to Tropical Storm Helene, our area is currently under a state of emergency. Additional time and guidance is given to reach compliance with certain items. Please note, violations may be cited during future visits if compliance is not met: Orientation Training: The orientation training record for Staff AH is blank. This staff was hired 3/10/25. To reach compliance, plan to complete the required 16 hours of orientation training with the staff member and document the training on the orientation training log. Health and Safety Training: Staff FN was initially hired 3/1/23 as a substitute. They transitioned to a lead teacher on 1/3/25. The Health and Safety Training topics were completed on 4/4/25. Moving forward, please note any substitutes that work more than 10 days in a 12 month period must complete Health and Safety training within the first year of hire. Recognizing and Responding to Suspicions of Child Maltreatment Training: Staff CC, hire date 1/6/25 did not have a certificate for the training on file. The training was due on 4/6/25. Plan to have this staff member complete the training immediately. Plan to print the certificate and place in the staff member’s file immediately upon completion. First Aid Training: Staff CC, hire date 4/6/25, had a certificate for BLS Provider training that expires 1/23/26. The training certificate stated that the training covered CPR and AED. The training certificate did not state that First Aid was part of the training. Plan to locate a First Aid training for this staff member. Please note, most First Aid trainings are paired with the CPR component and are rarely offered as standalone trainings. 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 5/15/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Expired medication: Destin Maximum Strength in space #6 (room 203) expired at the end of April. Please return the medication within next 48 hours. The following staff members will have Criminal Background Check qualifying letters expire soon: B. Brock- 10/5/25 D. Castillo- 9/1/25 We recommend staff begin the process to renew Criminal Background Checks up to six months prior to the expiration of the previous letter. Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: 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. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. 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. 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 5/1/2025 Number Present: 93 Completed Date: 5/1/2025 Age: From 0 To 6 Total Minutes: 205 Time In: 09:15 AM Time Out: 12:40 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 Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. Kaitlyn Marshall, Child Care Consultant, accompanied me for this visit. A signed copy of the visit summary was left on-site with you. Ms. Loria was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was eight-six (86) percent as of today prior to this visit. Permit type – four- star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/7/24. The last fire drill was practiced on 4/28/25. The last shelter-in-place drill was practiced on 4/28/25. The last playground inspection was documented on 3/13/25. The last fire inspection was approved on 3/28/25. The last sanitation inspection was conducted on 2/28/25 with nineteen (19) demerits for an approved classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 1/8/24 without hazards. Lead paint and asbestos testing has not been completed yet. Upon arrival, we announced our presence and the purpose of the visit. In space #1, a group of six (6) infants and one-year-old children were present with two (2) staff members. Three (3) children were on high chairs and had a snack. Small pieces of English muffins were served. Other three (3) children explored the environment and mouthed some toys. Two (2) evacuation cribs were available, sleep checks were filled out for previous days, feeding plans were signed and posted. Diaper creams were in compliance. In space #2, a group of ten (10) children, four-to-six years of age, were present with two (2) staff members. They participated in group time, listening to a story and sang songs. No medications were maintained in this classroom. In space #3, a group of eleven (11) children, two-to-three years of age returned from playground. The children washed their hands and sat at the tables. One (1) prescription medication and diaper creams were maintained in this classroom. The lock to the medication box was not secured, though the pad lock was on the box. In space #4, a group of twelve (12) children, two -to-four years of age were present with two (2) teachers. The children participated in group time then transitioned to the playground. Some easily torn plastics were accessible to children. In space #5, a group of thirteen (13) children, four-to-five years of age, were present with two (2) staff members. The children engaged in various activities, such as listening to stories, working on worksheet and art activity and building Duplo blocks. No medications were maintained in the classroom. In space #6, a group of ten (10) children, one-to-two years of age, were present with two (2) staff members. The children played with cardboard blocks, stuffed animals and other materials. The children in space #7 went for a walk in the buggies. A group of eight (8) children, infants and one (1) year old children were present with two (2) staff members. In space #8, a group of seven (7) children, all one (1) year of age, were present with two (2) staff members. The children explored the environment, picked up rattles and moved around. Space #9 was not used during the visit. Space #10, a group of sixteen (16) children had morning snacks. The children had English muffin with Jelly. Some students brought food from home. One (1) child had crackers and apple sauce. Supervision and interaction were adequate in all classrooms. All existing staff files were monitored and six (6) new staff files were monitored in full. No children’s files were monitored during today’s visit. The playgrounds were inspected. On the younger children’s playground, the children played with riding toys, tree house structure and accessories. On the older children’s playground, the children played with a climber, a slide structure, sandbox and riding toys. Astroturf is placed around the slide structure. Mulch was measured for seven (7) inches around the climber. No safety hazards were observed. 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 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. In space #4, three (3) outlets on the extension cord located under a teacher desk were not covered with safety covers. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #4, a can of Febreeze Luxe Air aerosol spray was stored in the cabinet. The cabinet had baby proof device. In space #5, a can of Barbasol shaving cream and two (2) packs of Energizer AA batteries were stored on the top shelf. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #3, Nystatin was maintained in a medication box along with diaper creams. The medication box had a padlock, but the lock was not secured. 15A NCAC 18A .2820(d) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #3, Nystatin was maintained in a medication box without its original box with a pharmacy label. .0803(2)(a) 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 space #4, several plastic materials were accessible to the a child, two (2) years of age. Under the changing table, there were six (6) packs of diapers in plastic wrappers. On the shelf on the desk, there was a bag of tree cut outs and leaves. There was mesh bags in a plastic bag. There was a bag of wooden beads and strings in a plastic bag on top of the desk. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The last playground inspection was conducted on 3/13/25. .0605(q) Technical assistance was provided as follows: 812: Electrical outlets Electrical outlets must be covered with safety covers. This requirement applies to all outlets including extension cords unless the outlet itself is tamper resistant. Refer to 10A NCAC 09 .0604(c). 840: Hazardous products Potentially hazardous products including chemicals and aerosol products must be stored in locked storage. Padlock with keys, combination locks, magnetic locks are common examples. Baby proofing devices are not typically considered sufficient. Please maintain shaving creams in a locked storage in space #4. Additionally, batteries are also considered corrosive agents and need to be maintained in locked storage. Please refer to 15A NCAC 18A.2820(b). 841: Storage of medication Prescription medication shall be stored in locked storage. In space #3, the medication box had a padlock, but it was not secured. Please train the staff members to be aware what kinds of medications are maintained in the classroom. Diaper creams must be inaccessible to the children, but in locked storage, but any medications, prescription and over-the-counter, such as Nystatin, children’s Benadryl must be stored in locked storage. Refer to 15A NCAC 18A.2820(d). 844: Prescription medication Prescription medication must be in its original box with a pharmacy label. This is to prevent mistakes by verifying the right medication, right route, right dosage, right child and right time. Please ask the parent to provide the original box for Nystatin cream in space #3. Additionally, please use the medication authorization form for prescription medications. Refer to 10A NCAC 09 .0803(2)(a) 858: Easily torn plastics Any easily torn plastics, such as plastic wrappers must be inaccessible to children under three. (3). This is to prevent choking or suffocation. Please remove plastics from the products and maintain them in the containers, such as shoebox containers as needed. When all children in the group turns three (3), this rule does not apply. Refer to 10A NCAC 09 .0604(q). 859: Playground Inspection: Playground inspections must be conducted monthly. In your letter of compliance, include a statement that indicates how you will ensure playground inspections are conducted on a monthly basis. Refer to 10A NCAC 09 .0605(q). The following items were not cited as violations during the visit today. Due to Tropical Storm Helene, our area is currently under a state of emergency. Additional time and guidance is given to reach compliance with certain items. Please note, violations may be cited during future visits if compliance is not met: Orientation Training: The orientation training record for Staff AH is blank. This staff was hired 3/10/25. To reach compliance, plan to complete the required 16 hours of orientation training with the staff member and document the training on the orientation training log. Health and Safety Training: Staff FN was initially hired 3/1/23 as a substitute. They transitioned to a lead teacher on 1/3/25. The Health and Safety Training topics were completed on 4/4/25. Moving forward, please note any substitutes that work more than 10 days in a 12 month period must complete Health and Safety training within the first year of hire. Recognizing and Responding to Suspicions of Child Maltreatment Training: Staff CC, hire date 1/6/25 did not have a certificate for the training on file. The training was due on 4/6/25. Plan to have this staff member complete the training immediately. Plan to print the certificate and place in the staff member’s file immediately upon completion. First Aid Training: Staff CC, hire date 4/6/25, had a certificate for BLS Provider training that expires 1/23/26. The training certificate stated that the training covered CPR and AED. The training certificate did not state that First Aid was part of the training. Plan to locate a First Aid training for this staff member. Please note, most First Aid trainings are paired with the CPR component and are rarely offered as standalone trainings. 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 5/15/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Expired medication: Destin Maximum Strength in space #6 (room 203) expired at the end of April. Please return the medication within next 48 hours. The following staff members will have Criminal Background Check qualifying letters expire soon: B. Brock- 10/5/25 D. Castillo- 9/1/25 We recommend staff begin the process to renew Criminal Background Checks up to six months prior to the expiration of the previous letter. Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: 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. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. 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. 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 5/1/2025 Number Present: 93 Completed Date: 5/1/2025 Age: From 0 To 6 Total Minutes: 205 Time In: 09:15 AM Time Out: 12:40 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 Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. Kaitlyn Marshall, Child Care Consultant, accompanied me for this visit. A signed copy of the visit summary was left on-site with you. Ms. Loria was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was eight-six (86) percent as of today prior to this visit. Permit type – four- star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/7/24. The last fire drill was practiced on 4/28/25. The last shelter-in-place drill was practiced on 4/28/25. The last playground inspection was documented on 3/13/25. The last fire inspection was approved on 3/28/25. The last sanitation inspection was conducted on 2/28/25 with nineteen (19) demerits for an approved classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 1/8/24 without hazards. Lead paint and asbestos testing has not been completed yet. Upon arrival, we announced our presence and the purpose of the visit. In space #1, a group of six (6) infants and one-year-old children were present with two (2) staff members. Three (3) children were on high chairs and had a snack. Small pieces of English muffins were served. Other three (3) children explored the environment and mouthed some toys. Two (2) evacuation cribs were available, sleep checks were filled out for previous days, feeding plans were signed and posted. Diaper creams were in compliance. In space #2, a group of ten (10) children, four-to-six years of age, were present with two (2) staff members. They participated in group time, listening to a story and sang songs. No medications were maintained in this classroom. In space #3, a group of eleven (11) children, two-to-three years of age returned from playground. The children washed their hands and sat at the tables. One (1) prescription medication and diaper creams were maintained in this classroom. The lock to the medication box was not secured, though the pad lock was on the box. In space #4, a group of twelve (12) children, two -to-four years of age were present with two (2) teachers. The children participated in group time then transitioned to the playground. Some easily torn plastics were accessible to children. In space #5, a group of thirteen (13) children, four-to-five years of age, were present with two (2) staff members. The children engaged in various activities, such as listening to stories, working on worksheet and art activity and building Duplo blocks. No medications were maintained in the classroom. In space #6, a group of ten (10) children, one-to-two years of age, were present with two (2) staff members. The children played with cardboard blocks, stuffed animals and other materials. The children in space #7 went for a walk in the buggies. A group of eight (8) children, infants and one (1) year old children were present with two (2) staff members. In space #8, a group of seven (7) children, all one (1) year of age, were present with two (2) staff members. The children explored the environment, picked up rattles and moved around. Space #9 was not used during the visit. Space #10, a group of sixteen (16) children had morning snacks. The children had English muffin with Jelly. Some students brought food from home. One (1) child had crackers and apple sauce. Supervision and interaction were adequate in all classrooms. All existing staff files were monitored and six (6) new staff files were monitored in full. No children’s files were monitored during today’s visit. The playgrounds were inspected. On the younger children’s playground, the children played with riding toys, tree house structure and accessories. On the older children’s playground, the children played with a climber, a slide structure, sandbox and riding toys. Astroturf is placed around the slide structure. Mulch was measured for seven (7) inches around the climber. No safety hazards were observed. 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 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. In space #4, three (3) outlets on the extension cord located under a teacher desk were not covered with safety covers. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #4, a can of Febreeze Luxe Air aerosol spray was stored in the cabinet. The cabinet had baby proof device. In space #5, a can of Barbasol shaving cream and two (2) packs of Energizer AA batteries were stored on the top shelf. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #3, Nystatin was maintained in a medication box along with diaper creams. The medication box had a padlock, but the lock was not secured. 15A NCAC 18A .2820(d) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #3, Nystatin was maintained in a medication box without its original box with a pharmacy label. .0803(2)(a) 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 space #4, several plastic materials were accessible to the a child, two (2) years of age. Under the changing table, there were six (6) packs of diapers in plastic wrappers. On the shelf on the desk, there was a bag of tree cut outs and leaves. There was mesh bags in a plastic bag. There was a bag of wooden beads and strings in a plastic bag on top of the desk. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The last playground inspection was conducted on 3/13/25. .0605(q) Technical assistance was provided as follows: 812: Electrical outlets Electrical outlets must be covered with safety covers. This requirement applies to all outlets including extension cords unless the outlet itself is tamper resistant. Refer to 10A NCAC 09 .0604(c). 840: Hazardous products Potentially hazardous products including chemicals and aerosol products must be stored in locked storage. Padlock with keys, combination locks, magnetic locks are common examples. Baby proofing devices are not typically considered sufficient. Please maintain shaving creams in a locked storage in space #4. Additionally, batteries are also considered corrosive agents and need to be maintained in locked storage. Please refer to 15A NCAC 18A.2820(b). 841: Storage of medication Prescription medication shall be stored in locked storage. In space #3, the medication box had a padlock, but it was not secured. Please train the staff members to be aware what kinds of medications are maintained in the classroom. Diaper creams must be inaccessible to the children, but in locked storage, but any medications, prescription and over-the-counter, such as Nystatin, children’s Benadryl must be stored in locked storage. Refer to 15A NCAC 18A.2820(d). 844: Prescription medication Prescription medication must be in its original box with a pharmacy label. This is to prevent mistakes by verifying the right medication, right route, right dosage, right child and right time. Please ask the parent to provide the original box for Nystatin cream in space #3. Additionally, please use the medication authorization form for prescription medications. Refer to 10A NCAC 09 .0803(2)(a) 858: Easily torn plastics Any easily torn plastics, such as plastic wrappers must be inaccessible to children under three. (3). This is to prevent choking or suffocation. Please remove plastics from the products and maintain them in the containers, such as shoebox containers as needed. When all children in the group turns three (3), this rule does not apply. Refer to 10A NCAC 09 .0604(q). 859: Playground Inspection: Playground inspections must be conducted monthly. In your letter of compliance, include a statement that indicates how you will ensure playground inspections are conducted on a monthly basis. Refer to 10A NCAC 09 .0605(q). The following items were not cited as violations during the visit today. Due to Tropical Storm Helene, our area is currently under a state of emergency. Additional time and guidance is given to reach compliance with certain items. Please note, violations may be cited during future visits if compliance is not met: Orientation Training: The orientation training record for Staff AH is blank. This staff was hired 3/10/25. To reach compliance, plan to complete the required 16 hours of orientation training with the staff member and document the training on the orientation training log. Health and Safety Training: Staff FN was initially hired 3/1/23 as a substitute. They transitioned to a lead teacher on 1/3/25. The Health and Safety Training topics were completed on 4/4/25. Moving forward, please note any substitutes that work more than 10 days in a 12 month period must complete Health and Safety training within the first year of hire. Recognizing and Responding to Suspicions of Child Maltreatment Training: Staff CC, hire date 1/6/25 did not have a certificate for the training on file. The training was due on 4/6/25. Plan to have this staff member complete the training immediately. Plan to print the certificate and place in the staff member’s file immediately upon completion. First Aid Training: Staff CC, hire date 4/6/25, had a certificate for BLS Provider training that expires 1/23/26. The training certificate stated that the training covered CPR and AED. The training certificate did not state that First Aid was part of the training. Plan to locate a First Aid training for this staff member. Please note, most First Aid trainings are paired with the CPR component and are rarely offered as standalone trainings. 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 5/15/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Expired medication: Destin Maximum Strength in space #6 (room 203) expired at the end of April. Please return the medication within next 48 hours. The following staff members will have Criminal Background Check qualifying letters expire soon: B. Brock- 10/5/25 D. Castillo- 9/1/25 We recommend staff begin the process to renew Criminal Background Checks up to six months prior to the expiration of the previous letter. Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: 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. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. 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. 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 5/1/2025 Number Present: 93 Completed Date: 5/1/2025 Age: From 0 To 6 Total Minutes: 205 Time In: 09:15 AM Time Out: 12:40 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 Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. Kaitlyn Marshall, Child Care Consultant, accompanied me for this visit. A signed copy of the visit summary was left on-site with you. Ms. Loria was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was eight-six (86) percent as of today prior to this visit. Permit type – four- star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/7/24. The last fire drill was practiced on 4/28/25. The last shelter-in-place drill was practiced on 4/28/25. The last playground inspection was documented on 3/13/25. The last fire inspection was approved on 3/28/25. The last sanitation inspection was conducted on 2/28/25 with nineteen (19) demerits for an approved classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 1/8/24 without hazards. Lead paint and asbestos testing has not been completed yet. Upon arrival, we announced our presence and the purpose of the visit. In space #1, a group of six (6) infants and one-year-old children were present with two (2) staff members. Three (3) children were on high chairs and had a snack. Small pieces of English muffins were served. Other three (3) children explored the environment and mouthed some toys. Two (2) evacuation cribs were available, sleep checks were filled out for previous days, feeding plans were signed and posted. Diaper creams were in compliance. In space #2, a group of ten (10) children, four-to-six years of age, were present with two (2) staff members. They participated in group time, listening to a story and sang songs. No medications were maintained in this classroom. In space #3, a group of eleven (11) children, two-to-three years of age returned from playground. The children washed their hands and sat at the tables. One (1) prescription medication and diaper creams were maintained in this classroom. The lock to the medication box was not secured, though the pad lock was on the box. In space #4, a group of twelve (12) children, two -to-four years of age were present with two (2) teachers. The children participated in group time then transitioned to the playground. Some easily torn plastics were accessible to children. In space #5, a group of thirteen (13) children, four-to-five years of age, were present with two (2) staff members. The children engaged in various activities, such as listening to stories, working on worksheet and art activity and building Duplo blocks. No medications were maintained in the classroom. In space #6, a group of ten (10) children, one-to-two years of age, were present with two (2) staff members. The children played with cardboard blocks, stuffed animals and other materials. The children in space #7 went for a walk in the buggies. A group of eight (8) children, infants and one (1) year old children were present with two (2) staff members. In space #8, a group of seven (7) children, all one (1) year of age, were present with two (2) staff members. The children explored the environment, picked up rattles and moved around. Space #9 was not used during the visit. Space #10, a group of sixteen (16) children had morning snacks. The children had English muffin with Jelly. Some students brought food from home. One (1) child had crackers and apple sauce. Supervision and interaction were adequate in all classrooms. All existing staff files were monitored and six (6) new staff files were monitored in full. No children’s files were monitored during today’s visit. The playgrounds were inspected. On the younger children’s playground, the children played with riding toys, tree house structure and accessories. On the older children’s playground, the children played with a climber, a slide structure, sandbox and riding toys. Astroturf is placed around the slide structure. Mulch was measured for seven (7) inches around the climber. No safety hazards were observed. 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 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. In space #4, three (3) outlets on the extension cord located under a teacher desk were not covered with safety covers. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #4, a can of Febreeze Luxe Air aerosol spray was stored in the cabinet. The cabinet had baby proof device. In space #5, a can of Barbasol shaving cream and two (2) packs of Energizer AA batteries were stored on the top shelf. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #3, Nystatin was maintained in a medication box along with diaper creams. The medication box had a padlock, but the lock was not secured. 15A NCAC 18A .2820(d) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #3, Nystatin was maintained in a medication box without its original box with a pharmacy label. .0803(2)(a) 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 space #4, several plastic materials were accessible to the a child, two (2) years of age. Under the changing table, there were six (6) packs of diapers in plastic wrappers. On the shelf on the desk, there was a bag of tree cut outs and leaves. There was mesh bags in a plastic bag. There was a bag of wooden beads and strings in a plastic bag on top of the desk. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The last playground inspection was conducted on 3/13/25. .0605(q) Technical assistance was provided as follows: 812: Electrical outlets Electrical outlets must be covered with safety covers. This requirement applies to all outlets including extension cords unless the outlet itself is tamper resistant. Refer to 10A NCAC 09 .0604(c). 840: Hazardous products Potentially hazardous products including chemicals and aerosol products must be stored in locked storage. Padlock with keys, combination locks, magnetic locks are common examples. Baby proofing devices are not typically considered sufficient. Please maintain shaving creams in a locked storage in space #4. Additionally, batteries are also considered corrosive agents and need to be maintained in locked storage. Please refer to 15A NCAC 18A.2820(b). 841: Storage of medication Prescription medication shall be stored in locked storage. In space #3, the medication box had a padlock, but it was not secured. Please train the staff members to be aware what kinds of medications are maintained in the classroom. Diaper creams must be inaccessible to the children, but in locked storage, but any medications, prescription and over-the-counter, such as Nystatin, children’s Benadryl must be stored in locked storage. Refer to 15A NCAC 18A.2820(d). 844: Prescription medication Prescription medication must be in its original box with a pharmacy label. This is to prevent mistakes by verifying the right medication, right route, right dosage, right child and right time. Please ask the parent to provide the original box for Nystatin cream in space #3. Additionally, please use the medication authorization form for prescription medications. Refer to 10A NCAC 09 .0803(2)(a) 858: Easily torn plastics Any easily torn plastics, such as plastic wrappers must be inaccessible to children under three. (3). This is to prevent choking or suffocation. Please remove plastics from the products and maintain them in the containers, such as shoebox containers as needed. When all children in the group turns three (3), this rule does not apply. Refer to 10A NCAC 09 .0604(q). 859: Playground Inspection: Playground inspections must be conducted monthly. In your letter of compliance, include a statement that indicates how you will ensure playground inspections are conducted on a monthly basis. Refer to 10A NCAC 09 .0605(q). The following items were not cited as violations during the visit today. Due to Tropical Storm Helene, our area is currently under a state of emergency. Additional time and guidance is given to reach compliance with certain items. Please note, violations may be cited during future visits if compliance is not met: Orientation Training: The orientation training record for Staff AH is blank. This staff was hired 3/10/25. To reach compliance, plan to complete the required 16 hours of orientation training with the staff member and document the training on the orientation training log. Health and Safety Training: Staff FN was initially hired 3/1/23 as a substitute. They transitioned to a lead teacher on 1/3/25. The Health and Safety Training topics were completed on 4/4/25. Moving forward, please note any substitutes that work more than 10 days in a 12 month period must complete Health and Safety training within the first year of hire. Recognizing and Responding to Suspicions of Child Maltreatment Training: Staff CC, hire date 1/6/25 did not have a certificate for the training on file. The training was due on 4/6/25. Plan to have this staff member complete the training immediately. Plan to print the certificate and place in the staff member’s file immediately upon completion. First Aid Training: Staff CC, hire date 4/6/25, had a certificate for BLS Provider training that expires 1/23/26. The training certificate stated that the training covered CPR and AED. The training certificate did not state that First Aid was part of the training. Plan to locate a First Aid training for this staff member. Please note, most First Aid trainings are paired with the CPR component and are rarely offered as standalone trainings. 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 5/15/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Expired medication: Destin Maximum Strength in space #6 (room 203) expired at the end of April. Please return the medication within next 48 hours. The following staff members will have Criminal Background Check qualifying letters expire soon: B. Brock- 10/5/25 D. Castillo- 9/1/25 We recommend staff begin the process to renew Criminal Background Checks up to six months prior to the expiration of the previous letter. Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: 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. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. 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. 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 5/1/2025 Number Present: 93 Completed Date: 5/1/2025 Age: From 0 To 6 Total Minutes: 205 Time In: 09:15 AM Time Out: 12:40 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 Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. Kaitlyn Marshall, Child Care Consultant, accompanied me for this visit. A signed copy of the visit summary was left on-site with you. Ms. Loria was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was eight-six (86) percent as of today prior to this visit. Permit type – four- star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/7/24. The last fire drill was practiced on 4/28/25. The last shelter-in-place drill was practiced on 4/28/25. The last playground inspection was documented on 3/13/25. The last fire inspection was approved on 3/28/25. The last sanitation inspection was conducted on 2/28/25 with nineteen (19) demerits for an approved classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 1/8/24 without hazards. Lead paint and asbestos testing has not been completed yet. Upon arrival, we announced our presence and the purpose of the visit. In space #1, a group of six (6) infants and one-year-old children were present with two (2) staff members. Three (3) children were on high chairs and had a snack. Small pieces of English muffins were served. Other three (3) children explored the environment and mouthed some toys. Two (2) evacuation cribs were available, sleep checks were filled out for previous days, feeding plans were signed and posted. Diaper creams were in compliance. In space #2, a group of ten (10) children, four-to-six years of age, were present with two (2) staff members. They participated in group time, listening to a story and sang songs. No medications were maintained in this classroom. In space #3, a group of eleven (11) children, two-to-three years of age returned from playground. The children washed their hands and sat at the tables. One (1) prescription medication and diaper creams were maintained in this classroom. The lock to the medication box was not secured, though the pad lock was on the box. In space #4, a group of twelve (12) children, two -to-four years of age were present with two (2) teachers. The children participated in group time then transitioned to the playground. Some easily torn plastics were accessible to children. In space #5, a group of thirteen (13) children, four-to-five years of age, were present with two (2) staff members. The children engaged in various activities, such as listening to stories, working on worksheet and art activity and building Duplo blocks. No medications were maintained in the classroom. In space #6, a group of ten (10) children, one-to-two years of age, were present with two (2) staff members. The children played with cardboard blocks, stuffed animals and other materials. The children in space #7 went for a walk in the buggies. A group of eight (8) children, infants and one (1) year old children were present with two (2) staff members. In space #8, a group of seven (7) children, all one (1) year of age, were present with two (2) staff members. The children explored the environment, picked up rattles and moved around. Space #9 was not used during the visit. Space #10, a group of sixteen (16) children had morning snacks. The children had English muffin with Jelly. Some students brought food from home. One (1) child had crackers and apple sauce. Supervision and interaction were adequate in all classrooms. All existing staff files were monitored and six (6) new staff files were monitored in full. No children’s files were monitored during today’s visit. The playgrounds were inspected. On the younger children’s playground, the children played with riding toys, tree house structure and accessories. On the older children’s playground, the children played with a climber, a slide structure, sandbox and riding toys. Astroturf is placed around the slide structure. Mulch was measured for seven (7) inches around the climber. No safety hazards were observed. 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 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. In space #4, three (3) outlets on the extension cord located under a teacher desk were not covered with safety covers. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #4, a can of Febreeze Luxe Air aerosol spray was stored in the cabinet. The cabinet had baby proof device. In space #5, a can of Barbasol shaving cream and two (2) packs of Energizer AA batteries were stored on the top shelf. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #3, Nystatin was maintained in a medication box along with diaper creams. The medication box had a padlock, but the lock was not secured. 15A NCAC 18A .2820(d) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #3, Nystatin was maintained in a medication box without its original box with a pharmacy label. .0803(2)(a) 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 space #4, several plastic materials were accessible to the a child, two (2) years of age. Under the changing table, there were six (6) packs of diapers in plastic wrappers. On the shelf on the desk, there was a bag of tree cut outs and leaves. There was mesh bags in a plastic bag. There was a bag of wooden beads and strings in a plastic bag on top of the desk. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The last playground inspection was conducted on 3/13/25. .0605(q) Technical assistance was provided as follows: 812: Electrical outlets Electrical outlets must be covered with safety covers. This requirement applies to all outlets including extension cords unless the outlet itself is tamper resistant. Refer to 10A NCAC 09 .0604(c). 840: Hazardous products Potentially hazardous products including chemicals and aerosol products must be stored in locked storage. Padlock with keys, combination locks, magnetic locks are common examples. Baby proofing devices are not typically considered sufficient. Please maintain shaving creams in a locked storage in space #4. Additionally, batteries are also considered corrosive agents and need to be maintained in locked storage. Please refer to 15A NCAC 18A.2820(b). 841: Storage of medication Prescription medication shall be stored in locked storage. In space #3, the medication box had a padlock, but it was not secured. Please train the staff members to be aware what kinds of medications are maintained in the classroom. Diaper creams must be inaccessible to the children, but in locked storage, but any medications, prescription and over-the-counter, such as Nystatin, children’s Benadryl must be stored in locked storage. Refer to 15A NCAC 18A.2820(d). 844: Prescription medication Prescription medication must be in its original box with a pharmacy label. This is to prevent mistakes by verifying the right medication, right route, right dosage, right child and right time. Please ask the parent to provide the original box for Nystatin cream in space #3. Additionally, please use the medication authorization form for prescription medications. Refer to 10A NCAC 09 .0803(2)(a) 858: Easily torn plastics Any easily torn plastics, such as plastic wrappers must be inaccessible to children under three. (3). This is to prevent choking or suffocation. Please remove plastics from the products and maintain them in the containers, such as shoebox containers as needed. When all children in the group turns three (3), this rule does not apply. Refer to 10A NCAC 09 .0604(q). 859: Playground Inspection: Playground inspections must be conducted monthly. In your letter of compliance, include a statement that indicates how you will ensure playground inspections are conducted on a monthly basis. Refer to 10A NCAC 09 .0605(q). The following items were not cited as violations during the visit today. Due to Tropical Storm Helene, our area is currently under a state of emergency. Additional time and guidance is given to reach compliance with certain items. Please note, violations may be cited during future visits if compliance is not met: Orientation Training: The orientation training record for Staff AH is blank. This staff was hired 3/10/25. To reach compliance, plan to complete the required 16 hours of orientation training with the staff member and document the training on the orientation training log. Health and Safety Training: Staff FN was initially hired 3/1/23 as a substitute. They transitioned to a lead teacher on 1/3/25. The Health and Safety Training topics were completed on 4/4/25. Moving forward, please note any substitutes that work more than 10 days in a 12 month period must complete Health and Safety training within the first year of hire. Recognizing and Responding to Suspicions of Child Maltreatment Training: Staff CC, hire date 1/6/25 did not have a certificate for the training on file. The training was due on 4/6/25. Plan to have this staff member complete the training immediately. Plan to print the certificate and place in the staff member’s file immediately upon completion. First Aid Training: Staff CC, hire date 4/6/25, had a certificate for BLS Provider training that expires 1/23/26. The training certificate stated that the training covered CPR and AED. The training certificate did not state that First Aid was part of the training. Plan to locate a First Aid training for this staff member. Please note, most First Aid trainings are paired with the CPR component and are rarely offered as standalone trainings. 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 5/15/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Expired medication: Destin Maximum Strength in space #6 (room 203) expired at the end of April. Please return the medication within next 48 hours. The following staff members will have Criminal Background Check qualifying letters expire soon: B. Brock- 10/5/25 D. Castillo- 9/1/25 We recommend staff begin the process to renew Criminal Background Checks up to six months prior to the expiration of the previous letter. Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: 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. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. 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. 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 5/1/2025 Number Present: 93 Completed Date: 5/1/2025 Age: From 0 To 6 Total Minutes: 205 Time In: 09:15 AM Time Out: 12:40 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 Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. Kaitlyn Marshall, Child Care Consultant, accompanied me for this visit. A signed copy of the visit summary was left on-site with you. Ms. Loria was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was eight-six (86) percent as of today prior to this visit. Permit type – four- star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/7/24. The last fire drill was practiced on 4/28/25. The last shelter-in-place drill was practiced on 4/28/25. The last playground inspection was documented on 3/13/25. The last fire inspection was approved on 3/28/25. The last sanitation inspection was conducted on 2/28/25 with nineteen (19) demerits for an approved classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 1/8/24 without hazards. Lead paint and asbestos testing has not been completed yet. Upon arrival, we announced our presence and the purpose of the visit. In space #1, a group of six (6) infants and one-year-old children were present with two (2) staff members. Three (3) children were on high chairs and had a snack. Small pieces of English muffins were served. Other three (3) children explored the environment and mouthed some toys. Two (2) evacuation cribs were available, sleep checks were filled out for previous days, feeding plans were signed and posted. Diaper creams were in compliance. In space #2, a group of ten (10) children, four-to-six years of age, were present with two (2) staff members. They participated in group time, listening to a story and sang songs. No medications were maintained in this classroom. In space #3, a group of eleven (11) children, two-to-three years of age returned from playground. The children washed their hands and sat at the tables. One (1) prescription medication and diaper creams were maintained in this classroom. The lock to the medication box was not secured, though the pad lock was on the box. In space #4, a group of twelve (12) children, two -to-four years of age were present with two (2) teachers. The children participated in group time then transitioned to the playground. Some easily torn plastics were accessible to children. In space #5, a group of thirteen (13) children, four-to-five years of age, were present with two (2) staff members. The children engaged in various activities, such as listening to stories, working on worksheet and art activity and building Duplo blocks. No medications were maintained in the classroom. In space #6, a group of ten (10) children, one-to-two years of age, were present with two (2) staff members. The children played with cardboard blocks, stuffed animals and other materials. The children in space #7 went for a walk in the buggies. A group of eight (8) children, infants and one (1) year old children were present with two (2) staff members. In space #8, a group of seven (7) children, all one (1) year of age, were present with two (2) staff members. The children explored the environment, picked up rattles and moved around. Space #9 was not used during the visit. Space #10, a group of sixteen (16) children had morning snacks. The children had English muffin with Jelly. Some students brought food from home. One (1) child had crackers and apple sauce. Supervision and interaction were adequate in all classrooms. All existing staff files were monitored and six (6) new staff files were monitored in full. No children’s files were monitored during today’s visit. The playgrounds were inspected. On the younger children’s playground, the children played with riding toys, tree house structure and accessories. On the older children’s playground, the children played with a climber, a slide structure, sandbox and riding toys. Astroturf is placed around the slide structure. Mulch was measured for seven (7) inches around the climber. No safety hazards were observed. 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 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. In space #4, three (3) outlets on the extension cord located under a teacher desk were not covered with safety covers. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #4, a can of Febreeze Luxe Air aerosol spray was stored in the cabinet. The cabinet had baby proof device. In space #5, a can of Barbasol shaving cream and two (2) packs of Energizer AA batteries were stored on the top shelf. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #3, Nystatin was maintained in a medication box along with diaper creams. The medication box had a padlock, but the lock was not secured. 15A NCAC 18A .2820(d) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #3, Nystatin was maintained in a medication box without its original box with a pharmacy label. .0803(2)(a) 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 space #4, several plastic materials were accessible to the a child, two (2) years of age. Under the changing table, there were six (6) packs of diapers in plastic wrappers. On the shelf on the desk, there was a bag of tree cut outs and leaves. There was mesh bags in a plastic bag. There was a bag of wooden beads and strings in a plastic bag on top of the desk. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The last playground inspection was conducted on 3/13/25. .0605(q) Technical assistance was provided as follows: 812: Electrical outlets Electrical outlets must be covered with safety covers. This requirement applies to all outlets including extension cords unless the outlet itself is tamper resistant. Refer to 10A NCAC 09 .0604(c). 840: Hazardous products Potentially hazardous products including chemicals and aerosol products must be stored in locked storage. Padlock with keys, combination locks, magnetic locks are common examples. Baby proofing devices are not typically considered sufficient. Please maintain shaving creams in a locked storage in space #4. Additionally, batteries are also considered corrosive agents and need to be maintained in locked storage. Please refer to 15A NCAC 18A.2820(b). 841: Storage of medication Prescription medication shall be stored in locked storage. In space #3, the medication box had a padlock, but it was not secured. Please train the staff members to be aware what kinds of medications are maintained in the classroom. Diaper creams must be inaccessible to the children, but in locked storage, but any medications, prescription and over-the-counter, such as Nystatin, children’s Benadryl must be stored in locked storage. Refer to 15A NCAC 18A.2820(d). 844: Prescription medication Prescription medication must be in its original box with a pharmacy label. This is to prevent mistakes by verifying the right medication, right route, right dosage, right child and right time. Please ask the parent to provide the original box for Nystatin cream in space #3. Additionally, please use the medication authorization form for prescription medications. Refer to 10A NCAC 09 .0803(2)(a) 858: Easily torn plastics Any easily torn plastics, such as plastic wrappers must be inaccessible to children under three. (3). This is to prevent choking or suffocation. Please remove plastics from the products and maintain them in the containers, such as shoebox containers as needed. When all children in the group turns three (3), this rule does not apply. Refer to 10A NCAC 09 .0604(q). 859: Playground Inspection: Playground inspections must be conducted monthly. In your letter of compliance, include a statement that indicates how you will ensure playground inspections are conducted on a monthly basis. Refer to 10A NCAC 09 .0605(q). The following items were not cited as violations during the visit today. Due to Tropical Storm Helene, our area is currently under a state of emergency. Additional time and guidance is given to reach compliance with certain items. Please note, violations may be cited during future visits if compliance is not met: Orientation Training: The orientation training record for Staff AH is blank. This staff was hired 3/10/25. To reach compliance, plan to complete the required 16 hours of orientation training with the staff member and document the training on the orientation training log. Health and Safety Training: Staff FN was initially hired 3/1/23 as a substitute. They transitioned to a lead teacher on 1/3/25. The Health and Safety Training topics were completed on 4/4/25. Moving forward, please note any substitutes that work more than 10 days in a 12 month period must complete Health and Safety training within the first year of hire. Recognizing and Responding to Suspicions of Child Maltreatment Training: Staff CC, hire date 1/6/25 did not have a certificate for the training on file. The training was due on 4/6/25. Plan to have this staff member complete the training immediately. Plan to print the certificate and place in the staff member’s file immediately upon completion. First Aid Training: Staff CC, hire date 4/6/25, had a certificate for BLS Provider training that expires 1/23/26. The training certificate stated that the training covered CPR and AED. The training certificate did not state that First Aid was part of the training. Plan to locate a First Aid training for this staff member. Please note, most First Aid trainings are paired with the CPR component and are rarely offered as standalone trainings. 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 5/15/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Expired medication: Destin Maximum Strength in space #6 (room 203) expired at the end of April. Please return the medication within next 48 hours. The following staff members will have Criminal Background Check qualifying letters expire soon: B. Brock- 10/5/25 D. Castillo- 9/1/25 We recommend staff begin the process to renew Criminal Background Checks up to six months prior to the expiration of the previous letter. Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: 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. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. 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. 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 11/7/2024 Number Present: 101 Completed Date: 11/7/2024 Age: From 0 To 5 Total Minutes: 360 Time In: 09:00 AM Time Out: 03:00 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, Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Loria accompanied me. The indoor and outdoor areas were monitored today, including but not limited to 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-five (85) percent as of today prior to this visit. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Emmanuel Lutheran Church of Asheville, N.C., Inc. is current/active as of 11/6/24. Permit type – Four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meet enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/13/23. The last fire drill was practiced on 10/30/24. The last lockdown drill was practiced on 10/30/24. The last playground inspection was documented on 10/24/24. The last fire inspection was approved on 3/4/24. The last sanitation inspection was conducted on 1/31/24 with five (5) demerits for a superior classification. Incident log was up to date. Emergency Preparedness and Response (EPR) plan was updated on 9/23/24. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Upon arrival, I announced my presence and the purpose of the visit. In space #1, a group of seven (7) infants explored the material and environment. The staff members sat with the children and interacted. Posters, diaper creams, hazardous products, refrigerator, and other requirements were monitored. In space #2, a group of four-to-five-year-old children had group time. One (1) of the teachers lead the group time, and the other teacher cleaned the tables for snacks. The children sang songs and played finger play with the teacher. Two (2) emergency medications were maintained in the classroom. The children from space #3 played on the playground. A group of two-year-old children engaged in gross motor activities with riding toys, slide, toy vehicles, climber and sand. The mulch around the climber was measured for six (6) inches. No hazardous products were accessible to the children in the classroom. In space #4, a group of two-year-old children had P.E in the gym. The children engaged in tumbling activities. One (1) teacher took five (5) children back to the classroom during P.E time to change their diapers, leaving eight (8) children with another teacher. In space #5, a group of four-to-five-year-old children engaged in free play with blocks, manipulatives, art , science and housekeeping toys. A group of one-year-old children from space #6 and #7 played on the playground. The group went to the playground on shifts and were not mixed together. The children played with slide, riding toys, and bubbles. In space #8, a group of infants and one-year-old children took nap in the cribs. One (1) child was in the highchair and had pancakes for snack. One (1) of the teachers stayed with the child in the highchair until he/she was finished with the snack. Space #9 was not in use during today’s visit. In space #10, a group of three-to-four-year-old children had morning snack. The children had pancakes and milk. Cheeseburger, mixed fruits and tater tots were served for lunch. Staff interaction and supervision were adequate. Twelve (12) children’s files were monitored. Staff and Training Worksheet was submitted during the visit. The worksheet for five (5) substitute members had not been completed. Three (3) new substitute staff files were monitored during the visit. Please submit the additional staff and training worksheet for the substitute staff members. Additionally to the substitute staff files, seven (7) new staff files and three (3) existing staff files were monitored. CPR/First Aid training was schedule for three (3) staff members in October. One (1) staff member’s certification is expired as of today due to the cancelled class. The staff members are registered to complete the class on 11/16/24. A staff member hired on 8/5/24 was scheduled to complete ITS/SIDS training in October. The training is re-scheduled for 11/12/24. Ms. Loria is scheduled to complete the Playground Safety in Child Care training on 11/20/24. Currently two (2) other staff members are qualified to complete monthly playground inspection. The facility uses tanker to provider water to the existing sink. The facility is following the Emergency Operation Plan submitted on October 18, 2024. 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 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, bottles sent from home for two (2) children were not labeled with today's date. 15A NCAC 18A .2804(d) 541 The written feeding plan did not include the child's name, parent signature, and/or was not dated when received by the center. One (1) child's feeding plan in space #1 and one (1) child's feeding plan in #7 were not signed by the parents. .0902(a) 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. Epi-pen in space #2 expired in October 2024. Aquaphor Healing Ointment in #3 and #7 expired in October 2024. Those medications were not returned home or discarded. .0803(12) Technical assistance was provided as follows: 428: Activity plan Current activity plans shall be posted for parents to review. Please have the staff members in space #5 and #6 update the plans. 533: Bottles Per Sanitation rule 15A NCAC 18A .2804(d), bottles sent from home must be labeled with date and the child’s name. Staff members shall review the bottle each day to make sure that the appropriate date and names are on the bottles in case the parents forget to do so. 541: Feeding plan Feeding plan shall be created for all children under fifteen (15) months of age, and the child’s name, the parent signature and a date are required. Please ask the parents of the child in space #1 and #7 to sign the document. 849: Expired medications Expired medications including prescriptions and over-the-counter medications (lotions and sprays included) must be discarded or returned to the parents within seventy-two (72) hours. Please return the expired epi-pen in space #2 and diaper ointment in pace #7 to the parents. 1032: Medical statement 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Medical Report is a statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. It is 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. Medical statement is due prior to employment. When submitted, the medical statement shall not be older than 12 months. Please have the staff member hired on 8/26/24 acquire medical statement immediately. 1035: Emergency Information 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 is required for child care providers, including the director, uncompensated providers, substitute providers, and volunteers. It shall be in file on or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Please have the staff member hired on 9/9/24 fill out the form immediately. 1897: Recognizing and Responding to Suspicions of Child Maltreatment Please have the staff member hired on 8/5/24 complete the training immediately. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. 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 • Statement of compliance I must receive your compliance statement by 11/21/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins Address: PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: On-going training hours: Annual on-toing training period is based on each staff members hiring date. For example, staff A is hired on 1/1/2020, A’s annual training period for this year is 1/1/23 to 12/31/24. Ms. Loria is a new administrator, therefore, the technical assistance was provided for on-going training requirements. Quotam Teaching Strategies information was shared with Ms. Loria via email. Health and Training can be completed annually as part of on-going training as needed. ITS/SIDS training: ITS/SIDS training is valid for three (3) years. The staff member who cares for infants must complete the training within two (2) months of employment and maintain the certification. This training is different from ITS/SIDS training for Health and Safety training. In-person or Live online training is required for the staff members who care for infants. Reminder: Recognizing and Responding to Suspicions on Maltreatment training for the staff member hired on 8/12/24 is due on or before November 10, 2024. Boudreaux’s Butt Past for a child in space #7 will expire at the end of November. 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. 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 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 11/7/2024 Number Present: 101 Completed Date: 11/7/2024 Age: From 0 To 5 Total Minutes: 360 Time In: 09:00 AM Time Out: 03:00 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, Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Loria accompanied me. The indoor and outdoor areas were monitored today, including but not limited to 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-five (85) percent as of today prior to this visit. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Emmanuel Lutheran Church of Asheville, N.C., Inc. is current/active as of 11/6/24. Permit type – Four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meet enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/13/23. The last fire drill was practiced on 10/30/24. The last lockdown drill was practiced on 10/30/24. The last playground inspection was documented on 10/24/24. The last fire inspection was approved on 3/4/24. The last sanitation inspection was conducted on 1/31/24 with five (5) demerits for a superior classification. Incident log was up to date. Emergency Preparedness and Response (EPR) plan was updated on 9/23/24. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Upon arrival, I announced my presence and the purpose of the visit. In space #1, a group of seven (7) infants explored the material and environment. The staff members sat with the children and interacted. Posters, diaper creams, hazardous products, refrigerator, and other requirements were monitored. In space #2, a group of four-to-five-year-old children had group time. One (1) of the teachers lead the group time, and the other teacher cleaned the tables for snacks. The children sang songs and played finger play with the teacher. Two (2) emergency medications were maintained in the classroom. The children from space #3 played on the playground. A group of two-year-old children engaged in gross motor activities with riding toys, slide, toy vehicles, climber and sand. The mulch around the climber was measured for six (6) inches. No hazardous products were accessible to the children in the classroom. In space #4, a group of two-year-old children had P.E in the gym. The children engaged in tumbling activities. One (1) teacher took five (5) children back to the classroom during P.E time to change their diapers, leaving eight (8) children with another teacher. In space #5, a group of four-to-five-year-old children engaged in free play with blocks, manipulatives, art , science and housekeeping toys. A group of one-year-old children from space #6 and #7 played on the playground. The group went to the playground on shifts and were not mixed together. The children played with slide, riding toys, and bubbles. In space #8, a group of infants and one-year-old children took nap in the cribs. One (1) child was in the highchair and had pancakes for snack. One (1) of the teachers stayed with the child in the highchair until he/she was finished with the snack. Space #9 was not in use during today’s visit. In space #10, a group of three-to-four-year-old children had morning snack. The children had pancakes and milk. Cheeseburger, mixed fruits and tater tots were served for lunch. Staff interaction and supervision were adequate. Twelve (12) children’s files were monitored. Staff and Training Worksheet was submitted during the visit. The worksheet for five (5) substitute members had not been completed. Three (3) new substitute staff files were monitored during the visit. Please submit the additional staff and training worksheet for the substitute staff members. Additionally to the substitute staff files, seven (7) new staff files and three (3) existing staff files were monitored. CPR/First Aid training was schedule for three (3) staff members in October. One (1) staff member’s certification is expired as of today due to the cancelled class. The staff members are registered to complete the class on 11/16/24. A staff member hired on 8/5/24 was scheduled to complete ITS/SIDS training in October. The training is re-scheduled for 11/12/24. Ms. Loria is scheduled to complete the Playground Safety in Child Care training on 11/20/24. Currently two (2) other staff members are qualified to complete monthly playground inspection. The facility uses tanker to provider water to the existing sink. The facility is following the Emergency Operation Plan submitted on October 18, 2024. 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 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, bottles sent from home for two (2) children were not labeled with today's date. 15A NCAC 18A .2804(d) 541 The written feeding plan did not include the child's name, parent signature, and/or was not dated when received by the center. One (1) child's feeding plan in space #1 and one (1) child's feeding plan in #7 were not signed by the parents. .0902(a) 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. Epi-pen in space #2 expired in October 2024. Aquaphor Healing Ointment in #3 and #7 expired in October 2024. Those medications were not returned home or discarded. .0803(12) Technical assistance was provided as follows: 428: Activity plan Current activity plans shall be posted for parents to review. Please have the staff members in space #5 and #6 update the plans. 533: Bottles Per Sanitation rule 15A NCAC 18A .2804(d), bottles sent from home must be labeled with date and the child’s name. Staff members shall review the bottle each day to make sure that the appropriate date and names are on the bottles in case the parents forget to do so. 541: Feeding plan Feeding plan shall be created for all children under fifteen (15) months of age, and the child’s name, the parent signature and a date are required. Please ask the parents of the child in space #1 and #7 to sign the document. 849: Expired medications Expired medications including prescriptions and over-the-counter medications (lotions and sprays included) must be discarded or returned to the parents within seventy-two (72) hours. Please return the expired epi-pen in space #2 and diaper ointment in pace #7 to the parents. 1032: Medical statement 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Medical Report is a statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. It is 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. Medical statement is due prior to employment. When submitted, the medical statement shall not be older than 12 months. Please have the staff member hired on 8/26/24 acquire medical statement immediately. 1035: Emergency Information 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 is required for child care providers, including the director, uncompensated providers, substitute providers, and volunteers. It shall be in file on or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Please have the staff member hired on 9/9/24 fill out the form immediately. 1897: Recognizing and Responding to Suspicions of Child Maltreatment Please have the staff member hired on 8/5/24 complete the training immediately. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. 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 • Statement of compliance I must receive your compliance statement by 11/21/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins Address: PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: On-going training hours: Annual on-toing training period is based on each staff members hiring date. For example, staff A is hired on 1/1/2020, A’s annual training period for this year is 1/1/23 to 12/31/24. Ms. Loria is a new administrator, therefore, the technical assistance was provided for on-going training requirements. Quotam Teaching Strategies information was shared with Ms. Loria via email. Health and Training can be completed annually as part of on-going training as needed. ITS/SIDS training: ITS/SIDS training is valid for three (3) years. The staff member who cares for infants must complete the training within two (2) months of employment and maintain the certification. This training is different from ITS/SIDS training for Health and Safety training. In-person or Live online training is required for the staff members who care for infants. Reminder: Recognizing and Responding to Suspicions on Maltreatment training for the staff member hired on 8/12/24 is due on or before November 10, 2024. Boudreaux’s Butt Past for a child in space #7 will expire at the end of November. 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. 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 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 11/7/2024 Number Present: 101 Completed Date: 11/7/2024 Age: From 0 To 5 Total Minutes: 360 Time In: 09:00 AM Time Out: 03:00 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, Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Loria accompanied me. The indoor and outdoor areas were monitored today, including but not limited to 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-five (85) percent as of today prior to this visit. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Emmanuel Lutheran Church of Asheville, N.C., Inc. is current/active as of 11/6/24. Permit type – Four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meet enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/13/23. The last fire drill was practiced on 10/30/24. The last lockdown drill was practiced on 10/30/24. The last playground inspection was documented on 10/24/24. The last fire inspection was approved on 3/4/24. The last sanitation inspection was conducted on 1/31/24 with five (5) demerits for a superior classification. Incident log was up to date. Emergency Preparedness and Response (EPR) plan was updated on 9/23/24. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Upon arrival, I announced my presence and the purpose of the visit. In space #1, a group of seven (7) infants explored the material and environment. The staff members sat with the children and interacted. Posters, diaper creams, hazardous products, refrigerator, and other requirements were monitored. In space #2, a group of four-to-five-year-old children had group time. One (1) of the teachers lead the group time, and the other teacher cleaned the tables for snacks. The children sang songs and played finger play with the teacher. Two (2) emergency medications were maintained in the classroom. The children from space #3 played on the playground. A group of two-year-old children engaged in gross motor activities with riding toys, slide, toy vehicles, climber and sand. The mulch around the climber was measured for six (6) inches. No hazardous products were accessible to the children in the classroom. In space #4, a group of two-year-old children had P.E in the gym. The children engaged in tumbling activities. One (1) teacher took five (5) children back to the classroom during P.E time to change their diapers, leaving eight (8) children with another teacher. In space #5, a group of four-to-five-year-old children engaged in free play with blocks, manipulatives, art , science and housekeeping toys. A group of one-year-old children from space #6 and #7 played on the playground. The group went to the playground on shifts and were not mixed together. The children played with slide, riding toys, and bubbles. In space #8, a group of infants and one-year-old children took nap in the cribs. One (1) child was in the highchair and had pancakes for snack. One (1) of the teachers stayed with the child in the highchair until he/she was finished with the snack. Space #9 was not in use during today’s visit. In space #10, a group of three-to-four-year-old children had morning snack. The children had pancakes and milk. Cheeseburger, mixed fruits and tater tots were served for lunch. Staff interaction and supervision were adequate. Twelve (12) children’s files were monitored. Staff and Training Worksheet was submitted during the visit. The worksheet for five (5) substitute members had not been completed. Three (3) new substitute staff files were monitored during the visit. Please submit the additional staff and training worksheet for the substitute staff members. Additionally to the substitute staff files, seven (7) new staff files and three (3) existing staff files were monitored. CPR/First Aid training was schedule for three (3) staff members in October. One (1) staff member’s certification is expired as of today due to the cancelled class. The staff members are registered to complete the class on 11/16/24. A staff member hired on 8/5/24 was scheduled to complete ITS/SIDS training in October. The training is re-scheduled for 11/12/24. Ms. Loria is scheduled to complete the Playground Safety in Child Care training on 11/20/24. Currently two (2) other staff members are qualified to complete monthly playground inspection. The facility uses tanker to provider water to the existing sink. The facility is following the Emergency Operation Plan submitted on October 18, 2024. 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 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, bottles sent from home for two (2) children were not labeled with today's date. 15A NCAC 18A .2804(d) 541 The written feeding plan did not include the child's name, parent signature, and/or was not dated when received by the center. One (1) child's feeding plan in space #1 and one (1) child's feeding plan in #7 were not signed by the parents. .0902(a) 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. Epi-pen in space #2 expired in October 2024. Aquaphor Healing Ointment in #3 and #7 expired in October 2024. Those medications were not returned home or discarded. .0803(12) Technical assistance was provided as follows: 428: Activity plan Current activity plans shall be posted for parents to review. Please have the staff members in space #5 and #6 update the plans. 533: Bottles Per Sanitation rule 15A NCAC 18A .2804(d), bottles sent from home must be labeled with date and the child’s name. Staff members shall review the bottle each day to make sure that the appropriate date and names are on the bottles in case the parents forget to do so. 541: Feeding plan Feeding plan shall be created for all children under fifteen (15) months of age, and the child’s name, the parent signature and a date are required. Please ask the parents of the child in space #1 and #7 to sign the document. 849: Expired medications Expired medications including prescriptions and over-the-counter medications (lotions and sprays included) must be discarded or returned to the parents within seventy-two (72) hours. Please return the expired epi-pen in space #2 and diaper ointment in pace #7 to the parents. 1032: Medical statement 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Medical Report is a statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. It is 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. Medical statement is due prior to employment. When submitted, the medical statement shall not be older than 12 months. Please have the staff member hired on 8/26/24 acquire medical statement immediately. 1035: Emergency Information 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 is required for child care providers, including the director, uncompensated providers, substitute providers, and volunteers. It shall be in file on or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Please have the staff member hired on 9/9/24 fill out the form immediately. 1897: Recognizing and Responding to Suspicions of Child Maltreatment Please have the staff member hired on 8/5/24 complete the training immediately. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. 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 • Statement of compliance I must receive your compliance statement by 11/21/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins Address: PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: On-going training hours: Annual on-toing training period is based on each staff members hiring date. For example, staff A is hired on 1/1/2020, A’s annual training period for this year is 1/1/23 to 12/31/24. Ms. Loria is a new administrator, therefore, the technical assistance was provided for on-going training requirements. Quotam Teaching Strategies information was shared with Ms. Loria via email. Health and Training can be completed annually as part of on-going training as needed. ITS/SIDS training: ITS/SIDS training is valid for three (3) years. The staff member who cares for infants must complete the training within two (2) months of employment and maintain the certification. This training is different from ITS/SIDS training for Health and Safety training. In-person or Live online training is required for the staff members who care for infants. Reminder: Recognizing and Responding to Suspicions on Maltreatment training for the staff member hired on 8/12/24 is due on or before November 10, 2024. Boudreaux’s Butt Past for a child in space #7 will expire at the end of November. 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. 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 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 11/7/2024 Number Present: 101 Completed Date: 11/7/2024 Age: From 0 To 5 Total Minutes: 360 Time In: 09:00 AM Time Out: 03:00 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, Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Loria accompanied me. The indoor and outdoor areas were monitored today, including but not limited to 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-five (85) percent as of today prior to this visit. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Emmanuel Lutheran Church of Asheville, N.C., Inc. is current/active as of 11/6/24. Permit type – Four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meet enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/13/23. The last fire drill was practiced on 10/30/24. The last lockdown drill was practiced on 10/30/24. The last playground inspection was documented on 10/24/24. The last fire inspection was approved on 3/4/24. The last sanitation inspection was conducted on 1/31/24 with five (5) demerits for a superior classification. Incident log was up to date. Emergency Preparedness and Response (EPR) plan was updated on 9/23/24. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Upon arrival, I announced my presence and the purpose of the visit. In space #1, a group of seven (7) infants explored the material and environment. The staff members sat with the children and interacted. Posters, diaper creams, hazardous products, refrigerator, and other requirements were monitored. In space #2, a group of four-to-five-year-old children had group time. One (1) of the teachers lead the group time, and the other teacher cleaned the tables for snacks. The children sang songs and played finger play with the teacher. Two (2) emergency medications were maintained in the classroom. The children from space #3 played on the playground. A group of two-year-old children engaged in gross motor activities with riding toys, slide, toy vehicles, climber and sand. The mulch around the climber was measured for six (6) inches. No hazardous products were accessible to the children in the classroom. In space #4, a group of two-year-old children had P.E in the gym. The children engaged in tumbling activities. One (1) teacher took five (5) children back to the classroom during P.E time to change their diapers, leaving eight (8) children with another teacher. In space #5, a group of four-to-five-year-old children engaged in free play with blocks, manipulatives, art , science and housekeeping toys. A group of one-year-old children from space #6 and #7 played on the playground. The group went to the playground on shifts and were not mixed together. The children played with slide, riding toys, and bubbles. In space #8, a group of infants and one-year-old children took nap in the cribs. One (1) child was in the highchair and had pancakes for snack. One (1) of the teachers stayed with the child in the highchair until he/she was finished with the snack. Space #9 was not in use during today’s visit. In space #10, a group of three-to-four-year-old children had morning snack. The children had pancakes and milk. Cheeseburger, mixed fruits and tater tots were served for lunch. Staff interaction and supervision were adequate. Twelve (12) children’s files were monitored. Staff and Training Worksheet was submitted during the visit. The worksheet for five (5) substitute members had not been completed. Three (3) new substitute staff files were monitored during the visit. Please submit the additional staff and training worksheet for the substitute staff members. Additionally to the substitute staff files, seven (7) new staff files and three (3) existing staff files were monitored. CPR/First Aid training was schedule for three (3) staff members in October. One (1) staff member’s certification is expired as of today due to the cancelled class. The staff members are registered to complete the class on 11/16/24. A staff member hired on 8/5/24 was scheduled to complete ITS/SIDS training in October. The training is re-scheduled for 11/12/24. Ms. Loria is scheduled to complete the Playground Safety in Child Care training on 11/20/24. Currently two (2) other staff members are qualified to complete monthly playground inspection. The facility uses tanker to provider water to the existing sink. The facility is following the Emergency Operation Plan submitted on October 18, 2024. 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 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, bottles sent from home for two (2) children were not labeled with today's date. 15A NCAC 18A .2804(d) 541 The written feeding plan did not include the child's name, parent signature, and/or was not dated when received by the center. One (1) child's feeding plan in space #1 and one (1) child's feeding plan in #7 were not signed by the parents. .0902(a) 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. Epi-pen in space #2 expired in October 2024. Aquaphor Healing Ointment in #3 and #7 expired in October 2024. Those medications were not returned home or discarded. .0803(12) Technical assistance was provided as follows: 428: Activity plan Current activity plans shall be posted for parents to review. Please have the staff members in space #5 and #6 update the plans. 533: Bottles Per Sanitation rule 15A NCAC 18A .2804(d), bottles sent from home must be labeled with date and the child’s name. Staff members shall review the bottle each day to make sure that the appropriate date and names are on the bottles in case the parents forget to do so. 541: Feeding plan Feeding plan shall be created for all children under fifteen (15) months of age, and the child’s name, the parent signature and a date are required. Please ask the parents of the child in space #1 and #7 to sign the document. 849: Expired medications Expired medications including prescriptions and over-the-counter medications (lotions and sprays included) must be discarded or returned to the parents within seventy-two (72) hours. Please return the expired epi-pen in space #2 and diaper ointment in pace #7 to the parents. 1032: Medical statement 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Medical Report is a statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. It is 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. Medical statement is due prior to employment. When submitted, the medical statement shall not be older than 12 months. Please have the staff member hired on 8/26/24 acquire medical statement immediately. 1035: Emergency Information 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 is required for child care providers, including the director, uncompensated providers, substitute providers, and volunteers. It shall be in file on or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Please have the staff member hired on 9/9/24 fill out the form immediately. 1897: Recognizing and Responding to Suspicions of Child Maltreatment Please have the staff member hired on 8/5/24 complete the training immediately. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. 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 • Statement of compliance I must receive your compliance statement by 11/21/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins Address: PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: On-going training hours: Annual on-toing training period is based on each staff members hiring date. For example, staff A is hired on 1/1/2020, A’s annual training period for this year is 1/1/23 to 12/31/24. Ms. Loria is a new administrator, therefore, the technical assistance was provided for on-going training requirements. Quotam Teaching Strategies information was shared with Ms. Loria via email. Health and Training can be completed annually as part of on-going training as needed. ITS/SIDS training: ITS/SIDS training is valid for three (3) years. The staff member who cares for infants must complete the training within two (2) months of employment and maintain the certification. This training is different from ITS/SIDS training for Health and Safety training. In-person or Live online training is required for the staff members who care for infants. Reminder: Recognizing and Responding to Suspicions on Maltreatment training for the staff member hired on 8/12/24 is due on or before November 10, 2024. Boudreaux’s Butt Past for a child in space #7 will expire at the end of November. 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. 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 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 11/7/2024 Number Present: 101 Completed Date: 11/7/2024 Age: From 0 To 5 Total Minutes: 360 Time In: 09:00 AM Time Out: 03:00 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, Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Loria accompanied me. The indoor and outdoor areas were monitored today, including but not limited to 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-five (85) percent as of today prior to this visit. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Emmanuel Lutheran Church of Asheville, N.C., Inc. is current/active as of 11/6/24. Permit type – Four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meet enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/13/23. The last fire drill was practiced on 10/30/24. The last lockdown drill was practiced on 10/30/24. The last playground inspection was documented on 10/24/24. The last fire inspection was approved on 3/4/24. The last sanitation inspection was conducted on 1/31/24 with five (5) demerits for a superior classification. Incident log was up to date. Emergency Preparedness and Response (EPR) plan was updated on 9/23/24. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Upon arrival, I announced my presence and the purpose of the visit. In space #1, a group of seven (7) infants explored the material and environment. The staff members sat with the children and interacted. Posters, diaper creams, hazardous products, refrigerator, and other requirements were monitored. In space #2, a group of four-to-five-year-old children had group time. One (1) of the teachers lead the group time, and the other teacher cleaned the tables for snacks. The children sang songs and played finger play with the teacher. Two (2) emergency medications were maintained in the classroom. The children from space #3 played on the playground. A group of two-year-old children engaged in gross motor activities with riding toys, slide, toy vehicles, climber and sand. The mulch around the climber was measured for six (6) inches. No hazardous products were accessible to the children in the classroom. In space #4, a group of two-year-old children had P.E in the gym. The children engaged in tumbling activities. One (1) teacher took five (5) children back to the classroom during P.E time to change their diapers, leaving eight (8) children with another teacher. In space #5, a group of four-to-five-year-old children engaged in free play with blocks, manipulatives, art , science and housekeeping toys. A group of one-year-old children from space #6 and #7 played on the playground. The group went to the playground on shifts and were not mixed together. The children played with slide, riding toys, and bubbles. In space #8, a group of infants and one-year-old children took nap in the cribs. One (1) child was in the highchair and had pancakes for snack. One (1) of the teachers stayed with the child in the highchair until he/she was finished with the snack. Space #9 was not in use during today’s visit. In space #10, a group of three-to-four-year-old children had morning snack. The children had pancakes and milk. Cheeseburger, mixed fruits and tater tots were served for lunch. Staff interaction and supervision were adequate. Twelve (12) children’s files were monitored. Staff and Training Worksheet was submitted during the visit. The worksheet for five (5) substitute members had not been completed. Three (3) new substitute staff files were monitored during the visit. Please submit the additional staff and training worksheet for the substitute staff members. Additionally to the substitute staff files, seven (7) new staff files and three (3) existing staff files were monitored. CPR/First Aid training was schedule for three (3) staff members in October. One (1) staff member’s certification is expired as of today due to the cancelled class. The staff members are registered to complete the class on 11/16/24. A staff member hired on 8/5/24 was scheduled to complete ITS/SIDS training in October. The training is re-scheduled for 11/12/24. Ms. Loria is scheduled to complete the Playground Safety in Child Care training on 11/20/24. Currently two (2) other staff members are qualified to complete monthly playground inspection. The facility uses tanker to provider water to the existing sink. The facility is following the Emergency Operation Plan submitted on October 18, 2024. 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 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, bottles sent from home for two (2) children were not labeled with today's date. 15A NCAC 18A .2804(d) 541 The written feeding plan did not include the child's name, parent signature, and/or was not dated when received by the center. One (1) child's feeding plan in space #1 and one (1) child's feeding plan in #7 were not signed by the parents. .0902(a) 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. Epi-pen in space #2 expired in October 2024. Aquaphor Healing Ointment in #3 and #7 expired in October 2024. Those medications were not returned home or discarded. .0803(12) Technical assistance was provided as follows: 428: Activity plan Current activity plans shall be posted for parents to review. Please have the staff members in space #5 and #6 update the plans. 533: Bottles Per Sanitation rule 15A NCAC 18A .2804(d), bottles sent from home must be labeled with date and the child’s name. Staff members shall review the bottle each day to make sure that the appropriate date and names are on the bottles in case the parents forget to do so. 541: Feeding plan Feeding plan shall be created for all children under fifteen (15) months of age, and the child’s name, the parent signature and a date are required. Please ask the parents of the child in space #1 and #7 to sign the document. 849: Expired medications Expired medications including prescriptions and over-the-counter medications (lotions and sprays included) must be discarded or returned to the parents within seventy-two (72) hours. Please return the expired epi-pen in space #2 and diaper ointment in pace #7 to the parents. 1032: Medical statement 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Medical Report is a statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. It is 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. Medical statement is due prior to employment. When submitted, the medical statement shall not be older than 12 months. Please have the staff member hired on 8/26/24 acquire medical statement immediately. 1035: Emergency Information 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 is required for child care providers, including the director, uncompensated providers, substitute providers, and volunteers. It shall be in file on or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Please have the staff member hired on 9/9/24 fill out the form immediately. 1897: Recognizing and Responding to Suspicions of Child Maltreatment Please have the staff member hired on 8/5/24 complete the training immediately. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. 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 • Statement of compliance I must receive your compliance statement by 11/21/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins Address: PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: On-going training hours: Annual on-toing training period is based on each staff members hiring date. For example, staff A is hired on 1/1/2020, A’s annual training period for this year is 1/1/23 to 12/31/24. Ms. Loria is a new administrator, therefore, the technical assistance was provided for on-going training requirements. Quotam Teaching Strategies information was shared with Ms. Loria via email. Health and Training can be completed annually as part of on-going training as needed. ITS/SIDS training: ITS/SIDS training is valid for three (3) years. The staff member who cares for infants must complete the training within two (2) months of employment and maintain the certification. This training is different from ITS/SIDS training for Health and Safety training. In-person or Live online training is required for the staff members who care for infants. Reminder: Recognizing and Responding to Suspicions on Maltreatment training for the staff member hired on 8/12/24 is due on or before November 10, 2024. Boudreaux’s Butt Past for a child in space #7 will expire at the end of November. 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. 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 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 11/7/2024 Number Present: 101 Completed Date: 11/7/2024 Age: From 0 To 5 Total Minutes: 360 Time In: 09:00 AM Time Out: 03:00 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, Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Loria accompanied me. The indoor and outdoor areas were monitored today, including but not limited to 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-five (85) percent as of today prior to this visit. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Emmanuel Lutheran Church of Asheville, N.C., Inc. is current/active as of 11/6/24. Permit type – Four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meet enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/13/23. The last fire drill was practiced on 10/30/24. The last lockdown drill was practiced on 10/30/24. The last playground inspection was documented on 10/24/24. The last fire inspection was approved on 3/4/24. The last sanitation inspection was conducted on 1/31/24 with five (5) demerits for a superior classification. Incident log was up to date. Emergency Preparedness and Response (EPR) plan was updated on 9/23/24. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Upon arrival, I announced my presence and the purpose of the visit. In space #1, a group of seven (7) infants explored the material and environment. The staff members sat with the children and interacted. Posters, diaper creams, hazardous products, refrigerator, and other requirements were monitored. In space #2, a group of four-to-five-year-old children had group time. One (1) of the teachers lead the group time, and the other teacher cleaned the tables for snacks. The children sang songs and played finger play with the teacher. Two (2) emergency medications were maintained in the classroom. The children from space #3 played on the playground. A group of two-year-old children engaged in gross motor activities with riding toys, slide, toy vehicles, climber and sand. The mulch around the climber was measured for six (6) inches. No hazardous products were accessible to the children in the classroom. In space #4, a group of two-year-old children had P.E in the gym. The children engaged in tumbling activities. One (1) teacher took five (5) children back to the classroom during P.E time to change their diapers, leaving eight (8) children with another teacher. In space #5, a group of four-to-five-year-old children engaged in free play with blocks, manipulatives, art , science and housekeeping toys. A group of one-year-old children from space #6 and #7 played on the playground. The group went to the playground on shifts and were not mixed together. The children played with slide, riding toys, and bubbles. In space #8, a group of infants and one-year-old children took nap in the cribs. One (1) child was in the highchair and had pancakes for snack. One (1) of the teachers stayed with the child in the highchair until he/she was finished with the snack. Space #9 was not in use during today’s visit. In space #10, a group of three-to-four-year-old children had morning snack. The children had pancakes and milk. Cheeseburger, mixed fruits and tater tots were served for lunch. Staff interaction and supervision were adequate. Twelve (12) children’s files were monitored. Staff and Training Worksheet was submitted during the visit. The worksheet for five (5) substitute members had not been completed. Three (3) new substitute staff files were monitored during the visit. Please submit the additional staff and training worksheet for the substitute staff members. Additionally to the substitute staff files, seven (7) new staff files and three (3) existing staff files were monitored. CPR/First Aid training was schedule for three (3) staff members in October. One (1) staff member’s certification is expired as of today due to the cancelled class. The staff members are registered to complete the class on 11/16/24. A staff member hired on 8/5/24 was scheduled to complete ITS/SIDS training in October. The training is re-scheduled for 11/12/24. Ms. Loria is scheduled to complete the Playground Safety in Child Care training on 11/20/24. Currently two (2) other staff members are qualified to complete monthly playground inspection. The facility uses tanker to provider water to the existing sink. The facility is following the Emergency Operation Plan submitted on October 18, 2024. 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 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, bottles sent from home for two (2) children were not labeled with today's date. 15A NCAC 18A .2804(d) 541 The written feeding plan did not include the child's name, parent signature, and/or was not dated when received by the center. One (1) child's feeding plan in space #1 and one (1) child's feeding plan in #7 were not signed by the parents. .0902(a) 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. Epi-pen in space #2 expired in October 2024. Aquaphor Healing Ointment in #3 and #7 expired in October 2024. Those medications were not returned home or discarded. .0803(12) Technical assistance was provided as follows: 428: Activity plan Current activity plans shall be posted for parents to review. Please have the staff members in space #5 and #6 update the plans. 533: Bottles Per Sanitation rule 15A NCAC 18A .2804(d), bottles sent from home must be labeled with date and the child’s name. Staff members shall review the bottle each day to make sure that the appropriate date and names are on the bottles in case the parents forget to do so. 541: Feeding plan Feeding plan shall be created for all children under fifteen (15) months of age, and the child’s name, the parent signature and a date are required. Please ask the parents of the child in space #1 and #7 to sign the document. 849: Expired medications Expired medications including prescriptions and over-the-counter medications (lotions and sprays included) must be discarded or returned to the parents within seventy-two (72) hours. Please return the expired epi-pen in space #2 and diaper ointment in pace #7 to the parents. 1032: Medical statement 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Medical Report is a statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. It is 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. Medical statement is due prior to employment. When submitted, the medical statement shall not be older than 12 months. Please have the staff member hired on 8/26/24 acquire medical statement immediately. 1035: Emergency Information 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 is required for child care providers, including the director, uncompensated providers, substitute providers, and volunteers. It shall be in file on or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Please have the staff member hired on 9/9/24 fill out the form immediately. 1897: Recognizing and Responding to Suspicions of Child Maltreatment Please have the staff member hired on 8/5/24 complete the training immediately. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. 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 • Statement of compliance I must receive your compliance statement by 11/21/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins Address: PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: On-going training hours: Annual on-toing training period is based on each staff members hiring date. For example, staff A is hired on 1/1/2020, A’s annual training period for this year is 1/1/23 to 12/31/24. Ms. Loria is a new administrator, therefore, the technical assistance was provided for on-going training requirements. Quotam Teaching Strategies information was shared with Ms. Loria via email. Health and Training can be completed annually as part of on-going training as needed. ITS/SIDS training: ITS/SIDS training is valid for three (3) years. The staff member who cares for infants must complete the training within two (2) months of employment and maintain the certification. This training is different from ITS/SIDS training for Health and Safety training. In-person or Live online training is required for the staff members who care for infants. Reminder: Recognizing and Responding to Suspicions on Maltreatment training for the staff member hired on 8/12/24 is due on or before November 10, 2024. Boudreaux’s Butt Past for a child in space #7 will expire at the end of November. 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. 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 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 11/7/2024 Number Present: 101 Completed Date: 11/7/2024 Age: From 0 To 5 Total Minutes: 360 Time In: 09:00 AM Time Out: 03:00 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, Kaoru Eddins, Child Care Consultant and also signed by Nicole Loria, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Loria accompanied me. The indoor and outdoor areas were monitored today, including but not limited to 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-five (85) percent as of today prior to this visit. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Emmanuel Lutheran Church of Asheville, N.C., Inc. is current/active as of 11/6/24. Permit type – Four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meet enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/13/23. The last fire drill was practiced on 10/30/24. The last lockdown drill was practiced on 10/30/24. The last playground inspection was documented on 10/24/24. The last fire inspection was approved on 3/4/24. The last sanitation inspection was conducted on 1/31/24 with five (5) demerits for a superior classification. Incident log was up to date. Emergency Preparedness and Response (EPR) plan was updated on 9/23/24. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Upon arrival, I announced my presence and the purpose of the visit. In space #1, a group of seven (7) infants explored the material and environment. The staff members sat with the children and interacted. Posters, diaper creams, hazardous products, refrigerator, and other requirements were monitored. In space #2, a group of four-to-five-year-old children had group time. One (1) of the teachers lead the group time, and the other teacher cleaned the tables for snacks. The children sang songs and played finger play with the teacher. Two (2) emergency medications were maintained in the classroom. The children from space #3 played on the playground. A group of two-year-old children engaged in gross motor activities with riding toys, slide, toy vehicles, climber and sand. The mulch around the climber was measured for six (6) inches. No hazardous products were accessible to the children in the classroom. In space #4, a group of two-year-old children had P.E in the gym. The children engaged in tumbling activities. One (1) teacher took five (5) children back to the classroom during P.E time to change their diapers, leaving eight (8) children with another teacher. In space #5, a group of four-to-five-year-old children engaged in free play with blocks, manipulatives, art , science and housekeeping toys. A group of one-year-old children from space #6 and #7 played on the playground. The group went to the playground on shifts and were not mixed together. The children played with slide, riding toys, and bubbles. In space #8, a group of infants and one-year-old children took nap in the cribs. One (1) child was in the highchair and had pancakes for snack. One (1) of the teachers stayed with the child in the highchair until he/she was finished with the snack. Space #9 was not in use during today’s visit. In space #10, a group of three-to-four-year-old children had morning snack. The children had pancakes and milk. Cheeseburger, mixed fruits and tater tots were served for lunch. Staff interaction and supervision were adequate. Twelve (12) children’s files were monitored. Staff and Training Worksheet was submitted during the visit. The worksheet for five (5) substitute members had not been completed. Three (3) new substitute staff files were monitored during the visit. Please submit the additional staff and training worksheet for the substitute staff members. Additionally to the substitute staff files, seven (7) new staff files and three (3) existing staff files were monitored. CPR/First Aid training was schedule for three (3) staff members in October. One (1) staff member’s certification is expired as of today due to the cancelled class. The staff members are registered to complete the class on 11/16/24. A staff member hired on 8/5/24 was scheduled to complete ITS/SIDS training in October. The training is re-scheduled for 11/12/24. Ms. Loria is scheduled to complete the Playground Safety in Child Care training on 11/20/24. Currently two (2) other staff members are qualified to complete monthly playground inspection. The facility uses tanker to provider water to the existing sink. The facility is following the Emergency Operation Plan submitted on October 18, 2024. 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 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, bottles sent from home for two (2) children were not labeled with today's date. 15A NCAC 18A .2804(d) 541 The written feeding plan did not include the child's name, parent signature, and/or was not dated when received by the center. One (1) child's feeding plan in space #1 and one (1) child's feeding plan in #7 were not signed by the parents. .0902(a) 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. Epi-pen in space #2 expired in October 2024. Aquaphor Healing Ointment in #3 and #7 expired in October 2024. Those medications were not returned home or discarded. .0803(12) Technical assistance was provided as follows: 428: Activity plan Current activity plans shall be posted for parents to review. Please have the staff members in space #5 and #6 update the plans. 533: Bottles Per Sanitation rule 15A NCAC 18A .2804(d), bottles sent from home must be labeled with date and the child’s name. Staff members shall review the bottle each day to make sure that the appropriate date and names are on the bottles in case the parents forget to do so. 541: Feeding plan Feeding plan shall be created for all children under fifteen (15) months of age, and the child’s name, the parent signature and a date are required. Please ask the parents of the child in space #1 and #7 to sign the document. 849: Expired medications Expired medications including prescriptions and over-the-counter medications (lotions and sprays included) must be discarded or returned to the parents within seventy-two (72) hours. Please return the expired epi-pen in space #2 and diaper ointment in pace #7 to the parents. 1032: Medical statement 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Medical Report is a statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. It is 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. Medical statement is due prior to employment. When submitted, the medical statement shall not be older than 12 months. Please have the staff member hired on 8/26/24 acquire medical statement immediately. 1035: Emergency Information 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 is required for child care providers, including the director, uncompensated providers, substitute providers, and volunteers. It shall be in file on or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Please have the staff member hired on 9/9/24 fill out the form immediately. 1897: Recognizing and Responding to Suspicions of Child Maltreatment Please have the staff member hired on 8/5/24 complete the training immediately. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. 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 • Statement of compliance I must receive your compliance statement by 11/21/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins Address: PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: On-going training hours: Annual on-toing training period is based on each staff members hiring date. For example, staff A is hired on 1/1/2020, A’s annual training period for this year is 1/1/23 to 12/31/24. Ms. Loria is a new administrator, therefore, the technical assistance was provided for on-going training requirements. Quotam Teaching Strategies information was shared with Ms. Loria via email. Health and Training can be completed annually as part of on-going training as needed. ITS/SIDS training: ITS/SIDS training is valid for three (3) years. The staff member who cares for infants must complete the training within two (2) months of employment and maintain the certification. This training is different from ITS/SIDS training for Health and Safety training. In-person or Live online training is required for the staff members who care for infants. Reminder: Recognizing and Responding to Suspicions on Maltreatment training for the staff member hired on 8/12/24 is due on or before November 10, 2024. Boudreaux’s Butt Past for a child in space #7 will expire at the end of November. 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. 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 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 4/25/2024 Number Present: 99 Completed Date: 4/25/2024 Age: From 0 To 5 Total Minutes: 220 Time In: 09:10 AM Time Out: 12:50 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 Kaoru Eddins, Child Care Consultant and also signed by Christine Smith, Administrator, during the visit. Bonnie Mathis, Licensing Supervisor accompanied me to this visit. An electronic signed copy of the visit summary was left on- site with you today. Ms. Smith is leaving her position on 5/31/24. Camilla Harris-Wallace, the new administrator, has been hired and was present during the visit. Ms. Harris-Wallace accompanied Ms. Mathis during the walk-through. Ms. Smith was available during the visit. Indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition, and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight (88) percent as of 4/25/24 prior to this visit. Permit type – Four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/13/23. The last fire drill was practiced on 4/18/24. The last lockdown drill was practiced on 4/18/24. The last playground inspection was documented on 4/11/24. The last fire inspection was approved on 3/4/24. The last sanitation inspection was conducted on 1/31/24 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and is current. The approved curriculum for four-year-old children is Creative Curriculum. Upon arrival, we announced our presence and the purpose of the visit. Six (6) new staff files and twenty (20) existing staff files were monitored. All staff members have valid criminal background letters in the file. Those who are required to have First Aid, CPR and ITS/SIDS training have current training certificates in file. 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 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. One outlet next to the door was accessible in the classroom with two and three-year-old children. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One can of aerosol sunscreen was stored inaccessible, but not locked in the classroom with three-year-old children. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Nystatin was stored in a container with other diaper ointments inaccessible, but not locked as required for all prescription medications. 15A NCAC 18A .2820(d) 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. One emergency medication Auvi-Q that expired on 1/19/24 was not sent home in the classroom with two and three-year-old children. A second medication, Nystatin was not discarded or sent home after the prescription instructions stated to apply 7 - 14 days in the classroom with one and two-year-old children. The Nystatin prescription was dated 10/23/23. .0803(12) 851 When medication was administered, documentation was not completed or maintained for 6 months and/or the documentation did not include the required information. The staff member reported Nystatin was administered and was not documented. .0803(13)(a-e); .2318(3) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. One (1) medical action plan was not signed by the parent or physician for an Epi Pen in the classroom with one and two-year-old children. .0801(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Parent permission for an emergency medication was dated 7/13/23 and was not updated within six (6) months as require in the classroom for four and five-year-old children. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. There were two (2) staff files that contained medical information. All remaining staff's medical information was grouped together within one file. .0701(d) 1898 Staff did not complete the health and safety training within one year of employment. The administrator reported that one (1) substitute staff that has worked more than ten (10) days and has not completed Health and Safety Training. The staff member's date of employment is March 1, 2023. .1102(a) Technical assistance was provided as follows: 812: Outlets There was one (1) outlet uncovered in the classroom with two-and three-year-old children next to the door as you entered the room. An outlet protective cover was placed over the outlet correcting this violation. Reminder to maintain extra outlet covers in each space so they are readily available to insert to ensure a safe environment. Electric outlets under five (5) feet or below shall be covered with outlet safety covers. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 840: Hazardous products One (1) can of aerosol sunscreen was inaccessible, but not locked in the classroom with three-year-old children. This was removed and locked in a box during the visit. Reminder all aerosol cans must be stored locked because they are pressurized; therefore, considered hazardous. Potentially hazardous products, such as aerosol disinfecting spray shall be stored in a locked storage. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. 841: Storage of medication A prescription ointment was stored inaccessible, but unlocked with other diaper creams in the space with one and two-year-old children. All prescription medication whether ingested or topical must be stored locked. Nystatin was removed from the classroom today and was corrected during the visit. Any over-the-counter medication or prescription, in exception to emergency medication, diaper creams and lotions shall be locked. Storage with combination locks, magnetic locks and padlocks are considered locked storage. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use but are not required to be in locked storage. 847: Medication authorization form Two (2) emergency medications did not have a valid parent permission to administer on-site. Medication authorization form for prescription medications shall be signed by parents and is valid for up to six (6) months. Please ask the parents to fill out the new form or review the content and re-sign every six (6) months. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 849: Expired medication One (1) emergency medication expired on 1/19/24 and needs to be updated in the classroom with two-and three-year-old children. A second medication in the classroom with one and two-year-old children was not returned after the course of treatment. Expired medication shall be sent home or discarded within seventy-two (72) hours of its expiration date. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. 851: Medication log It was reported when that Nystatin was administered and not recorded. When prescription medications are administered, the information listed below shall be logged. You can print the medication authorization from and the medication log sheet can be printed at the Division’s website at https://ncchildcare.ncdhhs.gov. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (13) Any time prescription or over-the-counter medication is administered by center personnel to children receiving care, the following information shall be recorded: (a) the child's name; (b) the date the medication was given; (c) the time the medication was given; (d) the amount and the type of medication given; and (e) the name and signature of the person administering the medication. This information shall be noted on a medication permission slip, or on a separate form developed by the provider which includes the required information. This information shall be available for review by a representative of the Division during the time period the medication is being administered and for six months after the medication is administered. No documentation shall be required when items listed in Item (7) of this Rule are applied to children. 1835: Medical Action Plan A medical action plan in the classroom with infants and one-year-old children did not contain a parent or physician’s signature as required. You stated the child will not be allowed to return until this is completed. An action plan is a requirement for those children with chronic medical conditions, such as asthma, seizure, allergy that requires epi-pen and diabetes. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; 1890: Confidential information There are three (3) documents that are considered confidential information, which are Health Questionnaires, Medical statement and TB screening form. Those three (3) documents must be maintained separately from the other records, such as application, emergency information form and training certificates. Additionally, each staff member’s confidential information shall be maintained separately. Some centers use manilla envelopes to maintain their record. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. 1898: Health and Safety Training Health and Safety Training is required for the substitute staff members who work more than ten (10) cumulative days a school year. The substitute staff member hired on 3/1/23 (FN) needs to complete the training on or before 5/9/24. The staff member hired on 10/27/23 (LP) needs to complete the training on or before 10/26/24. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. The following persons shall be exempt from this requirement: (1) staff members that do not have caregiving responsibilities for a child or group of children; (2) service providers such as speech therapists, occupational therapists, and physical therapists; and (3) substitute providers who provide services for less than 10 days in a 12-month period. 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: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Storage of food brought from home: There are new Environmental Health sanitation guidelines for the storage of food brough from home. Please contact your Environmental Health specialist to seek additional guidelines. Reminder: Criminal background letter renewal: R. Swatzell shall renew the CBC qualification letter on or prior to 5/2/24. S. Warren shall renew the CBC qualification letter on or prior to 6/6/24. Rated License Cohort: Emmanuel Lutheran School is in cohort two (2). Your prep-year assessment year will be July 2024 through June 2025, and the assessment year will be July 2025 through June 2026. 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 4/25/2024 Number Present: 99 Completed Date: 4/25/2024 Age: From 0 To 5 Total Minutes: 220 Time In: 09:10 AM Time Out: 12:50 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 Kaoru Eddins, Child Care Consultant and also signed by Christine Smith, Administrator, during the visit. Bonnie Mathis, Licensing Supervisor accompanied me to this visit. An electronic signed copy of the visit summary was left on- site with you today. Ms. Smith is leaving her position on 5/31/24. Camilla Harris-Wallace, the new administrator, has been hired and was present during the visit. Ms. Harris-Wallace accompanied Ms. Mathis during the walk-through. Ms. Smith was available during the visit. Indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition, and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight (88) percent as of 4/25/24 prior to this visit. Permit type – Four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/13/23. The last fire drill was practiced on 4/18/24. The last lockdown drill was practiced on 4/18/24. The last playground inspection was documented on 4/11/24. The last fire inspection was approved on 3/4/24. The last sanitation inspection was conducted on 1/31/24 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and is current. The approved curriculum for four-year-old children is Creative Curriculum. Upon arrival, we announced our presence and the purpose of the visit. Six (6) new staff files and twenty (20) existing staff files were monitored. All staff members have valid criminal background letters in the file. Those who are required to have First Aid, CPR and ITS/SIDS training have current training certificates in file. 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 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. One outlet next to the door was accessible in the classroom with two and three-year-old children. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One can of aerosol sunscreen was stored inaccessible, but not locked in the classroom with three-year-old children. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Nystatin was stored in a container with other diaper ointments inaccessible, but not locked as required for all prescription medications. 15A NCAC 18A .2820(d) 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. One emergency medication Auvi-Q that expired on 1/19/24 was not sent home in the classroom with two and three-year-old children. A second medication, Nystatin was not discarded or sent home after the prescription instructions stated to apply 7 - 14 days in the classroom with one and two-year-old children. The Nystatin prescription was dated 10/23/23. .0803(12) 851 When medication was administered, documentation was not completed or maintained for 6 months and/or the documentation did not include the required information. The staff member reported Nystatin was administered and was not documented. .0803(13)(a-e); .2318(3) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. One (1) medical action plan was not signed by the parent or physician for an Epi Pen in the classroom with one and two-year-old children. .0801(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Parent permission for an emergency medication was dated 7/13/23 and was not updated within six (6) months as require in the classroom for four and five-year-old children. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. There were two (2) staff files that contained medical information. All remaining staff's medical information was grouped together within one file. .0701(d) 1898 Staff did not complete the health and safety training within one year of employment. The administrator reported that one (1) substitute staff that has worked more than ten (10) days and has not completed Health and Safety Training. The staff member's date of employment is March 1, 2023. .1102(a) Technical assistance was provided as follows: 812: Outlets There was one (1) outlet uncovered in the classroom with two-and three-year-old children next to the door as you entered the room. An outlet protective cover was placed over the outlet correcting this violation. Reminder to maintain extra outlet covers in each space so they are readily available to insert to ensure a safe environment. Electric outlets under five (5) feet or below shall be covered with outlet safety covers. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 840: Hazardous products One (1) can of aerosol sunscreen was inaccessible, but not locked in the classroom with three-year-old children. This was removed and locked in a box during the visit. Reminder all aerosol cans must be stored locked because they are pressurized; therefore, considered hazardous. Potentially hazardous products, such as aerosol disinfecting spray shall be stored in a locked storage. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. 841: Storage of medication A prescription ointment was stored inaccessible, but unlocked with other diaper creams in the space with one and two-year-old children. All prescription medication whether ingested or topical must be stored locked. Nystatin was removed from the classroom today and was corrected during the visit. Any over-the-counter medication or prescription, in exception to emergency medication, diaper creams and lotions shall be locked. Storage with combination locks, magnetic locks and padlocks are considered locked storage. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use but are not required to be in locked storage. 847: Medication authorization form Two (2) emergency medications did not have a valid parent permission to administer on-site. Medication authorization form for prescription medications shall be signed by parents and is valid for up to six (6) months. Please ask the parents to fill out the new form or review the content and re-sign every six (6) months. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 849: Expired medication One (1) emergency medication expired on 1/19/24 and needs to be updated in the classroom with two-and three-year-old children. A second medication in the classroom with one and two-year-old children was not returned after the course of treatment. Expired medication shall be sent home or discarded within seventy-two (72) hours of its expiration date. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. 851: Medication log It was reported when that Nystatin was administered and not recorded. When prescription medications are administered, the information listed below shall be logged. You can print the medication authorization from and the medication log sheet can be printed at the Division’s website at https://ncchildcare.ncdhhs.gov. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (13) Any time prescription or over-the-counter medication is administered by center personnel to children receiving care, the following information shall be recorded: (a) the child's name; (b) the date the medication was given; (c) the time the medication was given; (d) the amount and the type of medication given; and (e) the name and signature of the person administering the medication. This information shall be noted on a medication permission slip, or on a separate form developed by the provider which includes the required information. This information shall be available for review by a representative of the Division during the time period the medication is being administered and for six months after the medication is administered. No documentation shall be required when items listed in Item (7) of this Rule are applied to children. 1835: Medical Action Plan A medical action plan in the classroom with infants and one-year-old children did not contain a parent or physician’s signature as required. You stated the child will not be allowed to return until this is completed. An action plan is a requirement for those children with chronic medical conditions, such as asthma, seizure, allergy that requires epi-pen and diabetes. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; 1890: Confidential information There are three (3) documents that are considered confidential information, which are Health Questionnaires, Medical statement and TB screening form. Those three (3) documents must be maintained separately from the other records, such as application, emergency information form and training certificates. Additionally, each staff member’s confidential information shall be maintained separately. Some centers use manilla envelopes to maintain their record. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. 1898: Health and Safety Training Health and Safety Training is required for the substitute staff members who work more than ten (10) cumulative days a school year. The substitute staff member hired on 3/1/23 (FN) needs to complete the training on or before 5/9/24. The staff member hired on 10/27/23 (LP) needs to complete the training on or before 10/26/24. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. The following persons shall be exempt from this requirement: (1) staff members that do not have caregiving responsibilities for a child or group of children; (2) service providers such as speech therapists, occupational therapists, and physical therapists; and (3) substitute providers who provide services for less than 10 days in a 12-month period. 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: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Storage of food brought from home: There are new Environmental Health sanitation guidelines for the storage of food brough from home. Please contact your Environmental Health specialist to seek additional guidelines. Reminder: Criminal background letter renewal: R. Swatzell shall renew the CBC qualification letter on or prior to 5/2/24. S. Warren shall renew the CBC qualification letter on or prior to 6/6/24. Rated License Cohort: Emmanuel Lutheran School is in cohort two (2). Your prep-year assessment year will be July 2024 through June 2025, and the assessment year will be July 2025 through June 2026. 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 4/25/2024 Number Present: 99 Completed Date: 4/25/2024 Age: From 0 To 5 Total Minutes: 220 Time In: 09:10 AM Time Out: 12:50 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 Kaoru Eddins, Child Care Consultant and also signed by Christine Smith, Administrator, during the visit. Bonnie Mathis, Licensing Supervisor accompanied me to this visit. An electronic signed copy of the visit summary was left on- site with you today. Ms. Smith is leaving her position on 5/31/24. Camilla Harris-Wallace, the new administrator, has been hired and was present during the visit. Ms. Harris-Wallace accompanied Ms. Mathis during the walk-through. Ms. Smith was available during the visit. Indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition, and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight (88) percent as of 4/25/24 prior to this visit. Permit type – Four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/13/23. The last fire drill was practiced on 4/18/24. The last lockdown drill was practiced on 4/18/24. The last playground inspection was documented on 4/11/24. The last fire inspection was approved on 3/4/24. The last sanitation inspection was conducted on 1/31/24 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and is current. The approved curriculum for four-year-old children is Creative Curriculum. Upon arrival, we announced our presence and the purpose of the visit. Six (6) new staff files and twenty (20) existing staff files were monitored. All staff members have valid criminal background letters in the file. Those who are required to have First Aid, CPR and ITS/SIDS training have current training certificates in file. 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 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. One outlet next to the door was accessible in the classroom with two and three-year-old children. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One can of aerosol sunscreen was stored inaccessible, but not locked in the classroom with three-year-old children. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Nystatin was stored in a container with other diaper ointments inaccessible, but not locked as required for all prescription medications. 15A NCAC 18A .2820(d) 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. One emergency medication Auvi-Q that expired on 1/19/24 was not sent home in the classroom with two and three-year-old children. A second medication, Nystatin was not discarded or sent home after the prescription instructions stated to apply 7 - 14 days in the classroom with one and two-year-old children. The Nystatin prescription was dated 10/23/23. .0803(12) 851 When medication was administered, documentation was not completed or maintained for 6 months and/or the documentation did not include the required information. The staff member reported Nystatin was administered and was not documented. .0803(13)(a-e); .2318(3) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. One (1) medical action plan was not signed by the parent or physician for an Epi Pen in the classroom with one and two-year-old children. .0801(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Parent permission for an emergency medication was dated 7/13/23 and was not updated within six (6) months as require in the classroom for four and five-year-old children. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. There were two (2) staff files that contained medical information. All remaining staff's medical information was grouped together within one file. .0701(d) 1898 Staff did not complete the health and safety training within one year of employment. The administrator reported that one (1) substitute staff that has worked more than ten (10) days and has not completed Health and Safety Training. The staff member's date of employment is March 1, 2023. .1102(a) Technical assistance was provided as follows: 812: Outlets There was one (1) outlet uncovered in the classroom with two-and three-year-old children next to the door as you entered the room. An outlet protective cover was placed over the outlet correcting this violation. Reminder to maintain extra outlet covers in each space so they are readily available to insert to ensure a safe environment. Electric outlets under five (5) feet or below shall be covered with outlet safety covers. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 840: Hazardous products One (1) can of aerosol sunscreen was inaccessible, but not locked in the classroom with three-year-old children. This was removed and locked in a box during the visit. Reminder all aerosol cans must be stored locked because they are pressurized; therefore, considered hazardous. Potentially hazardous products, such as aerosol disinfecting spray shall be stored in a locked storage. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. 841: Storage of medication A prescription ointment was stored inaccessible, but unlocked with other diaper creams in the space with one and two-year-old children. All prescription medication whether ingested or topical must be stored locked. Nystatin was removed from the classroom today and was corrected during the visit. Any over-the-counter medication or prescription, in exception to emergency medication, diaper creams and lotions shall be locked. Storage with combination locks, magnetic locks and padlocks are considered locked storage. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use but are not required to be in locked storage. 847: Medication authorization form Two (2) emergency medications did not have a valid parent permission to administer on-site. Medication authorization form for prescription medications shall be signed by parents and is valid for up to six (6) months. Please ask the parents to fill out the new form or review the content and re-sign every six (6) months. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 849: Expired medication One (1) emergency medication expired on 1/19/24 and needs to be updated in the classroom with two-and three-year-old children. A second medication in the classroom with one and two-year-old children was not returned after the course of treatment. Expired medication shall be sent home or discarded within seventy-two (72) hours of its expiration date. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. 851: Medication log It was reported when that Nystatin was administered and not recorded. When prescription medications are administered, the information listed below shall be logged. You can print the medication authorization from and the medication log sheet can be printed at the Division’s website at https://ncchildcare.ncdhhs.gov. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (13) Any time prescription or over-the-counter medication is administered by center personnel to children receiving care, the following information shall be recorded: (a) the child's name; (b) the date the medication was given; (c) the time the medication was given; (d) the amount and the type of medication given; and (e) the name and signature of the person administering the medication. This information shall be noted on a medication permission slip, or on a separate form developed by the provider which includes the required information. This information shall be available for review by a representative of the Division during the time period the medication is being administered and for six months after the medication is administered. No documentation shall be required when items listed in Item (7) of this Rule are applied to children. 1835: Medical Action Plan A medical action plan in the classroom with infants and one-year-old children did not contain a parent or physician’s signature as required. You stated the child will not be allowed to return until this is completed. An action plan is a requirement for those children with chronic medical conditions, such as asthma, seizure, allergy that requires epi-pen and diabetes. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; 1890: Confidential information There are three (3) documents that are considered confidential information, which are Health Questionnaires, Medical statement and TB screening form. Those three (3) documents must be maintained separately from the other records, such as application, emergency information form and training certificates. Additionally, each staff member’s confidential information shall be maintained separately. Some centers use manilla envelopes to maintain their record. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. 1898: Health and Safety Training Health and Safety Training is required for the substitute staff members who work more than ten (10) cumulative days a school year. The substitute staff member hired on 3/1/23 (FN) needs to complete the training on or before 5/9/24. The staff member hired on 10/27/23 (LP) needs to complete the training on or before 10/26/24. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. The following persons shall be exempt from this requirement: (1) staff members that do not have caregiving responsibilities for a child or group of children; (2) service providers such as speech therapists, occupational therapists, and physical therapists; and (3) substitute providers who provide services for less than 10 days in a 12-month period. 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: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Storage of food brought from home: There are new Environmental Health sanitation guidelines for the storage of food brough from home. Please contact your Environmental Health specialist to seek additional guidelines. Reminder: Criminal background letter renewal: R. Swatzell shall renew the CBC qualification letter on or prior to 5/2/24. S. Warren shall renew the CBC qualification letter on or prior to 6/6/24. Rated License Cohort: Emmanuel Lutheran School is in cohort two (2). Your prep-year assessment year will be July 2024 through June 2025, and the assessment year will be July 2025 through June 2026. 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 4/25/2024 Number Present: 99 Completed Date: 4/25/2024 Age: From 0 To 5 Total Minutes: 220 Time In: 09:10 AM Time Out: 12:50 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 Kaoru Eddins, Child Care Consultant and also signed by Christine Smith, Administrator, during the visit. Bonnie Mathis, Licensing Supervisor accompanied me to this visit. An electronic signed copy of the visit summary was left on- site with you today. Ms. Smith is leaving her position on 5/31/24. Camilla Harris-Wallace, the new administrator, has been hired and was present during the visit. Ms. Harris-Wallace accompanied Ms. Mathis during the walk-through. Ms. Smith was available during the visit. Indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition, and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight (88) percent as of 4/25/24 prior to this visit. Permit type – Four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/13/23. The last fire drill was practiced on 4/18/24. The last lockdown drill was practiced on 4/18/24. The last playground inspection was documented on 4/11/24. The last fire inspection was approved on 3/4/24. The last sanitation inspection was conducted on 1/31/24 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and is current. The approved curriculum for four-year-old children is Creative Curriculum. Upon arrival, we announced our presence and the purpose of the visit. Six (6) new staff files and twenty (20) existing staff files were monitored. All staff members have valid criminal background letters in the file. Those who are required to have First Aid, CPR and ITS/SIDS training have current training certificates in file. 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 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. One outlet next to the door was accessible in the classroom with two and three-year-old children. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One can of aerosol sunscreen was stored inaccessible, but not locked in the classroom with three-year-old children. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Nystatin was stored in a container with other diaper ointments inaccessible, but not locked as required for all prescription medications. 15A NCAC 18A .2820(d) 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. One emergency medication Auvi-Q that expired on 1/19/24 was not sent home in the classroom with two and three-year-old children. A second medication, Nystatin was not discarded or sent home after the prescription instructions stated to apply 7 - 14 days in the classroom with one and two-year-old children. The Nystatin prescription was dated 10/23/23. .0803(12) 851 When medication was administered, documentation was not completed or maintained for 6 months and/or the documentation did not include the required information. The staff member reported Nystatin was administered and was not documented. .0803(13)(a-e); .2318(3) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. One (1) medical action plan was not signed by the parent or physician for an Epi Pen in the classroom with one and two-year-old children. .0801(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Parent permission for an emergency medication was dated 7/13/23 and was not updated within six (6) months as require in the classroom for four and five-year-old children. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. There were two (2) staff files that contained medical information. All remaining staff's medical information was grouped together within one file. .0701(d) 1898 Staff did not complete the health and safety training within one year of employment. The administrator reported that one (1) substitute staff that has worked more than ten (10) days and has not completed Health and Safety Training. The staff member's date of employment is March 1, 2023. .1102(a) Technical assistance was provided as follows: 812: Outlets There was one (1) outlet uncovered in the classroom with two-and three-year-old children next to the door as you entered the room. An outlet protective cover was placed over the outlet correcting this violation. Reminder to maintain extra outlet covers in each space so they are readily available to insert to ensure a safe environment. Electric outlets under five (5) feet or below shall be covered with outlet safety covers. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 840: Hazardous products One (1) can of aerosol sunscreen was inaccessible, but not locked in the classroom with three-year-old children. This was removed and locked in a box during the visit. Reminder all aerosol cans must be stored locked because they are pressurized; therefore, considered hazardous. Potentially hazardous products, such as aerosol disinfecting spray shall be stored in a locked storage. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. 841: Storage of medication A prescription ointment was stored inaccessible, but unlocked with other diaper creams in the space with one and two-year-old children. All prescription medication whether ingested or topical must be stored locked. Nystatin was removed from the classroom today and was corrected during the visit. Any over-the-counter medication or prescription, in exception to emergency medication, diaper creams and lotions shall be locked. Storage with combination locks, magnetic locks and padlocks are considered locked storage. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use but are not required to be in locked storage. 847: Medication authorization form Two (2) emergency medications did not have a valid parent permission to administer on-site. Medication authorization form for prescription medications shall be signed by parents and is valid for up to six (6) months. Please ask the parents to fill out the new form or review the content and re-sign every six (6) months. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 849: Expired medication One (1) emergency medication expired on 1/19/24 and needs to be updated in the classroom with two-and three-year-old children. A second medication in the classroom with one and two-year-old children was not returned after the course of treatment. Expired medication shall be sent home or discarded within seventy-two (72) hours of its expiration date. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. 851: Medication log It was reported when that Nystatin was administered and not recorded. When prescription medications are administered, the information listed below shall be logged. You can print the medication authorization from and the medication log sheet can be printed at the Division’s website at https://ncchildcare.ncdhhs.gov. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (13) Any time prescription or over-the-counter medication is administered by center personnel to children receiving care, the following information shall be recorded: (a) the child's name; (b) the date the medication was given; (c) the time the medication was given; (d) the amount and the type of medication given; and (e) the name and signature of the person administering the medication. This information shall be noted on a medication permission slip, or on a separate form developed by the provider which includes the required information. This information shall be available for review by a representative of the Division during the time period the medication is being administered and for six months after the medication is administered. No documentation shall be required when items listed in Item (7) of this Rule are applied to children. 1835: Medical Action Plan A medical action plan in the classroom with infants and one-year-old children did not contain a parent or physician’s signature as required. You stated the child will not be allowed to return until this is completed. An action plan is a requirement for those children with chronic medical conditions, such as asthma, seizure, allergy that requires epi-pen and diabetes. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; 1890: Confidential information There are three (3) documents that are considered confidential information, which are Health Questionnaires, Medical statement and TB screening form. Those three (3) documents must be maintained separately from the other records, such as application, emergency information form and training certificates. Additionally, each staff member’s confidential information shall be maintained separately. Some centers use manilla envelopes to maintain their record. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. 1898: Health and Safety Training Health and Safety Training is required for the substitute staff members who work more than ten (10) cumulative days a school year. The substitute staff member hired on 3/1/23 (FN) needs to complete the training on or before 5/9/24. The staff member hired on 10/27/23 (LP) needs to complete the training on or before 10/26/24. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. The following persons shall be exempt from this requirement: (1) staff members that do not have caregiving responsibilities for a child or group of children; (2) service providers such as speech therapists, occupational therapists, and physical therapists; and (3) substitute providers who provide services for less than 10 days in a 12-month period. 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: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Storage of food brought from home: There are new Environmental Health sanitation guidelines for the storage of food brough from home. Please contact your Environmental Health specialist to seek additional guidelines. Reminder: Criminal background letter renewal: R. Swatzell shall renew the CBC qualification letter on or prior to 5/2/24. S. Warren shall renew the CBC qualification letter on or prior to 6/6/24. Rated License Cohort: Emmanuel Lutheran School is in cohort two (2). Your prep-year assessment year will be July 2024 through June 2025, and the assessment year will be July 2025 through June 2026. 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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 .0801 · Violation

Name of Operation: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 4/25/2024 Number Present: 99 Completed Date: 4/25/2024 Age: From 0 To 5 Total Minutes: 220 Time In: 09:10 AM Time Out: 12:50 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 Kaoru Eddins, Child Care Consultant and also signed by Christine Smith, Administrator, during the visit. Bonnie Mathis, Licensing Supervisor accompanied me to this visit. An electronic signed copy of the visit summary was left on- site with you today. Ms. Smith is leaving her position on 5/31/24. Camilla Harris-Wallace, the new administrator, has been hired and was present during the visit. Ms. Harris-Wallace accompanied Ms. Mathis during the walk-through. Ms. Smith was available during the visit. Indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition, and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight (88) percent as of 4/25/24 prior to this visit. Permit type – Four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/13/23. The last fire drill was practiced on 4/18/24. The last lockdown drill was practiced on 4/18/24. The last playground inspection was documented on 4/11/24. The last fire inspection was approved on 3/4/24. The last sanitation inspection was conducted on 1/31/24 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and is current. The approved curriculum for four-year-old children is Creative Curriculum. Upon arrival, we announced our presence and the purpose of the visit. Six (6) new staff files and twenty (20) existing staff files were monitored. All staff members have valid criminal background letters in the file. Those who are required to have First Aid, CPR and ITS/SIDS training have current training certificates in file. 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 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. One outlet next to the door was accessible in the classroom with two and three-year-old children. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One can of aerosol sunscreen was stored inaccessible, but not locked in the classroom with three-year-old children. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Nystatin was stored in a container with other diaper ointments inaccessible, but not locked as required for all prescription medications. 15A NCAC 18A .2820(d) 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. One emergency medication Auvi-Q that expired on 1/19/24 was not sent home in the classroom with two and three-year-old children. A second medication, Nystatin was not discarded or sent home after the prescription instructions stated to apply 7 - 14 days in the classroom with one and two-year-old children. The Nystatin prescription was dated 10/23/23. .0803(12) 851 When medication was administered, documentation was not completed or maintained for 6 months and/or the documentation did not include the required information. The staff member reported Nystatin was administered and was not documented. .0803(13)(a-e); .2318(3) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. One (1) medical action plan was not signed by the parent or physician for an Epi Pen in the classroom with one and two-year-old children. .0801(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Parent permission for an emergency medication was dated 7/13/23 and was not updated within six (6) months as require in the classroom for four and five-year-old children. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. There were two (2) staff files that contained medical information. All remaining staff's medical information was grouped together within one file. .0701(d) 1898 Staff did not complete the health and safety training within one year of employment. The administrator reported that one (1) substitute staff that has worked more than ten (10) days and has not completed Health and Safety Training. The staff member's date of employment is March 1, 2023. .1102(a) Technical assistance was provided as follows: 812: Outlets There was one (1) outlet uncovered in the classroom with two-and three-year-old children next to the door as you entered the room. An outlet protective cover was placed over the outlet correcting this violation. Reminder to maintain extra outlet covers in each space so they are readily available to insert to ensure a safe environment. Electric outlets under five (5) feet or below shall be covered with outlet safety covers. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 840: Hazardous products One (1) can of aerosol sunscreen was inaccessible, but not locked in the classroom with three-year-old children. This was removed and locked in a box during the visit. Reminder all aerosol cans must be stored locked because they are pressurized; therefore, considered hazardous. Potentially hazardous products, such as aerosol disinfecting spray shall be stored in a locked storage. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. 841: Storage of medication A prescription ointment was stored inaccessible, but unlocked with other diaper creams in the space with one and two-year-old children. All prescription medication whether ingested or topical must be stored locked. Nystatin was removed from the classroom today and was corrected during the visit. Any over-the-counter medication or prescription, in exception to emergency medication, diaper creams and lotions shall be locked. Storage with combination locks, magnetic locks and padlocks are considered locked storage. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use but are not required to be in locked storage. 847: Medication authorization form Two (2) emergency medications did not have a valid parent permission to administer on-site. Medication authorization form for prescription medications shall be signed by parents and is valid for up to six (6) months. Please ask the parents to fill out the new form or review the content and re-sign every six (6) months. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 849: Expired medication One (1) emergency medication expired on 1/19/24 and needs to be updated in the classroom with two-and three-year-old children. A second medication in the classroom with one and two-year-old children was not returned after the course of treatment. Expired medication shall be sent home or discarded within seventy-two (72) hours of its expiration date. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. 851: Medication log It was reported when that Nystatin was administered and not recorded. When prescription medications are administered, the information listed below shall be logged. You can print the medication authorization from and the medication log sheet can be printed at the Division’s website at https://ncchildcare.ncdhhs.gov. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (13) Any time prescription or over-the-counter medication is administered by center personnel to children receiving care, the following information shall be recorded: (a) the child's name; (b) the date the medication was given; (c) the time the medication was given; (d) the amount and the type of medication given; and (e) the name and signature of the person administering the medication. This information shall be noted on a medication permission slip, or on a separate form developed by the provider which includes the required information. This information shall be available for review by a representative of the Division during the time period the medication is being administered and for six months after the medication is administered. No documentation shall be required when items listed in Item (7) of this Rule are applied to children. 1835: Medical Action Plan A medical action plan in the classroom with infants and one-year-old children did not contain a parent or physician’s signature as required. You stated the child will not be allowed to return until this is completed. An action plan is a requirement for those children with chronic medical conditions, such as asthma, seizure, allergy that requires epi-pen and diabetes. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; 1890: Confidential information There are three (3) documents that are considered confidential information, which are Health Questionnaires, Medical statement and TB screening form. Those three (3) documents must be maintained separately from the other records, such as application, emergency information form and training certificates. Additionally, each staff member’s confidential information shall be maintained separately. Some centers use manilla envelopes to maintain their record. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. 1898: Health and Safety Training Health and Safety Training is required for the substitute staff members who work more than ten (10) cumulative days a school year. The substitute staff member hired on 3/1/23 (FN) needs to complete the training on or before 5/9/24. The staff member hired on 10/27/23 (LP) needs to complete the training on or before 10/26/24. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. The following persons shall be exempt from this requirement: (1) staff members that do not have caregiving responsibilities for a child or group of children; (2) service providers such as speech therapists, occupational therapists, and physical therapists; and (3) substitute providers who provide services for less than 10 days in a 12-month period. 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: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Storage of food brought from home: There are new Environmental Health sanitation guidelines for the storage of food brough from home. Please contact your Environmental Health specialist to seek additional guidelines. Reminder: Criminal background letter renewal: R. Swatzell shall renew the CBC qualification letter on or prior to 5/2/24. S. Warren shall renew the CBC qualification letter on or prior to 6/6/24. Rated License Cohort: Emmanuel Lutheran School is in cohort two (2). Your prep-year assessment year will be July 2024 through June 2025, and the assessment year will be July 2025 through June 2026. 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 4/25/2024 Number Present: 99 Completed Date: 4/25/2024 Age: From 0 To 5 Total Minutes: 220 Time In: 09:10 AM Time Out: 12:50 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 Kaoru Eddins, Child Care Consultant and also signed by Christine Smith, Administrator, during the visit. Bonnie Mathis, Licensing Supervisor accompanied me to this visit. An electronic signed copy of the visit summary was left on- site with you today. Ms. Smith is leaving her position on 5/31/24. Camilla Harris-Wallace, the new administrator, has been hired and was present during the visit. Ms. Harris-Wallace accompanied Ms. Mathis during the walk-through. Ms. Smith was available during the visit. Indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition, and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight (88) percent as of 4/25/24 prior to this visit. Permit type – Four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/13/23. The last fire drill was practiced on 4/18/24. The last lockdown drill was practiced on 4/18/24. The last playground inspection was documented on 4/11/24. The last fire inspection was approved on 3/4/24. The last sanitation inspection was conducted on 1/31/24 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and is current. The approved curriculum for four-year-old children is Creative Curriculum. Upon arrival, we announced our presence and the purpose of the visit. Six (6) new staff files and twenty (20) existing staff files were monitored. All staff members have valid criminal background letters in the file. Those who are required to have First Aid, CPR and ITS/SIDS training have current training certificates in file. 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 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. One outlet next to the door was accessible in the classroom with two and three-year-old children. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One can of aerosol sunscreen was stored inaccessible, but not locked in the classroom with three-year-old children. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Nystatin was stored in a container with other diaper ointments inaccessible, but not locked as required for all prescription medications. 15A NCAC 18A .2820(d) 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. One emergency medication Auvi-Q that expired on 1/19/24 was not sent home in the classroom with two and three-year-old children. A second medication, Nystatin was not discarded or sent home after the prescription instructions stated to apply 7 - 14 days in the classroom with one and two-year-old children. The Nystatin prescription was dated 10/23/23. .0803(12) 851 When medication was administered, documentation was not completed or maintained for 6 months and/or the documentation did not include the required information. The staff member reported Nystatin was administered and was not documented. .0803(13)(a-e); .2318(3) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. One (1) medical action plan was not signed by the parent or physician for an Epi Pen in the classroom with one and two-year-old children. .0801(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Parent permission for an emergency medication was dated 7/13/23 and was not updated within six (6) months as require in the classroom for four and five-year-old children. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. There were two (2) staff files that contained medical information. All remaining staff's medical information was grouped together within one file. .0701(d) 1898 Staff did not complete the health and safety training within one year of employment. The administrator reported that one (1) substitute staff that has worked more than ten (10) days and has not completed Health and Safety Training. The staff member's date of employment is March 1, 2023. .1102(a) Technical assistance was provided as follows: 812: Outlets There was one (1) outlet uncovered in the classroom with two-and three-year-old children next to the door as you entered the room. An outlet protective cover was placed over the outlet correcting this violation. Reminder to maintain extra outlet covers in each space so they are readily available to insert to ensure a safe environment. Electric outlets under five (5) feet or below shall be covered with outlet safety covers. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 840: Hazardous products One (1) can of aerosol sunscreen was inaccessible, but not locked in the classroom with three-year-old children. This was removed and locked in a box during the visit. Reminder all aerosol cans must be stored locked because they are pressurized; therefore, considered hazardous. Potentially hazardous products, such as aerosol disinfecting spray shall be stored in a locked storage. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. 841: Storage of medication A prescription ointment was stored inaccessible, but unlocked with other diaper creams in the space with one and two-year-old children. All prescription medication whether ingested or topical must be stored locked. Nystatin was removed from the classroom today and was corrected during the visit. Any over-the-counter medication or prescription, in exception to emergency medication, diaper creams and lotions shall be locked. Storage with combination locks, magnetic locks and padlocks are considered locked storage. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use but are not required to be in locked storage. 847: Medication authorization form Two (2) emergency medications did not have a valid parent permission to administer on-site. Medication authorization form for prescription medications shall be signed by parents and is valid for up to six (6) months. Please ask the parents to fill out the new form or review the content and re-sign every six (6) months. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 849: Expired medication One (1) emergency medication expired on 1/19/24 and needs to be updated in the classroom with two-and three-year-old children. A second medication in the classroom with one and two-year-old children was not returned after the course of treatment. Expired medication shall be sent home or discarded within seventy-two (72) hours of its expiration date. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. 851: Medication log It was reported when that Nystatin was administered and not recorded. When prescription medications are administered, the information listed below shall be logged. You can print the medication authorization from and the medication log sheet can be printed at the Division’s website at https://ncchildcare.ncdhhs.gov. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (13) Any time prescription or over-the-counter medication is administered by center personnel to children receiving care, the following information shall be recorded: (a) the child's name; (b) the date the medication was given; (c) the time the medication was given; (d) the amount and the type of medication given; and (e) the name and signature of the person administering the medication. This information shall be noted on a medication permission slip, or on a separate form developed by the provider which includes the required information. This information shall be available for review by a representative of the Division during the time period the medication is being administered and for six months after the medication is administered. No documentation shall be required when items listed in Item (7) of this Rule are applied to children. 1835: Medical Action Plan A medical action plan in the classroom with infants and one-year-old children did not contain a parent or physician’s signature as required. You stated the child will not be allowed to return until this is completed. An action plan is a requirement for those children with chronic medical conditions, such as asthma, seizure, allergy that requires epi-pen and diabetes. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; 1890: Confidential information There are three (3) documents that are considered confidential information, which are Health Questionnaires, Medical statement and TB screening form. Those three (3) documents must be maintained separately from the other records, such as application, emergency information form and training certificates. Additionally, each staff member’s confidential information shall be maintained separately. Some centers use manilla envelopes to maintain their record. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. 1898: Health and Safety Training Health and Safety Training is required for the substitute staff members who work more than ten (10) cumulative days a school year. The substitute staff member hired on 3/1/23 (FN) needs to complete the training on or before 5/9/24. The staff member hired on 10/27/23 (LP) needs to complete the training on or before 10/26/24. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. The following persons shall be exempt from this requirement: (1) staff members that do not have caregiving responsibilities for a child or group of children; (2) service providers such as speech therapists, occupational therapists, and physical therapists; and (3) substitute providers who provide services for less than 10 days in a 12-month period. 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: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Storage of food brought from home: There are new Environmental Health sanitation guidelines for the storage of food brough from home. Please contact your Environmental Health specialist to seek additional guidelines. Reminder: Criminal background letter renewal: R. Swatzell shall renew the CBC qualification letter on or prior to 5/2/24. S. Warren shall renew the CBC qualification letter on or prior to 6/6/24. Rated License Cohort: Emmanuel Lutheran School is in cohort two (2). Your prep-year assessment year will be July 2024 through June 2025, and the assessment year will be July 2025 through June 2026. 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 4/25/2024 Number Present: 99 Completed Date: 4/25/2024 Age: From 0 To 5 Total Minutes: 220 Time In: 09:10 AM Time Out: 12:50 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 Kaoru Eddins, Child Care Consultant and also signed by Christine Smith, Administrator, during the visit. Bonnie Mathis, Licensing Supervisor accompanied me to this visit. An electronic signed copy of the visit summary was left on- site with you today. Ms. Smith is leaving her position on 5/31/24. Camilla Harris-Wallace, the new administrator, has been hired and was present during the visit. Ms. Harris-Wallace accompanied Ms. Mathis during the walk-through. Ms. Smith was available during the visit. Indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition, and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight (88) percent as of 4/25/24 prior to this visit. Permit type – Four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/13/23. The last fire drill was practiced on 4/18/24. The last lockdown drill was practiced on 4/18/24. The last playground inspection was documented on 4/11/24. The last fire inspection was approved on 3/4/24. The last sanitation inspection was conducted on 1/31/24 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and is current. The approved curriculum for four-year-old children is Creative Curriculum. Upon arrival, we announced our presence and the purpose of the visit. Six (6) new staff files and twenty (20) existing staff files were monitored. All staff members have valid criminal background letters in the file. Those who are required to have First Aid, CPR and ITS/SIDS training have current training certificates in file. 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 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. One outlet next to the door was accessible in the classroom with two and three-year-old children. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One can of aerosol sunscreen was stored inaccessible, but not locked in the classroom with three-year-old children. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Nystatin was stored in a container with other diaper ointments inaccessible, but not locked as required for all prescription medications. 15A NCAC 18A .2820(d) 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. One emergency medication Auvi-Q that expired on 1/19/24 was not sent home in the classroom with two and three-year-old children. A second medication, Nystatin was not discarded or sent home after the prescription instructions stated to apply 7 - 14 days in the classroom with one and two-year-old children. The Nystatin prescription was dated 10/23/23. .0803(12) 851 When medication was administered, documentation was not completed or maintained for 6 months and/or the documentation did not include the required information. The staff member reported Nystatin was administered and was not documented. .0803(13)(a-e); .2318(3) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. One (1) medical action plan was not signed by the parent or physician for an Epi Pen in the classroom with one and two-year-old children. .0801(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Parent permission for an emergency medication was dated 7/13/23 and was not updated within six (6) months as require in the classroom for four and five-year-old children. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. There were two (2) staff files that contained medical information. All remaining staff's medical information was grouped together within one file. .0701(d) 1898 Staff did not complete the health and safety training within one year of employment. The administrator reported that one (1) substitute staff that has worked more than ten (10) days and has not completed Health and Safety Training. The staff member's date of employment is March 1, 2023. .1102(a) Technical assistance was provided as follows: 812: Outlets There was one (1) outlet uncovered in the classroom with two-and three-year-old children next to the door as you entered the room. An outlet protective cover was placed over the outlet correcting this violation. Reminder to maintain extra outlet covers in each space so they are readily available to insert to ensure a safe environment. Electric outlets under five (5) feet or below shall be covered with outlet safety covers. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 840: Hazardous products One (1) can of aerosol sunscreen was inaccessible, but not locked in the classroom with three-year-old children. This was removed and locked in a box during the visit. Reminder all aerosol cans must be stored locked because they are pressurized; therefore, considered hazardous. Potentially hazardous products, such as aerosol disinfecting spray shall be stored in a locked storage. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. 841: Storage of medication A prescription ointment was stored inaccessible, but unlocked with other diaper creams in the space with one and two-year-old children. All prescription medication whether ingested or topical must be stored locked. Nystatin was removed from the classroom today and was corrected during the visit. Any over-the-counter medication or prescription, in exception to emergency medication, diaper creams and lotions shall be locked. Storage with combination locks, magnetic locks and padlocks are considered locked storage. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use but are not required to be in locked storage. 847: Medication authorization form Two (2) emergency medications did not have a valid parent permission to administer on-site. Medication authorization form for prescription medications shall be signed by parents and is valid for up to six (6) months. Please ask the parents to fill out the new form or review the content and re-sign every six (6) months. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 849: Expired medication One (1) emergency medication expired on 1/19/24 and needs to be updated in the classroom with two-and three-year-old children. A second medication in the classroom with one and two-year-old children was not returned after the course of treatment. Expired medication shall be sent home or discarded within seventy-two (72) hours of its expiration date. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. 851: Medication log It was reported when that Nystatin was administered and not recorded. When prescription medications are administered, the information listed below shall be logged. You can print the medication authorization from and the medication log sheet can be printed at the Division’s website at https://ncchildcare.ncdhhs.gov. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (13) Any time prescription or over-the-counter medication is administered by center personnel to children receiving care, the following information shall be recorded: (a) the child's name; (b) the date the medication was given; (c) the time the medication was given; (d) the amount and the type of medication given; and (e) the name and signature of the person administering the medication. This information shall be noted on a medication permission slip, or on a separate form developed by the provider which includes the required information. This information shall be available for review by a representative of the Division during the time period the medication is being administered and for six months after the medication is administered. No documentation shall be required when items listed in Item (7) of this Rule are applied to children. 1835: Medical Action Plan A medical action plan in the classroom with infants and one-year-old children did not contain a parent or physician’s signature as required. You stated the child will not be allowed to return until this is completed. An action plan is a requirement for those children with chronic medical conditions, such as asthma, seizure, allergy that requires epi-pen and diabetes. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; 1890: Confidential information There are three (3) documents that are considered confidential information, which are Health Questionnaires, Medical statement and TB screening form. Those three (3) documents must be maintained separately from the other records, such as application, emergency information form and training certificates. Additionally, each staff member’s confidential information shall be maintained separately. Some centers use manilla envelopes to maintain their record. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. 1898: Health and Safety Training Health and Safety Training is required for the substitute staff members who work more than ten (10) cumulative days a school year. The substitute staff member hired on 3/1/23 (FN) needs to complete the training on or before 5/9/24. The staff member hired on 10/27/23 (LP) needs to complete the training on or before 10/26/24. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. The following persons shall be exempt from this requirement: (1) staff members that do not have caregiving responsibilities for a child or group of children; (2) service providers such as speech therapists, occupational therapists, and physical therapists; and (3) substitute providers who provide services for less than 10 days in a 12-month period. 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: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Storage of food brought from home: There are new Environmental Health sanitation guidelines for the storage of food brough from home. Please contact your Environmental Health specialist to seek additional guidelines. Reminder: Criminal background letter renewal: R. Swatzell shall renew the CBC qualification letter on or prior to 5/2/24. S. Warren shall renew the CBC qualification letter on or prior to 6/6/24. Rated License Cohort: Emmanuel Lutheran School is in cohort two (2). Your prep-year assessment year will be July 2024 through June 2025, and the assessment year will be July 2025 through June 2026. 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 4/25/2024 Number Present: 99 Completed Date: 4/25/2024 Age: From 0 To 5 Total Minutes: 220 Time In: 09:10 AM Time Out: 12:50 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 Kaoru Eddins, Child Care Consultant and also signed by Christine Smith, Administrator, during the visit. Bonnie Mathis, Licensing Supervisor accompanied me to this visit. An electronic signed copy of the visit summary was left on- site with you today. Ms. Smith is leaving her position on 5/31/24. Camilla Harris-Wallace, the new administrator, has been hired and was present during the visit. Ms. Harris-Wallace accompanied Ms. Mathis during the walk-through. Ms. Smith was available during the visit. Indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition, and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight (88) percent as of 4/25/24 prior to this visit. Permit type – Four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/13/23. The last fire drill was practiced on 4/18/24. The last lockdown drill was practiced on 4/18/24. The last playground inspection was documented on 4/11/24. The last fire inspection was approved on 3/4/24. The last sanitation inspection was conducted on 1/31/24 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and is current. The approved curriculum for four-year-old children is Creative Curriculum. Upon arrival, we announced our presence and the purpose of the visit. Six (6) new staff files and twenty (20) existing staff files were monitored. All staff members have valid criminal background letters in the file. Those who are required to have First Aid, CPR and ITS/SIDS training have current training certificates in file. 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 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. One outlet next to the door was accessible in the classroom with two and three-year-old children. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One can of aerosol sunscreen was stored inaccessible, but not locked in the classroom with three-year-old children. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Nystatin was stored in a container with other diaper ointments inaccessible, but not locked as required for all prescription medications. 15A NCAC 18A .2820(d) 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. One emergency medication Auvi-Q that expired on 1/19/24 was not sent home in the classroom with two and three-year-old children. A second medication, Nystatin was not discarded or sent home after the prescription instructions stated to apply 7 - 14 days in the classroom with one and two-year-old children. The Nystatin prescription was dated 10/23/23. .0803(12) 851 When medication was administered, documentation was not completed or maintained for 6 months and/or the documentation did not include the required information. The staff member reported Nystatin was administered and was not documented. .0803(13)(a-e); .2318(3) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. One (1) medical action plan was not signed by the parent or physician for an Epi Pen in the classroom with one and two-year-old children. .0801(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Parent permission for an emergency medication was dated 7/13/23 and was not updated within six (6) months as require in the classroom for four and five-year-old children. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. There were two (2) staff files that contained medical information. All remaining staff's medical information was grouped together within one file. .0701(d) 1898 Staff did not complete the health and safety training within one year of employment. The administrator reported that one (1) substitute staff that has worked more than ten (10) days and has not completed Health and Safety Training. The staff member's date of employment is March 1, 2023. .1102(a) Technical assistance was provided as follows: 812: Outlets There was one (1) outlet uncovered in the classroom with two-and three-year-old children next to the door as you entered the room. An outlet protective cover was placed over the outlet correcting this violation. Reminder to maintain extra outlet covers in each space so they are readily available to insert to ensure a safe environment. Electric outlets under five (5) feet or below shall be covered with outlet safety covers. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 840: Hazardous products One (1) can of aerosol sunscreen was inaccessible, but not locked in the classroom with three-year-old children. This was removed and locked in a box during the visit. Reminder all aerosol cans must be stored locked because they are pressurized; therefore, considered hazardous. Potentially hazardous products, such as aerosol disinfecting spray shall be stored in a locked storage. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. 841: Storage of medication A prescription ointment was stored inaccessible, but unlocked with other diaper creams in the space with one and two-year-old children. All prescription medication whether ingested or topical must be stored locked. Nystatin was removed from the classroom today and was corrected during the visit. Any over-the-counter medication or prescription, in exception to emergency medication, diaper creams and lotions shall be locked. Storage with combination locks, magnetic locks and padlocks are considered locked storage. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use but are not required to be in locked storage. 847: Medication authorization form Two (2) emergency medications did not have a valid parent permission to administer on-site. Medication authorization form for prescription medications shall be signed by parents and is valid for up to six (6) months. Please ask the parents to fill out the new form or review the content and re-sign every six (6) months. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 849: Expired medication One (1) emergency medication expired on 1/19/24 and needs to be updated in the classroom with two-and three-year-old children. A second medication in the classroom with one and two-year-old children was not returned after the course of treatment. Expired medication shall be sent home or discarded within seventy-two (72) hours of its expiration date. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. 851: Medication log It was reported when that Nystatin was administered and not recorded. When prescription medications are administered, the information listed below shall be logged. You can print the medication authorization from and the medication log sheet can be printed at the Division’s website at https://ncchildcare.ncdhhs.gov. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (13) Any time prescription or over-the-counter medication is administered by center personnel to children receiving care, the following information shall be recorded: (a) the child's name; (b) the date the medication was given; (c) the time the medication was given; (d) the amount and the type of medication given; and (e) the name and signature of the person administering the medication. This information shall be noted on a medication permission slip, or on a separate form developed by the provider which includes the required information. This information shall be available for review by a representative of the Division during the time period the medication is being administered and for six months after the medication is administered. No documentation shall be required when items listed in Item (7) of this Rule are applied to children. 1835: Medical Action Plan A medical action plan in the classroom with infants and one-year-old children did not contain a parent or physician’s signature as required. You stated the child will not be allowed to return until this is completed. An action plan is a requirement for those children with chronic medical conditions, such as asthma, seizure, allergy that requires epi-pen and diabetes. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; 1890: Confidential information There are three (3) documents that are considered confidential information, which are Health Questionnaires, Medical statement and TB screening form. Those three (3) documents must be maintained separately from the other records, such as application, emergency information form and training certificates. Additionally, each staff member’s confidential information shall be maintained separately. Some centers use manilla envelopes to maintain their record. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. 1898: Health and Safety Training Health and Safety Training is required for the substitute staff members who work more than ten (10) cumulative days a school year. The substitute staff member hired on 3/1/23 (FN) needs to complete the training on or before 5/9/24. The staff member hired on 10/27/23 (LP) needs to complete the training on or before 10/26/24. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. The following persons shall be exempt from this requirement: (1) staff members that do not have caregiving responsibilities for a child or group of children; (2) service providers such as speech therapists, occupational therapists, and physical therapists; and (3) substitute providers who provide services for less than 10 days in a 12-month period. 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: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Storage of food brought from home: There are new Environmental Health sanitation guidelines for the storage of food brough from home. Please contact your Environmental Health specialist to seek additional guidelines. Reminder: Criminal background letter renewal: R. Swatzell shall renew the CBC qualification letter on or prior to 5/2/24. S. Warren shall renew the CBC qualification letter on or prior to 6/6/24. Rated License Cohort: Emmanuel Lutheran School is in cohort two (2). Your prep-year assessment year will be July 2024 through June 2025, and the assessment year will be July 2025 through June 2026. 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 4/25/2024 Number Present: 99 Completed Date: 4/25/2024 Age: From 0 To 5 Total Minutes: 220 Time In: 09:10 AM Time Out: 12:50 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 Kaoru Eddins, Child Care Consultant and also signed by Christine Smith, Administrator, during the visit. Bonnie Mathis, Licensing Supervisor accompanied me to this visit. An electronic signed copy of the visit summary was left on- site with you today. Ms. Smith is leaving her position on 5/31/24. Camilla Harris-Wallace, the new administrator, has been hired and was present during the visit. Ms. Harris-Wallace accompanied Ms. Mathis during the walk-through. Ms. Smith was available during the visit. Indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition, and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight (88) percent as of 4/25/24 prior to this visit. Permit type – Four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/13/23. The last fire drill was practiced on 4/18/24. The last lockdown drill was practiced on 4/18/24. The last playground inspection was documented on 4/11/24. The last fire inspection was approved on 3/4/24. The last sanitation inspection was conducted on 1/31/24 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and is current. The approved curriculum for four-year-old children is Creative Curriculum. Upon arrival, we announced our presence and the purpose of the visit. Six (6) new staff files and twenty (20) existing staff files were monitored. All staff members have valid criminal background letters in the file. Those who are required to have First Aid, CPR and ITS/SIDS training have current training certificates in file. 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 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. One outlet next to the door was accessible in the classroom with two and three-year-old children. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One can of aerosol sunscreen was stored inaccessible, but not locked in the classroom with three-year-old children. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Nystatin was stored in a container with other diaper ointments inaccessible, but not locked as required for all prescription medications. 15A NCAC 18A .2820(d) 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. One emergency medication Auvi-Q that expired on 1/19/24 was not sent home in the classroom with two and three-year-old children. A second medication, Nystatin was not discarded or sent home after the prescription instructions stated to apply 7 - 14 days in the classroom with one and two-year-old children. The Nystatin prescription was dated 10/23/23. .0803(12) 851 When medication was administered, documentation was not completed or maintained for 6 months and/or the documentation did not include the required information. The staff member reported Nystatin was administered and was not documented. .0803(13)(a-e); .2318(3) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. One (1) medical action plan was not signed by the parent or physician for an Epi Pen in the classroom with one and two-year-old children. .0801(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Parent permission for an emergency medication was dated 7/13/23 and was not updated within six (6) months as require in the classroom for four and five-year-old children. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. There were two (2) staff files that contained medical information. All remaining staff's medical information was grouped together within one file. .0701(d) 1898 Staff did not complete the health and safety training within one year of employment. The administrator reported that one (1) substitute staff that has worked more than ten (10) days and has not completed Health and Safety Training. The staff member's date of employment is March 1, 2023. .1102(a) Technical assistance was provided as follows: 812: Outlets There was one (1) outlet uncovered in the classroom with two-and three-year-old children next to the door as you entered the room. An outlet protective cover was placed over the outlet correcting this violation. Reminder to maintain extra outlet covers in each space so they are readily available to insert to ensure a safe environment. Electric outlets under five (5) feet or below shall be covered with outlet safety covers. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 840: Hazardous products One (1) can of aerosol sunscreen was inaccessible, but not locked in the classroom with three-year-old children. This was removed and locked in a box during the visit. Reminder all aerosol cans must be stored locked because they are pressurized; therefore, considered hazardous. Potentially hazardous products, such as aerosol disinfecting spray shall be stored in a locked storage. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. 841: Storage of medication A prescription ointment was stored inaccessible, but unlocked with other diaper creams in the space with one and two-year-old children. All prescription medication whether ingested or topical must be stored locked. Nystatin was removed from the classroom today and was corrected during the visit. Any over-the-counter medication or prescription, in exception to emergency medication, diaper creams and lotions shall be locked. Storage with combination locks, magnetic locks and padlocks are considered locked storage. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use but are not required to be in locked storage. 847: Medication authorization form Two (2) emergency medications did not have a valid parent permission to administer on-site. Medication authorization form for prescription medications shall be signed by parents and is valid for up to six (6) months. Please ask the parents to fill out the new form or review the content and re-sign every six (6) months. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 849: Expired medication One (1) emergency medication expired on 1/19/24 and needs to be updated in the classroom with two-and three-year-old children. A second medication in the classroom with one and two-year-old children was not returned after the course of treatment. Expired medication shall be sent home or discarded within seventy-two (72) hours of its expiration date. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. 851: Medication log It was reported when that Nystatin was administered and not recorded. When prescription medications are administered, the information listed below shall be logged. You can print the medication authorization from and the medication log sheet can be printed at the Division’s website at https://ncchildcare.ncdhhs.gov. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (13) Any time prescription or over-the-counter medication is administered by center personnel to children receiving care, the following information shall be recorded: (a) the child's name; (b) the date the medication was given; (c) the time the medication was given; (d) the amount and the type of medication given; and (e) the name and signature of the person administering the medication. This information shall be noted on a medication permission slip, or on a separate form developed by the provider which includes the required information. This information shall be available for review by a representative of the Division during the time period the medication is being administered and for six months after the medication is administered. No documentation shall be required when items listed in Item (7) of this Rule are applied to children. 1835: Medical Action Plan A medical action plan in the classroom with infants and one-year-old children did not contain a parent or physician’s signature as required. You stated the child will not be allowed to return until this is completed. An action plan is a requirement for those children with chronic medical conditions, such as asthma, seizure, allergy that requires epi-pen and diabetes. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; 1890: Confidential information There are three (3) documents that are considered confidential information, which are Health Questionnaires, Medical statement and TB screening form. Those three (3) documents must be maintained separately from the other records, such as application, emergency information form and training certificates. Additionally, each staff member’s confidential information shall be maintained separately. Some centers use manilla envelopes to maintain their record. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. 1898: Health and Safety Training Health and Safety Training is required for the substitute staff members who work more than ten (10) cumulative days a school year. The substitute staff member hired on 3/1/23 (FN) needs to complete the training on or before 5/9/24. The staff member hired on 10/27/23 (LP) needs to complete the training on or before 10/26/24. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. The following persons shall be exempt from this requirement: (1) staff members that do not have caregiving responsibilities for a child or group of children; (2) service providers such as speech therapists, occupational therapists, and physical therapists; and (3) substitute providers who provide services for less than 10 days in a 12-month period. 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: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Storage of food brought from home: There are new Environmental Health sanitation guidelines for the storage of food brough from home. Please contact your Environmental Health specialist to seek additional guidelines. Reminder: Criminal background letter renewal: R. Swatzell shall renew the CBC qualification letter on or prior to 5/2/24. S. Warren shall renew the CBC qualification letter on or prior to 6/6/24. Rated License Cohort: Emmanuel Lutheran School is in cohort two (2). Your prep-year assessment year will be July 2024 through June 2025, and the assessment year will be July 2025 through June 2026. 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 4/25/2024 Number Present: 99 Completed Date: 4/25/2024 Age: From 0 To 5 Total Minutes: 220 Time In: 09:10 AM Time Out: 12:50 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 Kaoru Eddins, Child Care Consultant and also signed by Christine Smith, Administrator, during the visit. Bonnie Mathis, Licensing Supervisor accompanied me to this visit. An electronic signed copy of the visit summary was left on- site with you today. Ms. Smith is leaving her position on 5/31/24. Camilla Harris-Wallace, the new administrator, has been hired and was present during the visit. Ms. Harris-Wallace accompanied Ms. Mathis during the walk-through. Ms. Smith was available during the visit. Indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition, and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight (88) percent as of 4/25/24 prior to this visit. Permit type – Four-star center license issued on 6/20/19. Special Services/Restrictions – daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/13/23. The last fire drill was practiced on 4/18/24. The last lockdown drill was practiced on 4/18/24. The last playground inspection was documented on 4/11/24. The last fire inspection was approved on 3/4/24. The last sanitation inspection was conducted on 1/31/24 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and is current. The approved curriculum for four-year-old children is Creative Curriculum. Upon arrival, we announced our presence and the purpose of the visit. Six (6) new staff files and twenty (20) existing staff files were monitored. All staff members have valid criminal background letters in the file. Those who are required to have First Aid, CPR and ITS/SIDS training have current training certificates in file. 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 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. One outlet next to the door was accessible in the classroom with two and three-year-old children. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One can of aerosol sunscreen was stored inaccessible, but not locked in the classroom with three-year-old children. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Nystatin was stored in a container with other diaper ointments inaccessible, but not locked as required for all prescription medications. 15A NCAC 18A .2820(d) 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. One emergency medication Auvi-Q that expired on 1/19/24 was not sent home in the classroom with two and three-year-old children. A second medication, Nystatin was not discarded or sent home after the prescription instructions stated to apply 7 - 14 days in the classroom with one and two-year-old children. The Nystatin prescription was dated 10/23/23. .0803(12) 851 When medication was administered, documentation was not completed or maintained for 6 months and/or the documentation did not include the required information. The staff member reported Nystatin was administered and was not documented. .0803(13)(a-e); .2318(3) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. One (1) medical action plan was not signed by the parent or physician for an Epi Pen in the classroom with one and two-year-old children. .0801(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Parent permission for an emergency medication was dated 7/13/23 and was not updated within six (6) months as require in the classroom for four and five-year-old children. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. There were two (2) staff files that contained medical information. All remaining staff's medical information was grouped together within one file. .0701(d) 1898 Staff did not complete the health and safety training within one year of employment. The administrator reported that one (1) substitute staff that has worked more than ten (10) days and has not completed Health and Safety Training. The staff member's date of employment is March 1, 2023. .1102(a) Technical assistance was provided as follows: 812: Outlets There was one (1) outlet uncovered in the classroom with two-and three-year-old children next to the door as you entered the room. An outlet protective cover was placed over the outlet correcting this violation. Reminder to maintain extra outlet covers in each space so they are readily available to insert to ensure a safe environment. Electric outlets under five (5) feet or below shall be covered with outlet safety covers. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 840: Hazardous products One (1) can of aerosol sunscreen was inaccessible, but not locked in the classroom with three-year-old children. This was removed and locked in a box during the visit. Reminder all aerosol cans must be stored locked because they are pressurized; therefore, considered hazardous. Potentially hazardous products, such as aerosol disinfecting spray shall be stored in a locked storage. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. 841: Storage of medication A prescription ointment was stored inaccessible, but unlocked with other diaper creams in the space with one and two-year-old children. All prescription medication whether ingested or topical must be stored locked. Nystatin was removed from the classroom today and was corrected during the visit. Any over-the-counter medication or prescription, in exception to emergency medication, diaper creams and lotions shall be locked. Storage with combination locks, magnetic locks and padlocks are considered locked storage. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use but are not required to be in locked storage. 847: Medication authorization form Two (2) emergency medications did not have a valid parent permission to administer on-site. Medication authorization form for prescription medications shall be signed by parents and is valid for up to six (6) months. Please ask the parents to fill out the new form or review the content and re-sign every six (6) months. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 849: Expired medication One (1) emergency medication expired on 1/19/24 and needs to be updated in the classroom with two-and three-year-old children. A second medication in the classroom with one and two-year-old children was not returned after the course of treatment. Expired medication shall be sent home or discarded within seventy-two (72) hours of its expiration date. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. 851: Medication log It was reported when that Nystatin was administered and not recorded. When prescription medications are administered, the information listed below shall be logged. You can print the medication authorization from and the medication log sheet can be printed at the Division’s website at https://ncchildcare.ncdhhs.gov. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (13) Any time prescription or over-the-counter medication is administered by center personnel to children receiving care, the following information shall be recorded: (a) the child's name; (b) the date the medication was given; (c) the time the medication was given; (d) the amount and the type of medication given; and (e) the name and signature of the person administering the medication. This information shall be noted on a medication permission slip, or on a separate form developed by the provider which includes the required information. This information shall be available for review by a representative of the Division during the time period the medication is being administered and for six months after the medication is administered. No documentation shall be required when items listed in Item (7) of this Rule are applied to children. 1835: Medical Action Plan A medical action plan in the classroom with infants and one-year-old children did not contain a parent or physician’s signature as required. You stated the child will not be allowed to return until this is completed. An action plan is a requirement for those children with chronic medical conditions, such as asthma, seizure, allergy that requires epi-pen and diabetes. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; 1890: Confidential information There are three (3) documents that are considered confidential information, which are Health Questionnaires, Medical statement and TB screening form. Those three (3) documents must be maintained separately from the other records, such as application, emergency information form and training certificates. Additionally, each staff member’s confidential information shall be maintained separately. Some centers use manilla envelopes to maintain their record. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. 1898: Health and Safety Training Health and Safety Training is required for the substitute staff members who work more than ten (10) cumulative days a school year. The substitute staff member hired on 3/1/23 (FN) needs to complete the training on or before 5/9/24. The staff member hired on 10/27/23 (LP) needs to complete the training on or before 10/26/24. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. The following persons shall be exempt from this requirement: (1) staff members that do not have caregiving responsibilities for a child or group of children; (2) service providers such as speech therapists, occupational therapists, and physical therapists; and (3) substitute providers who provide services for less than 10 days in a 12-month period. 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: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@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: Storage of food brought from home: There are new Environmental Health sanitation guidelines for the storage of food brough from home. Please contact your Environmental Health specialist to seek additional guidelines. Reminder: Criminal background letter renewal: R. Swatzell shall renew the CBC qualification letter on or prior to 5/2/24. S. Warren shall renew the CBC qualification letter on or prior to 6/6/24. Rated License Cohort: Emmanuel Lutheran School is in cohort two (2). Your prep-year assessment year will be July 2024 through June 2025, and the assessment year will be July 2025 through June 2026. 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013, 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 11/13/2023 Number Present: 97 Completed Date: 11/13/2023 Age: From 0 To 5 Total Minutes: 315 Time In: 11:00 AM Time Out: 04:15 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 Kaoru Eddins, Child Care Consultant and also signed by Chrstine Smith, Administrator, during the visit. An electronic signed copy of the visit summary was printed and left with you. Today, Christine Smith, Administrator, was available during the visit. Limited monitoring of child care rules was conducted, including but not limited to 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 ninety (90) percentage as of 11/6/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Emmanuel Lutheran Church of Asheville, N.C, Inc., is current/active as of 11/6/23. Permit type - four-star center license issued on 6/20/19. Special Services/Restrictions - daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/17/22. The last fire drill was practiced on 10/24/23. The last lockdown drill was practiced on 10/24/23. The last playground inspection was documented on 11/7/23. The last fire inspection was approved on 3/15/23. The last sanitation inspection was conducted on 11/21/22 with four (4) demerits for a superior classification. Sanitation inspection for the lunch room was conducted on 4/24/23 and the program for the school program was on 10/24/23. Please contact your Environmental Health Specialist to schedule an inspection in November. The Emergency Medical Care plan was posted and current. The curriculum for four-year-old children is Creative Curriculum. Upon arrival, I announced my presence and the purpose of the visit. In space #1, a group of infants engaged in various activities. One (1) of the teachers took three (3) infants for a walk in the Bye Bye Buggy while the other teacher cared for three (3) infants in the classroom. One (1) child was asleep in the crib, and the other two (2) children played on the floor. Sleep check was filled out for the child. In space #2, a group of four-to-five-year-old children engaged in free play using magnetic tiles toy vehicles, blocks, Legos, connecting cubes, and other toys. In space #3, a group of two-year-old children had lunch. Today’s menu was BBQ meatballs, hush puppies, green beans, pears, and milk. The items were listed on the menu. Some children brought lunch from home, but school lunch was also served to those children. In space #4, a group of two-to-three-year-old children engaged in discussions during a group time. The children and the teacher discussed what they were thankful for. The teacher also read books to the children. In space #5, a group of four-year-old children played on the playground. The children engaged in gross motor activities with slide structure, sandbox, a climber and tricycles. The mulch was measured for seven (7) inches on the preschool playground and all equipment were in good repair. In space #6, a group of one-to-two-year-old children transitioned from lunchtime to free play/getting ready for rest time. The children washed their hands and face after the lunch and played with materials in the classroom. One (1) teacher supervised handwashing and cleaned the tables, while the other teacher supervised and interacted with children. In space #7, a group of one-year-old children played and transitioned to the rest time. One (1) teacher checked and changed the children’s diapers while the other teacher supervised and interacted with children. In space #8, a group of infants and one-year-old children engaged in various activities. One (1) child was having lunch in the high chair. One (1) child was asleep in the crib and one (1) child was being changed. The shoulder straps for the high chair were removed. The child was buckled with waist strap. In space #9, which is used as a multi-purpose room, a group of children from space #10 had a music class. The music class is held every Mondays. The children engaged in song, dance and the review of different instruments. Infant/toddler playground was inspected. There were two (2) portable slide structures, three (3) play houses, riding toys and other gross motor accessories were available . Half of the playground is grassed, and the other half is covered with astroturf. Over-the-counter medications and emergency medications were monitored. In space #3, both action plan and the permission form for an Epi-pen were expired. In space #4, a permission form for an Epi-pen was not available for review. In space #7, a permission form for a diaper cream was expired. Supervision and interaction with children were adequate. Thirteen (13) children’s files, three (3) new staff members’ files and three (3) existing staff members’ files were monitored. One (1) of the children’s incident report was not filed in the child’s file. Confidential documents were not filed separately for all staff members. 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/ This facility does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #9 (room 113), two(2) containers of Clorox disinfecting wipes were accessible to children on the shelf. In space #4, two (2) containers of Clorox disinfecting wipes were stored on the shelf by the door accessible to children. .2820(b) 847 Parent's medication authorization did not include required information. In space #3, a permission form for an Epi-pen expired on 5/18/23. In space #4, a permission form for a child with Epi-pen was not available for review. 10A NCAC 09 .0803(4)(6-9) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. Incident report for a child was logged but the report was not in the child's file. .0802 (e) 861 Prohibited styrofoam and foam rubber products were accessible to children under 3 years of age and/or approved foam products were used without proper supervision. In space #4, Laura Lynn Ziplock bags and tall kitchen trash bags were accessible to children. .0604(q) 871 Center staff did not comply with the safe sleep policy. In space #1, a child slept with a pacifier with a pacifier holder/stuffed animal. The pacifier and the holder was out of the child's mouth. In space #8, at 11:40 am, the last sleep check for the child who was asleep was logged at 11:15 am. 10A NCAC 09 .0606(a) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #3, an action plan for a child with Epi-pen expired on 8/22/23. .0801(b) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Out of six (6) staff files I reviewed, confidential information for all six (6) staff members were maintained with other documents in the staff files. .0701(d) Technical Assistance were provided as follows: 840: Hazardous Materials Potentially hazardous materials, such as cleaners with a warning “keep out of reach of children” shall be maintained at least five (5) feet or above. Staff members shall store their personal items, such as purse out of reach of children as well. 15A NCAC 18A .2820 STORAGE aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. (c) Non-aerosol sanitizing, disinfecting, and detergent solutions, hand sanitizers, and hand lotions shall be kept out of reach of children when not in use but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent (soapy water) solutions. Hand soap other than that which is in bulk containers is not required to be kept out of reach of children or in locked storage. (f) Employee purses and other personal effects shall be kept out of reach of children. 847: Medication permission form Authorization to administer medication is required for all medications including epi-pen. The teachers shall not administer any types of medication without the authorization. Both Action plan and the permission form is required for all emergency medications. The permission form for prescription medication is valid for six (6) months. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 852: Incident Report: Incident report must be maintained in each child’s file after obtaining parent signature and logged on the incident log. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (e) The child care provider shall complete an incident report each time a child is injured as a result of an incident occurring while the child is in care. This incident report shall include: (1) facility identifying information; (2) the child's name; (3) date and time of the incident; (4) witness to the incident; (5) time the parent is notified of the incident and by whom; (6) piece of equipment involved, if applicable; (7) cause of injury, if applicable; (8) type of injury, if applicable; (9) body part injured, if applicable; (10) where the child received medical treatment, if applicable; (11) description of how and where the incident occurred, and the First Aid received; and (12) steps taken to prevent reoccurrence. This report shall be signed by the person completing it and by the parent, a copy given to the parent or a parent signature declining a copy and the report maintained in the child's file. A copy of the form may be found on the Division's website at http://ncchildcare.ncdhhs.gova 861: Easily Torn Plastics Easily torn plastics, including grocery bags, Ziplock bags, plastic wrappers and trash bags must be inaccessible to children under three (3) years of age. Please store them at least five (5) feet or above. 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. 871: Safe Sleep practice Infants, children at twelve (12) months of age or younger must sleep with no objects in the crib including blankets and stuffed animals. Pacifier hold shall be removed from the crib when the child sleeps in the crib. Sleep checks for infants shall be completed at least every fifteen (15) minutes. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (2) 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 with a sleeping infant aged 12 months or younger; (6) specifies that caregivers shall visually check, in person, sleeping infants aged 12 months or younger at least every 15 minutes; 1835: Action Plan Action plan for asthma is required. The plan shall be renewed annually and stay valid. The action plan is valid for twelve (12) months. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/ 1890: Confidential information Confidential information (medial statement, TB results and Health Questionnaire) shall be maintained separately from the other documents in staff files. Please note that Emergency Information form is not a confidential information. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. Technical assistance was provided as follows: You will document the rule reference and specifics about the violations here. Provide your discussion with the operator and/or TA you provided. Best practice can go here too. 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 11/27/23 Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013 or email kaoru.eddins@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: Sleep check documents: 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. Staff and Training Worksheet: Item #5: Orientation Please put dates for this section. If the orientation was offered prior to two (2) weeks/six (6) weeks requirements, only the date of completion be filled. Item #11: Emergency information and Health Questionnaire: Please put dates for this section. Both forms shall be updated annually. Item #17: Health and Safety training The date of completion of the training goes here, rather than the next due date. Item #25/#26: EPR and EMC review The facility’s EPR and EMC review is included in the new staff orientation. The annual review for both documents are required for all existing staff members as well. I suggest leaving documentation of the review for each staff member. Attendance roster or acknowledgement form is suggested. Sanitation inspection: Your last sanitation inspection was completed on 11/21/22. If you don’t receive sanitation inspection soon, please contact your Environmental Health Specialist. A sanitation inspection shall be completed before 11/30/23. If you have any questions or concerns regarding the Stabilization, Expansion and Access 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 11/13/2023 Number Present: 97 Completed Date: 11/13/2023 Age: From 0 To 5 Total Minutes: 315 Time In: 11:00 AM Time Out: 04:15 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 Kaoru Eddins, Child Care Consultant and also signed by Chrstine Smith, Administrator, during the visit. An electronic signed copy of the visit summary was printed and left with you. Today, Christine Smith, Administrator, was available during the visit. Limited monitoring of child care rules was conducted, including but not limited to 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 ninety (90) percentage as of 11/6/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Emmanuel Lutheran Church of Asheville, N.C, Inc., is current/active as of 11/6/23. Permit type - four-star center license issued on 6/20/19. Special Services/Restrictions - daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/17/22. The last fire drill was practiced on 10/24/23. The last lockdown drill was practiced on 10/24/23. The last playground inspection was documented on 11/7/23. The last fire inspection was approved on 3/15/23. The last sanitation inspection was conducted on 11/21/22 with four (4) demerits for a superior classification. Sanitation inspection for the lunch room was conducted on 4/24/23 and the program for the school program was on 10/24/23. Please contact your Environmental Health Specialist to schedule an inspection in November. The Emergency Medical Care plan was posted and current. The curriculum for four-year-old children is Creative Curriculum. Upon arrival, I announced my presence and the purpose of the visit. In space #1, a group of infants engaged in various activities. One (1) of the teachers took three (3) infants for a walk in the Bye Bye Buggy while the other teacher cared for three (3) infants in the classroom. One (1) child was asleep in the crib, and the other two (2) children played on the floor. Sleep check was filled out for the child. In space #2, a group of four-to-five-year-old children engaged in free play using magnetic tiles toy vehicles, blocks, Legos, connecting cubes, and other toys. In space #3, a group of two-year-old children had lunch. Today’s menu was BBQ meatballs, hush puppies, green beans, pears, and milk. The items were listed on the menu. Some children brought lunch from home, but school lunch was also served to those children. In space #4, a group of two-to-three-year-old children engaged in discussions during a group time. The children and the teacher discussed what they were thankful for. The teacher also read books to the children. In space #5, a group of four-year-old children played on the playground. The children engaged in gross motor activities with slide structure, sandbox, a climber and tricycles. The mulch was measured for seven (7) inches on the preschool playground and all equipment were in good repair. In space #6, a group of one-to-two-year-old children transitioned from lunchtime to free play/getting ready for rest time. The children washed their hands and face after the lunch and played with materials in the classroom. One (1) teacher supervised handwashing and cleaned the tables, while the other teacher supervised and interacted with children. In space #7, a group of one-year-old children played and transitioned to the rest time. One (1) teacher checked and changed the children’s diapers while the other teacher supervised and interacted with children. In space #8, a group of infants and one-year-old children engaged in various activities. One (1) child was having lunch in the high chair. One (1) child was asleep in the crib and one (1) child was being changed. The shoulder straps for the high chair were removed. The child was buckled with waist strap. In space #9, which is used as a multi-purpose room, a group of children from space #10 had a music class. The music class is held every Mondays. The children engaged in song, dance and the review of different instruments. Infant/toddler playground was inspected. There were two (2) portable slide structures, three (3) play houses, riding toys and other gross motor accessories were available . Half of the playground is grassed, and the other half is covered with astroturf. Over-the-counter medications and emergency medications were monitored. In space #3, both action plan and the permission form for an Epi-pen were expired. In space #4, a permission form for an Epi-pen was not available for review. In space #7, a permission form for a diaper cream was expired. Supervision and interaction with children were adequate. Thirteen (13) children’s files, three (3) new staff members’ files and three (3) existing staff members’ files were monitored. One (1) of the children’s incident report was not filed in the child’s file. Confidential documents were not filed separately for all staff members. 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/ This facility does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #9 (room 113), two(2) containers of Clorox disinfecting wipes were accessible to children on the shelf. In space #4, two (2) containers of Clorox disinfecting wipes were stored on the shelf by the door accessible to children. .2820(b) 847 Parent's medication authorization did not include required information. In space #3, a permission form for an Epi-pen expired on 5/18/23. In space #4, a permission form for a child with Epi-pen was not available for review. 10A NCAC 09 .0803(4)(6-9) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. Incident report for a child was logged but the report was not in the child's file. .0802 (e) 861 Prohibited styrofoam and foam rubber products were accessible to children under 3 years of age and/or approved foam products were used without proper supervision. In space #4, Laura Lynn Ziplock bags and tall kitchen trash bags were accessible to children. .0604(q) 871 Center staff did not comply with the safe sleep policy. In space #1, a child slept with a pacifier with a pacifier holder/stuffed animal. The pacifier and the holder was out of the child's mouth. In space #8, at 11:40 am, the last sleep check for the child who was asleep was logged at 11:15 am. 10A NCAC 09 .0606(a) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #3, an action plan for a child with Epi-pen expired on 8/22/23. .0801(b) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Out of six (6) staff files I reviewed, confidential information for all six (6) staff members were maintained with other documents in the staff files. .0701(d) Technical Assistance were provided as follows: 840: Hazardous Materials Potentially hazardous materials, such as cleaners with a warning “keep out of reach of children” shall be maintained at least five (5) feet or above. Staff members shall store their personal items, such as purse out of reach of children as well. 15A NCAC 18A .2820 STORAGE aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. (c) Non-aerosol sanitizing, disinfecting, and detergent solutions, hand sanitizers, and hand lotions shall be kept out of reach of children when not in use but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent (soapy water) solutions. Hand soap other than that which is in bulk containers is not required to be kept out of reach of children or in locked storage. (f) Employee purses and other personal effects shall be kept out of reach of children. 847: Medication permission form Authorization to administer medication is required for all medications including epi-pen. The teachers shall not administer any types of medication without the authorization. Both Action plan and the permission form is required for all emergency medications. The permission form for prescription medication is valid for six (6) months. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 852: Incident Report: Incident report must be maintained in each child’s file after obtaining parent signature and logged on the incident log. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (e) The child care provider shall complete an incident report each time a child is injured as a result of an incident occurring while the child is in care. This incident report shall include: (1) facility identifying information; (2) the child's name; (3) date and time of the incident; (4) witness to the incident; (5) time the parent is notified of the incident and by whom; (6) piece of equipment involved, if applicable; (7) cause of injury, if applicable; (8) type of injury, if applicable; (9) body part injured, if applicable; (10) where the child received medical treatment, if applicable; (11) description of how and where the incident occurred, and the First Aid received; and (12) steps taken to prevent reoccurrence. This report shall be signed by the person completing it and by the parent, a copy given to the parent or a parent signature declining a copy and the report maintained in the child's file. A copy of the form may be found on the Division's website at http://ncchildcare.ncdhhs.gova 861: Easily Torn Plastics Easily torn plastics, including grocery bags, Ziplock bags, plastic wrappers and trash bags must be inaccessible to children under three (3) years of age. Please store them at least five (5) feet or above. 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. 871: Safe Sleep practice Infants, children at twelve (12) months of age or younger must sleep with no objects in the crib including blankets and stuffed animals. Pacifier hold shall be removed from the crib when the child sleeps in the crib. Sleep checks for infants shall be completed at least every fifteen (15) minutes. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (2) 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 with a sleeping infant aged 12 months or younger; (6) specifies that caregivers shall visually check, in person, sleeping infants aged 12 months or younger at least every 15 minutes; 1835: Action Plan Action plan for asthma is required. The plan shall be renewed annually and stay valid. The action plan is valid for twelve (12) months. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/ 1890: Confidential information Confidential information (medial statement, TB results and Health Questionnaire) shall be maintained separately from the other documents in staff files. Please note that Emergency Information form is not a confidential information. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. Technical assistance was provided as follows: You will document the rule reference and specifics about the violations here. Provide your discussion with the operator and/or TA you provided. Best practice can go here too. 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 11/27/23 Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013 or email kaoru.eddins@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: Sleep check documents: 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. Staff and Training Worksheet: Item #5: Orientation Please put dates for this section. If the orientation was offered prior to two (2) weeks/six (6) weeks requirements, only the date of completion be filled. Item #11: Emergency information and Health Questionnaire: Please put dates for this section. Both forms shall be updated annually. Item #17: Health and Safety training The date of completion of the training goes here, rather than the next due date. Item #25/#26: EPR and EMC review The facility’s EPR and EMC review is included in the new staff orientation. The annual review for both documents are required for all existing staff members as well. I suggest leaving documentation of the review for each staff member. Attendance roster or acknowledgement form is suggested. Sanitation inspection: Your last sanitation inspection was completed on 11/21/22. If you don’t receive sanitation inspection soon, please contact your Environmental Health Specialist. A sanitation inspection shall be completed before 11/30/23. If you have any questions or concerns regarding the Stabilization, Expansion and Access 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 11/13/2023 Number Present: 97 Completed Date: 11/13/2023 Age: From 0 To 5 Total Minutes: 315 Time In: 11:00 AM Time Out: 04:15 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 Kaoru Eddins, Child Care Consultant and also signed by Chrstine Smith, Administrator, during the visit. An electronic signed copy of the visit summary was printed and left with you. Today, Christine Smith, Administrator, was available during the visit. Limited monitoring of child care rules was conducted, including but not limited to 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 ninety (90) percentage as of 11/6/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Emmanuel Lutheran Church of Asheville, N.C, Inc., is current/active as of 11/6/23. Permit type - four-star center license issued on 6/20/19. Special Services/Restrictions - daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/17/22. The last fire drill was practiced on 10/24/23. The last lockdown drill was practiced on 10/24/23. The last playground inspection was documented on 11/7/23. The last fire inspection was approved on 3/15/23. The last sanitation inspection was conducted on 11/21/22 with four (4) demerits for a superior classification. Sanitation inspection for the lunch room was conducted on 4/24/23 and the program for the school program was on 10/24/23. Please contact your Environmental Health Specialist to schedule an inspection in November. The Emergency Medical Care plan was posted and current. The curriculum for four-year-old children is Creative Curriculum. Upon arrival, I announced my presence and the purpose of the visit. In space #1, a group of infants engaged in various activities. One (1) of the teachers took three (3) infants for a walk in the Bye Bye Buggy while the other teacher cared for three (3) infants in the classroom. One (1) child was asleep in the crib, and the other two (2) children played on the floor. Sleep check was filled out for the child. In space #2, a group of four-to-five-year-old children engaged in free play using magnetic tiles toy vehicles, blocks, Legos, connecting cubes, and other toys. In space #3, a group of two-year-old children had lunch. Today’s menu was BBQ meatballs, hush puppies, green beans, pears, and milk. The items were listed on the menu. Some children brought lunch from home, but school lunch was also served to those children. In space #4, a group of two-to-three-year-old children engaged in discussions during a group time. The children and the teacher discussed what they were thankful for. The teacher also read books to the children. In space #5, a group of four-year-old children played on the playground. The children engaged in gross motor activities with slide structure, sandbox, a climber and tricycles. The mulch was measured for seven (7) inches on the preschool playground and all equipment were in good repair. In space #6, a group of one-to-two-year-old children transitioned from lunchtime to free play/getting ready for rest time. The children washed their hands and face after the lunch and played with materials in the classroom. One (1) teacher supervised handwashing and cleaned the tables, while the other teacher supervised and interacted with children. In space #7, a group of one-year-old children played and transitioned to the rest time. One (1) teacher checked and changed the children’s diapers while the other teacher supervised and interacted with children. In space #8, a group of infants and one-year-old children engaged in various activities. One (1) child was having lunch in the high chair. One (1) child was asleep in the crib and one (1) child was being changed. The shoulder straps for the high chair were removed. The child was buckled with waist strap. In space #9, which is used as a multi-purpose room, a group of children from space #10 had a music class. The music class is held every Mondays. The children engaged in song, dance and the review of different instruments. Infant/toddler playground was inspected. There were two (2) portable slide structures, three (3) play houses, riding toys and other gross motor accessories were available . Half of the playground is grassed, and the other half is covered with astroturf. Over-the-counter medications and emergency medications were monitored. In space #3, both action plan and the permission form for an Epi-pen were expired. In space #4, a permission form for an Epi-pen was not available for review. In space #7, a permission form for a diaper cream was expired. Supervision and interaction with children were adequate. Thirteen (13) children’s files, three (3) new staff members’ files and three (3) existing staff members’ files were monitored. One (1) of the children’s incident report was not filed in the child’s file. Confidential documents were not filed separately for all staff members. 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/ This facility does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #9 (room 113), two(2) containers of Clorox disinfecting wipes were accessible to children on the shelf. In space #4, two (2) containers of Clorox disinfecting wipes were stored on the shelf by the door accessible to children. .2820(b) 847 Parent's medication authorization did not include required information. In space #3, a permission form for an Epi-pen expired on 5/18/23. In space #4, a permission form for a child with Epi-pen was not available for review. 10A NCAC 09 .0803(4)(6-9) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. Incident report for a child was logged but the report was not in the child's file. .0802 (e) 861 Prohibited styrofoam and foam rubber products were accessible to children under 3 years of age and/or approved foam products were used without proper supervision. In space #4, Laura Lynn Ziplock bags and tall kitchen trash bags were accessible to children. .0604(q) 871 Center staff did not comply with the safe sleep policy. In space #1, a child slept with a pacifier with a pacifier holder/stuffed animal. The pacifier and the holder was out of the child's mouth. In space #8, at 11:40 am, the last sleep check for the child who was asleep was logged at 11:15 am. 10A NCAC 09 .0606(a) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #3, an action plan for a child with Epi-pen expired on 8/22/23. .0801(b) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Out of six (6) staff files I reviewed, confidential information for all six (6) staff members were maintained with other documents in the staff files. .0701(d) Technical Assistance were provided as follows: 840: Hazardous Materials Potentially hazardous materials, such as cleaners with a warning “keep out of reach of children” shall be maintained at least five (5) feet or above. Staff members shall store their personal items, such as purse out of reach of children as well. 15A NCAC 18A .2820 STORAGE aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. (c) Non-aerosol sanitizing, disinfecting, and detergent solutions, hand sanitizers, and hand lotions shall be kept out of reach of children when not in use but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent (soapy water) solutions. Hand soap other than that which is in bulk containers is not required to be kept out of reach of children or in locked storage. (f) Employee purses and other personal effects shall be kept out of reach of children. 847: Medication permission form Authorization to administer medication is required for all medications including epi-pen. The teachers shall not administer any types of medication without the authorization. Both Action plan and the permission form is required for all emergency medications. The permission form for prescription medication is valid for six (6) months. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 852: Incident Report: Incident report must be maintained in each child’s file after obtaining parent signature and logged on the incident log. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (e) The child care provider shall complete an incident report each time a child is injured as a result of an incident occurring while the child is in care. This incident report shall include: (1) facility identifying information; (2) the child's name; (3) date and time of the incident; (4) witness to the incident; (5) time the parent is notified of the incident and by whom; (6) piece of equipment involved, if applicable; (7) cause of injury, if applicable; (8) type of injury, if applicable; (9) body part injured, if applicable; (10) where the child received medical treatment, if applicable; (11) description of how and where the incident occurred, and the First Aid received; and (12) steps taken to prevent reoccurrence. This report shall be signed by the person completing it and by the parent, a copy given to the parent or a parent signature declining a copy and the report maintained in the child's file. A copy of the form may be found on the Division's website at http://ncchildcare.ncdhhs.gova 861: Easily Torn Plastics Easily torn plastics, including grocery bags, Ziplock bags, plastic wrappers and trash bags must be inaccessible to children under three (3) years of age. Please store them at least five (5) feet or above. 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. 871: Safe Sleep practice Infants, children at twelve (12) months of age or younger must sleep with no objects in the crib including blankets and stuffed animals. Pacifier hold shall be removed from the crib when the child sleeps in the crib. Sleep checks for infants shall be completed at least every fifteen (15) minutes. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (2) 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 with a sleeping infant aged 12 months or younger; (6) specifies that caregivers shall visually check, in person, sleeping infants aged 12 months or younger at least every 15 minutes; 1835: Action Plan Action plan for asthma is required. The plan shall be renewed annually and stay valid. The action plan is valid for twelve (12) months. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/ 1890: Confidential information Confidential information (medial statement, TB results and Health Questionnaire) shall be maintained separately from the other documents in staff files. Please note that Emergency Information form is not a confidential information. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. Technical assistance was provided as follows: You will document the rule reference and specifics about the violations here. Provide your discussion with the operator and/or TA you provided. Best practice can go here too. 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 11/27/23 Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013 or email kaoru.eddins@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: Sleep check documents: 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. Staff and Training Worksheet: Item #5: Orientation Please put dates for this section. If the orientation was offered prior to two (2) weeks/six (6) weeks requirements, only the date of completion be filled. Item #11: Emergency information and Health Questionnaire: Please put dates for this section. Both forms shall be updated annually. Item #17: Health and Safety training The date of completion of the training goes here, rather than the next due date. Item #25/#26: EPR and EMC review The facility’s EPR and EMC review is included in the new staff orientation. The annual review for both documents are required for all existing staff members as well. I suggest leaving documentation of the review for each staff member. Attendance roster or acknowledgement form is suggested. Sanitation inspection: Your last sanitation inspection was completed on 11/21/22. If you don’t receive sanitation inspection soon, please contact your Environmental Health Specialist. A sanitation inspection shall be completed before 11/30/23. If you have any questions or concerns regarding the Stabilization, Expansion and Access 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 11/13/2023 Number Present: 97 Completed Date: 11/13/2023 Age: From 0 To 5 Total Minutes: 315 Time In: 11:00 AM Time Out: 04:15 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 Kaoru Eddins, Child Care Consultant and also signed by Chrstine Smith, Administrator, during the visit. An electronic signed copy of the visit summary was printed and left with you. Today, Christine Smith, Administrator, was available during the visit. Limited monitoring of child care rules was conducted, including but not limited to 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 ninety (90) percentage as of 11/6/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Emmanuel Lutheran Church of Asheville, N.C, Inc., is current/active as of 11/6/23. Permit type - four-star center license issued on 6/20/19. Special Services/Restrictions - daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/17/22. The last fire drill was practiced on 10/24/23. The last lockdown drill was practiced on 10/24/23. The last playground inspection was documented on 11/7/23. The last fire inspection was approved on 3/15/23. The last sanitation inspection was conducted on 11/21/22 with four (4) demerits for a superior classification. Sanitation inspection for the lunch room was conducted on 4/24/23 and the program for the school program was on 10/24/23. Please contact your Environmental Health Specialist to schedule an inspection in November. The Emergency Medical Care plan was posted and current. The curriculum for four-year-old children is Creative Curriculum. Upon arrival, I announced my presence and the purpose of the visit. In space #1, a group of infants engaged in various activities. One (1) of the teachers took three (3) infants for a walk in the Bye Bye Buggy while the other teacher cared for three (3) infants in the classroom. One (1) child was asleep in the crib, and the other two (2) children played on the floor. Sleep check was filled out for the child. In space #2, a group of four-to-five-year-old children engaged in free play using magnetic tiles toy vehicles, blocks, Legos, connecting cubes, and other toys. In space #3, a group of two-year-old children had lunch. Today’s menu was BBQ meatballs, hush puppies, green beans, pears, and milk. The items were listed on the menu. Some children brought lunch from home, but school lunch was also served to those children. In space #4, a group of two-to-three-year-old children engaged in discussions during a group time. The children and the teacher discussed what they were thankful for. The teacher also read books to the children. In space #5, a group of four-year-old children played on the playground. The children engaged in gross motor activities with slide structure, sandbox, a climber and tricycles. The mulch was measured for seven (7) inches on the preschool playground and all equipment were in good repair. In space #6, a group of one-to-two-year-old children transitioned from lunchtime to free play/getting ready for rest time. The children washed their hands and face after the lunch and played with materials in the classroom. One (1) teacher supervised handwashing and cleaned the tables, while the other teacher supervised and interacted with children. In space #7, a group of one-year-old children played and transitioned to the rest time. One (1) teacher checked and changed the children’s diapers while the other teacher supervised and interacted with children. In space #8, a group of infants and one-year-old children engaged in various activities. One (1) child was having lunch in the high chair. One (1) child was asleep in the crib and one (1) child was being changed. The shoulder straps for the high chair were removed. The child was buckled with waist strap. In space #9, which is used as a multi-purpose room, a group of children from space #10 had a music class. The music class is held every Mondays. The children engaged in song, dance and the review of different instruments. Infant/toddler playground was inspected. There were two (2) portable slide structures, three (3) play houses, riding toys and other gross motor accessories were available . Half of the playground is grassed, and the other half is covered with astroturf. Over-the-counter medications and emergency medications were monitored. In space #3, both action plan and the permission form for an Epi-pen were expired. In space #4, a permission form for an Epi-pen was not available for review. In space #7, a permission form for a diaper cream was expired. Supervision and interaction with children were adequate. Thirteen (13) children’s files, three (3) new staff members’ files and three (3) existing staff members’ files were monitored. One (1) of the children’s incident report was not filed in the child’s file. Confidential documents were not filed separately for all staff members. 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/ This facility does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #9 (room 113), two(2) containers of Clorox disinfecting wipes were accessible to children on the shelf. In space #4, two (2) containers of Clorox disinfecting wipes were stored on the shelf by the door accessible to children. .2820(b) 847 Parent's medication authorization did not include required information. In space #3, a permission form for an Epi-pen expired on 5/18/23. In space #4, a permission form for a child with Epi-pen was not available for review. 10A NCAC 09 .0803(4)(6-9) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. Incident report for a child was logged but the report was not in the child's file. .0802 (e) 861 Prohibited styrofoam and foam rubber products were accessible to children under 3 years of age and/or approved foam products were used without proper supervision. In space #4, Laura Lynn Ziplock bags and tall kitchen trash bags were accessible to children. .0604(q) 871 Center staff did not comply with the safe sleep policy. In space #1, a child slept with a pacifier with a pacifier holder/stuffed animal. The pacifier and the holder was out of the child's mouth. In space #8, at 11:40 am, the last sleep check for the child who was asleep was logged at 11:15 am. 10A NCAC 09 .0606(a) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #3, an action plan for a child with Epi-pen expired on 8/22/23. .0801(b) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Out of six (6) staff files I reviewed, confidential information for all six (6) staff members were maintained with other documents in the staff files. .0701(d) Technical Assistance were provided as follows: 840: Hazardous Materials Potentially hazardous materials, such as cleaners with a warning “keep out of reach of children” shall be maintained at least five (5) feet or above. Staff members shall store their personal items, such as purse out of reach of children as well. 15A NCAC 18A .2820 STORAGE aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. (c) Non-aerosol sanitizing, disinfecting, and detergent solutions, hand sanitizers, and hand lotions shall be kept out of reach of children when not in use but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent (soapy water) solutions. Hand soap other than that which is in bulk containers is not required to be kept out of reach of children or in locked storage. (f) Employee purses and other personal effects shall be kept out of reach of children. 847: Medication permission form Authorization to administer medication is required for all medications including epi-pen. The teachers shall not administer any types of medication without the authorization. Both Action plan and the permission form is required for all emergency medications. The permission form for prescription medication is valid for six (6) months. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 852: Incident Report: Incident report must be maintained in each child’s file after obtaining parent signature and logged on the incident log. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (e) The child care provider shall complete an incident report each time a child is injured as a result of an incident occurring while the child is in care. This incident report shall include: (1) facility identifying information; (2) the child's name; (3) date and time of the incident; (4) witness to the incident; (5) time the parent is notified of the incident and by whom; (6) piece of equipment involved, if applicable; (7) cause of injury, if applicable; (8) type of injury, if applicable; (9) body part injured, if applicable; (10) where the child received medical treatment, if applicable; (11) description of how and where the incident occurred, and the First Aid received; and (12) steps taken to prevent reoccurrence. This report shall be signed by the person completing it and by the parent, a copy given to the parent or a parent signature declining a copy and the report maintained in the child's file. A copy of the form may be found on the Division's website at http://ncchildcare.ncdhhs.gova 861: Easily Torn Plastics Easily torn plastics, including grocery bags, Ziplock bags, plastic wrappers and trash bags must be inaccessible to children under three (3) years of age. Please store them at least five (5) feet or above. 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. 871: Safe Sleep practice Infants, children at twelve (12) months of age or younger must sleep with no objects in the crib including blankets and stuffed animals. Pacifier hold shall be removed from the crib when the child sleeps in the crib. Sleep checks for infants shall be completed at least every fifteen (15) minutes. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (2) 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 with a sleeping infant aged 12 months or younger; (6) specifies that caregivers shall visually check, in person, sleeping infants aged 12 months or younger at least every 15 minutes; 1835: Action Plan Action plan for asthma is required. The plan shall be renewed annually and stay valid. The action plan is valid for twelve (12) months. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/ 1890: Confidential information Confidential information (medial statement, TB results and Health Questionnaire) shall be maintained separately from the other documents in staff files. Please note that Emergency Information form is not a confidential information. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. Technical assistance was provided as follows: You will document the rule reference and specifics about the violations here. Provide your discussion with the operator and/or TA you provided. Best practice can go here too. 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 11/27/23 Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013 or email kaoru.eddins@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: Sleep check documents: 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. Staff and Training Worksheet: Item #5: Orientation Please put dates for this section. If the orientation was offered prior to two (2) weeks/six (6) weeks requirements, only the date of completion be filled. Item #11: Emergency information and Health Questionnaire: Please put dates for this section. Both forms shall be updated annually. Item #17: Health and Safety training The date of completion of the training goes here, rather than the next due date. Item #25/#26: EPR and EMC review The facility’s EPR and EMC review is included in the new staff orientation. The annual review for both documents are required for all existing staff members as well. I suggest leaving documentation of the review for each staff member. Attendance roster or acknowledgement form is suggested. Sanitation inspection: Your last sanitation inspection was completed on 11/21/22. If you don’t receive sanitation inspection soon, please contact your Environmental Health Specialist. A sanitation inspection shall be completed before 11/30/23. If you have any questions or concerns regarding the Stabilization, Expansion and Access 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 11/13/2023 Number Present: 97 Completed Date: 11/13/2023 Age: From 0 To 5 Total Minutes: 315 Time In: 11:00 AM Time Out: 04:15 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 Kaoru Eddins, Child Care Consultant and also signed by Chrstine Smith, Administrator, during the visit. An electronic signed copy of the visit summary was printed and left with you. Today, Christine Smith, Administrator, was available during the visit. Limited monitoring of child care rules was conducted, including but not limited to 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 ninety (90) percentage as of 11/6/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Emmanuel Lutheran Church of Asheville, N.C, Inc., is current/active as of 11/6/23. Permit type - four-star center license issued on 6/20/19. Special Services/Restrictions - daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/17/22. The last fire drill was practiced on 10/24/23. The last lockdown drill was practiced on 10/24/23. The last playground inspection was documented on 11/7/23. The last fire inspection was approved on 3/15/23. The last sanitation inspection was conducted on 11/21/22 with four (4) demerits for a superior classification. Sanitation inspection for the lunch room was conducted on 4/24/23 and the program for the school program was on 10/24/23. Please contact your Environmental Health Specialist to schedule an inspection in November. The Emergency Medical Care plan was posted and current. The curriculum for four-year-old children is Creative Curriculum. Upon arrival, I announced my presence and the purpose of the visit. In space #1, a group of infants engaged in various activities. One (1) of the teachers took three (3) infants for a walk in the Bye Bye Buggy while the other teacher cared for three (3) infants in the classroom. One (1) child was asleep in the crib, and the other two (2) children played on the floor. Sleep check was filled out for the child. In space #2, a group of four-to-five-year-old children engaged in free play using magnetic tiles toy vehicles, blocks, Legos, connecting cubes, and other toys. In space #3, a group of two-year-old children had lunch. Today’s menu was BBQ meatballs, hush puppies, green beans, pears, and milk. The items were listed on the menu. Some children brought lunch from home, but school lunch was also served to those children. In space #4, a group of two-to-three-year-old children engaged in discussions during a group time. The children and the teacher discussed what they were thankful for. The teacher also read books to the children. In space #5, a group of four-year-old children played on the playground. The children engaged in gross motor activities with slide structure, sandbox, a climber and tricycles. The mulch was measured for seven (7) inches on the preschool playground and all equipment were in good repair. In space #6, a group of one-to-two-year-old children transitioned from lunchtime to free play/getting ready for rest time. The children washed their hands and face after the lunch and played with materials in the classroom. One (1) teacher supervised handwashing and cleaned the tables, while the other teacher supervised and interacted with children. In space #7, a group of one-year-old children played and transitioned to the rest time. One (1) teacher checked and changed the children’s diapers while the other teacher supervised and interacted with children. In space #8, a group of infants and one-year-old children engaged in various activities. One (1) child was having lunch in the high chair. One (1) child was asleep in the crib and one (1) child was being changed. The shoulder straps for the high chair were removed. The child was buckled with waist strap. In space #9, which is used as a multi-purpose room, a group of children from space #10 had a music class. The music class is held every Mondays. The children engaged in song, dance and the review of different instruments. Infant/toddler playground was inspected. There were two (2) portable slide structures, three (3) play houses, riding toys and other gross motor accessories were available . Half of the playground is grassed, and the other half is covered with astroturf. Over-the-counter medications and emergency medications were monitored. In space #3, both action plan and the permission form for an Epi-pen were expired. In space #4, a permission form for an Epi-pen was not available for review. In space #7, a permission form for a diaper cream was expired. Supervision and interaction with children were adequate. Thirteen (13) children’s files, three (3) new staff members’ files and three (3) existing staff members’ files were monitored. One (1) of the children’s incident report was not filed in the child’s file. Confidential documents were not filed separately for all staff members. 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/ This facility does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #9 (room 113), two(2) containers of Clorox disinfecting wipes were accessible to children on the shelf. In space #4, two (2) containers of Clorox disinfecting wipes were stored on the shelf by the door accessible to children. .2820(b) 847 Parent's medication authorization did not include required information. In space #3, a permission form for an Epi-pen expired on 5/18/23. In space #4, a permission form for a child with Epi-pen was not available for review. 10A NCAC 09 .0803(4)(6-9) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. Incident report for a child was logged but the report was not in the child's file. .0802 (e) 861 Prohibited styrofoam and foam rubber products were accessible to children under 3 years of age and/or approved foam products were used without proper supervision. In space #4, Laura Lynn Ziplock bags and tall kitchen trash bags were accessible to children. .0604(q) 871 Center staff did not comply with the safe sleep policy. In space #1, a child slept with a pacifier with a pacifier holder/stuffed animal. The pacifier and the holder was out of the child's mouth. In space #8, at 11:40 am, the last sleep check for the child who was asleep was logged at 11:15 am. 10A NCAC 09 .0606(a) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #3, an action plan for a child with Epi-pen expired on 8/22/23. .0801(b) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Out of six (6) staff files I reviewed, confidential information for all six (6) staff members were maintained with other documents in the staff files. .0701(d) Technical Assistance were provided as follows: 840: Hazardous Materials Potentially hazardous materials, such as cleaners with a warning “keep out of reach of children” shall be maintained at least five (5) feet or above. Staff members shall store their personal items, such as purse out of reach of children as well. 15A NCAC 18A .2820 STORAGE aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. (c) Non-aerosol sanitizing, disinfecting, and detergent solutions, hand sanitizers, and hand lotions shall be kept out of reach of children when not in use but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent (soapy water) solutions. Hand soap other than that which is in bulk containers is not required to be kept out of reach of children or in locked storage. (f) Employee purses and other personal effects shall be kept out of reach of children. 847: Medication permission form Authorization to administer medication is required for all medications including epi-pen. The teachers shall not administer any types of medication without the authorization. Both Action plan and the permission form is required for all emergency medications. The permission form for prescription medication is valid for six (6) months. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 852: Incident Report: Incident report must be maintained in each child’s file after obtaining parent signature and logged on the incident log. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (e) The child care provider shall complete an incident report each time a child is injured as a result of an incident occurring while the child is in care. This incident report shall include: (1) facility identifying information; (2) the child's name; (3) date and time of the incident; (4) witness to the incident; (5) time the parent is notified of the incident and by whom; (6) piece of equipment involved, if applicable; (7) cause of injury, if applicable; (8) type of injury, if applicable; (9) body part injured, if applicable; (10) where the child received medical treatment, if applicable; (11) description of how and where the incident occurred, and the First Aid received; and (12) steps taken to prevent reoccurrence. This report shall be signed by the person completing it and by the parent, a copy given to the parent or a parent signature declining a copy and the report maintained in the child's file. A copy of the form may be found on the Division's website at http://ncchildcare.ncdhhs.gova 861: Easily Torn Plastics Easily torn plastics, including grocery bags, Ziplock bags, plastic wrappers and trash bags must be inaccessible to children under three (3) years of age. Please store them at least five (5) feet or above. 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. 871: Safe Sleep practice Infants, children at twelve (12) months of age or younger must sleep with no objects in the crib including blankets and stuffed animals. Pacifier hold shall be removed from the crib when the child sleeps in the crib. Sleep checks for infants shall be completed at least every fifteen (15) minutes. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (2) 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 with a sleeping infant aged 12 months or younger; (6) specifies that caregivers shall visually check, in person, sleeping infants aged 12 months or younger at least every 15 minutes; 1835: Action Plan Action plan for asthma is required. The plan shall be renewed annually and stay valid. The action plan is valid for twelve (12) months. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/ 1890: Confidential information Confidential information (medial statement, TB results and Health Questionnaire) shall be maintained separately from the other documents in staff files. Please note that Emergency Information form is not a confidential information. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. Technical assistance was provided as follows: You will document the rule reference and specifics about the violations here. Provide your discussion with the operator and/or TA you provided. Best practice can go here too. 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 11/27/23 Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013 or email kaoru.eddins@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: Sleep check documents: 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. Staff and Training Worksheet: Item #5: Orientation Please put dates for this section. If the orientation was offered prior to two (2) weeks/six (6) weeks requirements, only the date of completion be filled. Item #11: Emergency information and Health Questionnaire: Please put dates for this section. Both forms shall be updated annually. Item #17: Health and Safety training The date of completion of the training goes here, rather than the next due date. Item #25/#26: EPR and EMC review The facility’s EPR and EMC review is included in the new staff orientation. The annual review for both documents are required for all existing staff members as well. I suggest leaving documentation of the review for each staff member. Attendance roster or acknowledgement form is suggested. Sanitation inspection: Your last sanitation inspection was completed on 11/21/22. If you don’t receive sanitation inspection soon, please contact your Environmental Health Specialist. A sanitation inspection shall be completed before 11/30/23. If you have any questions or concerns regarding the Stabilization, Expansion and Access 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 11/13/2023 Number Present: 97 Completed Date: 11/13/2023 Age: From 0 To 5 Total Minutes: 315 Time In: 11:00 AM Time Out: 04:15 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 Kaoru Eddins, Child Care Consultant and also signed by Chrstine Smith, Administrator, during the visit. An electronic signed copy of the visit summary was printed and left with you. Today, Christine Smith, Administrator, was available during the visit. Limited monitoring of child care rules was conducted, including but not limited to 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 ninety (90) percentage as of 11/6/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Emmanuel Lutheran Church of Asheville, N.C, Inc., is current/active as of 11/6/23. Permit type - four-star center license issued on 6/20/19. Special Services/Restrictions - daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/17/22. The last fire drill was practiced on 10/24/23. The last lockdown drill was practiced on 10/24/23. The last playground inspection was documented on 11/7/23. The last fire inspection was approved on 3/15/23. The last sanitation inspection was conducted on 11/21/22 with four (4) demerits for a superior classification. Sanitation inspection for the lunch room was conducted on 4/24/23 and the program for the school program was on 10/24/23. Please contact your Environmental Health Specialist to schedule an inspection in November. The Emergency Medical Care plan was posted and current. The curriculum for four-year-old children is Creative Curriculum. Upon arrival, I announced my presence and the purpose of the visit. In space #1, a group of infants engaged in various activities. One (1) of the teachers took three (3) infants for a walk in the Bye Bye Buggy while the other teacher cared for three (3) infants in the classroom. One (1) child was asleep in the crib, and the other two (2) children played on the floor. Sleep check was filled out for the child. In space #2, a group of four-to-five-year-old children engaged in free play using magnetic tiles toy vehicles, blocks, Legos, connecting cubes, and other toys. In space #3, a group of two-year-old children had lunch. Today’s menu was BBQ meatballs, hush puppies, green beans, pears, and milk. The items were listed on the menu. Some children brought lunch from home, but school lunch was also served to those children. In space #4, a group of two-to-three-year-old children engaged in discussions during a group time. The children and the teacher discussed what they were thankful for. The teacher also read books to the children. In space #5, a group of four-year-old children played on the playground. The children engaged in gross motor activities with slide structure, sandbox, a climber and tricycles. The mulch was measured for seven (7) inches on the preschool playground and all equipment were in good repair. In space #6, a group of one-to-two-year-old children transitioned from lunchtime to free play/getting ready for rest time. The children washed their hands and face after the lunch and played with materials in the classroom. One (1) teacher supervised handwashing and cleaned the tables, while the other teacher supervised and interacted with children. In space #7, a group of one-year-old children played and transitioned to the rest time. One (1) teacher checked and changed the children’s diapers while the other teacher supervised and interacted with children. In space #8, a group of infants and one-year-old children engaged in various activities. One (1) child was having lunch in the high chair. One (1) child was asleep in the crib and one (1) child was being changed. The shoulder straps for the high chair were removed. The child was buckled with waist strap. In space #9, which is used as a multi-purpose room, a group of children from space #10 had a music class. The music class is held every Mondays. The children engaged in song, dance and the review of different instruments. Infant/toddler playground was inspected. There were two (2) portable slide structures, three (3) play houses, riding toys and other gross motor accessories were available . Half of the playground is grassed, and the other half is covered with astroturf. Over-the-counter medications and emergency medications were monitored. In space #3, both action plan and the permission form for an Epi-pen were expired. In space #4, a permission form for an Epi-pen was not available for review. In space #7, a permission form for a diaper cream was expired. Supervision and interaction with children were adequate. Thirteen (13) children’s files, three (3) new staff members’ files and three (3) existing staff members’ files were monitored. One (1) of the children’s incident report was not filed in the child’s file. Confidential documents were not filed separately for all staff members. 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/ This facility does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #9 (room 113), two(2) containers of Clorox disinfecting wipes were accessible to children on the shelf. In space #4, two (2) containers of Clorox disinfecting wipes were stored on the shelf by the door accessible to children. .2820(b) 847 Parent's medication authorization did not include required information. In space #3, a permission form for an Epi-pen expired on 5/18/23. In space #4, a permission form for a child with Epi-pen was not available for review. 10A NCAC 09 .0803(4)(6-9) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. Incident report for a child was logged but the report was not in the child's file. .0802 (e) 861 Prohibited styrofoam and foam rubber products were accessible to children under 3 years of age and/or approved foam products were used without proper supervision. In space #4, Laura Lynn Ziplock bags and tall kitchen trash bags were accessible to children. .0604(q) 871 Center staff did not comply with the safe sleep policy. In space #1, a child slept with a pacifier with a pacifier holder/stuffed animal. The pacifier and the holder was out of the child's mouth. In space #8, at 11:40 am, the last sleep check for the child who was asleep was logged at 11:15 am. 10A NCAC 09 .0606(a) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #3, an action plan for a child with Epi-pen expired on 8/22/23. .0801(b) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Out of six (6) staff files I reviewed, confidential information for all six (6) staff members were maintained with other documents in the staff files. .0701(d) Technical Assistance were provided as follows: 840: Hazardous Materials Potentially hazardous materials, such as cleaners with a warning “keep out of reach of children” shall be maintained at least five (5) feet or above. Staff members shall store their personal items, such as purse out of reach of children as well. 15A NCAC 18A .2820 STORAGE aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. (c) Non-aerosol sanitizing, disinfecting, and detergent solutions, hand sanitizers, and hand lotions shall be kept out of reach of children when not in use but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent (soapy water) solutions. Hand soap other than that which is in bulk containers is not required to be kept out of reach of children or in locked storage. (f) Employee purses and other personal effects shall be kept out of reach of children. 847: Medication permission form Authorization to administer medication is required for all medications including epi-pen. The teachers shall not administer any types of medication without the authorization. Both Action plan and the permission form is required for all emergency medications. The permission form for prescription medication is valid for six (6) months. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 852: Incident Report: Incident report must be maintained in each child’s file after obtaining parent signature and logged on the incident log. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (e) The child care provider shall complete an incident report each time a child is injured as a result of an incident occurring while the child is in care. This incident report shall include: (1) facility identifying information; (2) the child's name; (3) date and time of the incident; (4) witness to the incident; (5) time the parent is notified of the incident and by whom; (6) piece of equipment involved, if applicable; (7) cause of injury, if applicable; (8) type of injury, if applicable; (9) body part injured, if applicable; (10) where the child received medical treatment, if applicable; (11) description of how and where the incident occurred, and the First Aid received; and (12) steps taken to prevent reoccurrence. This report shall be signed by the person completing it and by the parent, a copy given to the parent or a parent signature declining a copy and the report maintained in the child's file. A copy of the form may be found on the Division's website at http://ncchildcare.ncdhhs.gova 861: Easily Torn Plastics Easily torn plastics, including grocery bags, Ziplock bags, plastic wrappers and trash bags must be inaccessible to children under three (3) years of age. Please store them at least five (5) feet or above. 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. 871: Safe Sleep practice Infants, children at twelve (12) months of age or younger must sleep with no objects in the crib including blankets and stuffed animals. Pacifier hold shall be removed from the crib when the child sleeps in the crib. Sleep checks for infants shall be completed at least every fifteen (15) minutes. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (2) 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 with a sleeping infant aged 12 months or younger; (6) specifies that caregivers shall visually check, in person, sleeping infants aged 12 months or younger at least every 15 minutes; 1835: Action Plan Action plan for asthma is required. The plan shall be renewed annually and stay valid. The action plan is valid for twelve (12) months. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/ 1890: Confidential information Confidential information (medial statement, TB results and Health Questionnaire) shall be maintained separately from the other documents in staff files. Please note that Emergency Information form is not a confidential information. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. Technical assistance was provided as follows: You will document the rule reference and specifics about the violations here. Provide your discussion with the operator and/or TA you provided. Best practice can go here too. 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 11/27/23 Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013 or email kaoru.eddins@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: Sleep check documents: 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. Staff and Training Worksheet: Item #5: Orientation Please put dates for this section. If the orientation was offered prior to two (2) weeks/six (6) weeks requirements, only the date of completion be filled. Item #11: Emergency information and Health Questionnaire: Please put dates for this section. Both forms shall be updated annually. Item #17: Health and Safety training The date of completion of the training goes here, rather than the next due date. Item #25/#26: EPR and EMC review The facility’s EPR and EMC review is included in the new staff orientation. The annual review for both documents are required for all existing staff members as well. I suggest leaving documentation of the review for each staff member. Attendance roster or acknowledgement form is suggested. Sanitation inspection: Your last sanitation inspection was completed on 11/21/22. If you don’t receive sanitation inspection soon, please contact your Environmental Health Specialist. A sanitation inspection shall be completed before 11/30/23. If you have any questions or concerns regarding the Stabilization, Expansion and Access 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 11/13/2023 Number Present: 97 Completed Date: 11/13/2023 Age: From 0 To 5 Total Minutes: 315 Time In: 11:00 AM Time Out: 04:15 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 Kaoru Eddins, Child Care Consultant and also signed by Chrstine Smith, Administrator, during the visit. An electronic signed copy of the visit summary was printed and left with you. Today, Christine Smith, Administrator, was available during the visit. Limited monitoring of child care rules was conducted, including but not limited to 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 ninety (90) percentage as of 11/6/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Emmanuel Lutheran Church of Asheville, N.C, Inc., is current/active as of 11/6/23. Permit type - four-star center license issued on 6/20/19. Special Services/Restrictions - daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/17/22. The last fire drill was practiced on 10/24/23. The last lockdown drill was practiced on 10/24/23. The last playground inspection was documented on 11/7/23. The last fire inspection was approved on 3/15/23. The last sanitation inspection was conducted on 11/21/22 with four (4) demerits for a superior classification. Sanitation inspection for the lunch room was conducted on 4/24/23 and the program for the school program was on 10/24/23. Please contact your Environmental Health Specialist to schedule an inspection in November. The Emergency Medical Care plan was posted and current. The curriculum for four-year-old children is Creative Curriculum. Upon arrival, I announced my presence and the purpose of the visit. In space #1, a group of infants engaged in various activities. One (1) of the teachers took three (3) infants for a walk in the Bye Bye Buggy while the other teacher cared for three (3) infants in the classroom. One (1) child was asleep in the crib, and the other two (2) children played on the floor. Sleep check was filled out for the child. In space #2, a group of four-to-five-year-old children engaged in free play using magnetic tiles toy vehicles, blocks, Legos, connecting cubes, and other toys. In space #3, a group of two-year-old children had lunch. Today’s menu was BBQ meatballs, hush puppies, green beans, pears, and milk. The items were listed on the menu. Some children brought lunch from home, but school lunch was also served to those children. In space #4, a group of two-to-three-year-old children engaged in discussions during a group time. The children and the teacher discussed what they were thankful for. The teacher also read books to the children. In space #5, a group of four-year-old children played on the playground. The children engaged in gross motor activities with slide structure, sandbox, a climber and tricycles. The mulch was measured for seven (7) inches on the preschool playground and all equipment were in good repair. In space #6, a group of one-to-two-year-old children transitioned from lunchtime to free play/getting ready for rest time. The children washed their hands and face after the lunch and played with materials in the classroom. One (1) teacher supervised handwashing and cleaned the tables, while the other teacher supervised and interacted with children. In space #7, a group of one-year-old children played and transitioned to the rest time. One (1) teacher checked and changed the children’s diapers while the other teacher supervised and interacted with children. In space #8, a group of infants and one-year-old children engaged in various activities. One (1) child was having lunch in the high chair. One (1) child was asleep in the crib and one (1) child was being changed. The shoulder straps for the high chair were removed. The child was buckled with waist strap. In space #9, which is used as a multi-purpose room, a group of children from space #10 had a music class. The music class is held every Mondays. The children engaged in song, dance and the review of different instruments. Infant/toddler playground was inspected. There were two (2) portable slide structures, three (3) play houses, riding toys and other gross motor accessories were available . Half of the playground is grassed, and the other half is covered with astroturf. Over-the-counter medications and emergency medications were monitored. In space #3, both action plan and the permission form for an Epi-pen were expired. In space #4, a permission form for an Epi-pen was not available for review. In space #7, a permission form for a diaper cream was expired. Supervision and interaction with children were adequate. Thirteen (13) children’s files, three (3) new staff members’ files and three (3) existing staff members’ files were monitored. One (1) of the children’s incident report was not filed in the child’s file. Confidential documents were not filed separately for all staff members. 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/ This facility does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #9 (room 113), two(2) containers of Clorox disinfecting wipes were accessible to children on the shelf. In space #4, two (2) containers of Clorox disinfecting wipes were stored on the shelf by the door accessible to children. .2820(b) 847 Parent's medication authorization did not include required information. In space #3, a permission form for an Epi-pen expired on 5/18/23. In space #4, a permission form for a child with Epi-pen was not available for review. 10A NCAC 09 .0803(4)(6-9) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. Incident report for a child was logged but the report was not in the child's file. .0802 (e) 861 Prohibited styrofoam and foam rubber products were accessible to children under 3 years of age and/or approved foam products were used without proper supervision. In space #4, Laura Lynn Ziplock bags and tall kitchen trash bags were accessible to children. .0604(q) 871 Center staff did not comply with the safe sleep policy. In space #1, a child slept with a pacifier with a pacifier holder/stuffed animal. The pacifier and the holder was out of the child's mouth. In space #8, at 11:40 am, the last sleep check for the child who was asleep was logged at 11:15 am. 10A NCAC 09 .0606(a) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #3, an action plan for a child with Epi-pen expired on 8/22/23. .0801(b) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Out of six (6) staff files I reviewed, confidential information for all six (6) staff members were maintained with other documents in the staff files. .0701(d) Technical Assistance were provided as follows: 840: Hazardous Materials Potentially hazardous materials, such as cleaners with a warning “keep out of reach of children” shall be maintained at least five (5) feet or above. Staff members shall store their personal items, such as purse out of reach of children as well. 15A NCAC 18A .2820 STORAGE aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. (c) Non-aerosol sanitizing, disinfecting, and detergent solutions, hand sanitizers, and hand lotions shall be kept out of reach of children when not in use but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent (soapy water) solutions. Hand soap other than that which is in bulk containers is not required to be kept out of reach of children or in locked storage. (f) Employee purses and other personal effects shall be kept out of reach of children. 847: Medication permission form Authorization to administer medication is required for all medications including epi-pen. The teachers shall not administer any types of medication without the authorization. Both Action plan and the permission form is required for all emergency medications. The permission form for prescription medication is valid for six (6) months. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 852: Incident Report: Incident report must be maintained in each child’s file after obtaining parent signature and logged on the incident log. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (e) The child care provider shall complete an incident report each time a child is injured as a result of an incident occurring while the child is in care. This incident report shall include: (1) facility identifying information; (2) the child's name; (3) date and time of the incident; (4) witness to the incident; (5) time the parent is notified of the incident and by whom; (6) piece of equipment involved, if applicable; (7) cause of injury, if applicable; (8) type of injury, if applicable; (9) body part injured, if applicable; (10) where the child received medical treatment, if applicable; (11) description of how and where the incident occurred, and the First Aid received; and (12) steps taken to prevent reoccurrence. This report shall be signed by the person completing it and by the parent, a copy given to the parent or a parent signature declining a copy and the report maintained in the child's file. A copy of the form may be found on the Division's website at http://ncchildcare.ncdhhs.gova 861: Easily Torn Plastics Easily torn plastics, including grocery bags, Ziplock bags, plastic wrappers and trash bags must be inaccessible to children under three (3) years of age. Please store them at least five (5) feet or above. 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. 871: Safe Sleep practice Infants, children at twelve (12) months of age or younger must sleep with no objects in the crib including blankets and stuffed animals. Pacifier hold shall be removed from the crib when the child sleeps in the crib. Sleep checks for infants shall be completed at least every fifteen (15) minutes. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (2) 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 with a sleeping infant aged 12 months or younger; (6) specifies that caregivers shall visually check, in person, sleeping infants aged 12 months or younger at least every 15 minutes; 1835: Action Plan Action plan for asthma is required. The plan shall be renewed annually and stay valid. The action plan is valid for twelve (12) months. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/ 1890: Confidential information Confidential information (medial statement, TB results and Health Questionnaire) shall be maintained separately from the other documents in staff files. Please note that Emergency Information form is not a confidential information. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. Technical assistance was provided as follows: You will document the rule reference and specifics about the violations here. Provide your discussion with the operator and/or TA you provided. Best practice can go here too. 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 11/27/23 Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013 or email kaoru.eddins@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: Sleep check documents: 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. Staff and Training Worksheet: Item #5: Orientation Please put dates for this section. If the orientation was offered prior to two (2) weeks/six (6) weeks requirements, only the date of completion be filled. Item #11: Emergency information and Health Questionnaire: Please put dates for this section. Both forms shall be updated annually. Item #17: Health and Safety training The date of completion of the training goes here, rather than the next due date. Item #25/#26: EPR and EMC review The facility’s EPR and EMC review is included in the new staff orientation. The annual review for both documents are required for all existing staff members as well. I suggest leaving documentation of the review for each staff member. Attendance roster or acknowledgement form is suggested. Sanitation inspection: Your last sanitation inspection was completed on 11/21/22. If you don’t receive sanitation inspection soon, please contact your Environmental Health Specialist. A sanitation inspection shall be completed before 11/30/23. If you have any questions or concerns regarding the Stabilization, Expansion and Access 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 11/13/2023 Number Present: 97 Completed Date: 11/13/2023 Age: From 0 To 5 Total Minutes: 315 Time In: 11:00 AM Time Out: 04:15 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 Kaoru Eddins, Child Care Consultant and also signed by Chrstine Smith, Administrator, during the visit. An electronic signed copy of the visit summary was printed and left with you. Today, Christine Smith, Administrator, was available during the visit. Limited monitoring of child care rules was conducted, including but not limited to 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 ninety (90) percentage as of 11/6/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Emmanuel Lutheran Church of Asheville, N.C, Inc., is current/active as of 11/6/23. Permit type - four-star center license issued on 6/20/19. Special Services/Restrictions - daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/17/22. The last fire drill was practiced on 10/24/23. The last lockdown drill was practiced on 10/24/23. The last playground inspection was documented on 11/7/23. The last fire inspection was approved on 3/15/23. The last sanitation inspection was conducted on 11/21/22 with four (4) demerits for a superior classification. Sanitation inspection for the lunch room was conducted on 4/24/23 and the program for the school program was on 10/24/23. Please contact your Environmental Health Specialist to schedule an inspection in November. The Emergency Medical Care plan was posted and current. The curriculum for four-year-old children is Creative Curriculum. Upon arrival, I announced my presence and the purpose of the visit. In space #1, a group of infants engaged in various activities. One (1) of the teachers took three (3) infants for a walk in the Bye Bye Buggy while the other teacher cared for three (3) infants in the classroom. One (1) child was asleep in the crib, and the other two (2) children played on the floor. Sleep check was filled out for the child. In space #2, a group of four-to-five-year-old children engaged in free play using magnetic tiles toy vehicles, blocks, Legos, connecting cubes, and other toys. In space #3, a group of two-year-old children had lunch. Today’s menu was BBQ meatballs, hush puppies, green beans, pears, and milk. The items were listed on the menu. Some children brought lunch from home, but school lunch was also served to those children. In space #4, a group of two-to-three-year-old children engaged in discussions during a group time. The children and the teacher discussed what they were thankful for. The teacher also read books to the children. In space #5, a group of four-year-old children played on the playground. The children engaged in gross motor activities with slide structure, sandbox, a climber and tricycles. The mulch was measured for seven (7) inches on the preschool playground and all equipment were in good repair. In space #6, a group of one-to-two-year-old children transitioned from lunchtime to free play/getting ready for rest time. The children washed their hands and face after the lunch and played with materials in the classroom. One (1) teacher supervised handwashing and cleaned the tables, while the other teacher supervised and interacted with children. In space #7, a group of one-year-old children played and transitioned to the rest time. One (1) teacher checked and changed the children’s diapers while the other teacher supervised and interacted with children. In space #8, a group of infants and one-year-old children engaged in various activities. One (1) child was having lunch in the high chair. One (1) child was asleep in the crib and one (1) child was being changed. The shoulder straps for the high chair were removed. The child was buckled with waist strap. In space #9, which is used as a multi-purpose room, a group of children from space #10 had a music class. The music class is held every Mondays. The children engaged in song, dance and the review of different instruments. Infant/toddler playground was inspected. There were two (2) portable slide structures, three (3) play houses, riding toys and other gross motor accessories were available . Half of the playground is grassed, and the other half is covered with astroturf. Over-the-counter medications and emergency medications were monitored. In space #3, both action plan and the permission form for an Epi-pen were expired. In space #4, a permission form for an Epi-pen was not available for review. In space #7, a permission form for a diaper cream was expired. Supervision and interaction with children were adequate. Thirteen (13) children’s files, three (3) new staff members’ files and three (3) existing staff members’ files were monitored. One (1) of the children’s incident report was not filed in the child’s file. Confidential documents were not filed separately for all staff members. 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/ This facility does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #9 (room 113), two(2) containers of Clorox disinfecting wipes were accessible to children on the shelf. In space #4, two (2) containers of Clorox disinfecting wipes were stored on the shelf by the door accessible to children. .2820(b) 847 Parent's medication authorization did not include required information. In space #3, a permission form for an Epi-pen expired on 5/18/23. In space #4, a permission form for a child with Epi-pen was not available for review. 10A NCAC 09 .0803(4)(6-9) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. Incident report for a child was logged but the report was not in the child's file. .0802 (e) 861 Prohibited styrofoam and foam rubber products were accessible to children under 3 years of age and/or approved foam products were used without proper supervision. In space #4, Laura Lynn Ziplock bags and tall kitchen trash bags were accessible to children. .0604(q) 871 Center staff did not comply with the safe sleep policy. In space #1, a child slept with a pacifier with a pacifier holder/stuffed animal. The pacifier and the holder was out of the child's mouth. In space #8, at 11:40 am, the last sleep check for the child who was asleep was logged at 11:15 am. 10A NCAC 09 .0606(a) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #3, an action plan for a child with Epi-pen expired on 8/22/23. .0801(b) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Out of six (6) staff files I reviewed, confidential information for all six (6) staff members were maintained with other documents in the staff files. .0701(d) Technical Assistance were provided as follows: 840: Hazardous Materials Potentially hazardous materials, such as cleaners with a warning “keep out of reach of children” shall be maintained at least five (5) feet or above. Staff members shall store their personal items, such as purse out of reach of children as well. 15A NCAC 18A .2820 STORAGE aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. (c) Non-aerosol sanitizing, disinfecting, and detergent solutions, hand sanitizers, and hand lotions shall be kept out of reach of children when not in use but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent (soapy water) solutions. Hand soap other than that which is in bulk containers is not required to be kept out of reach of children or in locked storage. (f) Employee purses and other personal effects shall be kept out of reach of children. 847: Medication permission form Authorization to administer medication is required for all medications including epi-pen. The teachers shall not administer any types of medication without the authorization. Both Action plan and the permission form is required for all emergency medications. The permission form for prescription medication is valid for six (6) months. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 852: Incident Report: Incident report must be maintained in each child’s file after obtaining parent signature and logged on the incident log. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (e) The child care provider shall complete an incident report each time a child is injured as a result of an incident occurring while the child is in care. This incident report shall include: (1) facility identifying information; (2) the child's name; (3) date and time of the incident; (4) witness to the incident; (5) time the parent is notified of the incident and by whom; (6) piece of equipment involved, if applicable; (7) cause of injury, if applicable; (8) type of injury, if applicable; (9) body part injured, if applicable; (10) where the child received medical treatment, if applicable; (11) description of how and where the incident occurred, and the First Aid received; and (12) steps taken to prevent reoccurrence. This report shall be signed by the person completing it and by the parent, a copy given to the parent or a parent signature declining a copy and the report maintained in the child's file. A copy of the form may be found on the Division's website at http://ncchildcare.ncdhhs.gova 861: Easily Torn Plastics Easily torn plastics, including grocery bags, Ziplock bags, plastic wrappers and trash bags must be inaccessible to children under three (3) years of age. Please store them at least five (5) feet or above. 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. 871: Safe Sleep practice Infants, children at twelve (12) months of age or younger must sleep with no objects in the crib including blankets and stuffed animals. Pacifier hold shall be removed from the crib when the child sleeps in the crib. Sleep checks for infants shall be completed at least every fifteen (15) minutes. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (2) 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 with a sleeping infant aged 12 months or younger; (6) specifies that caregivers shall visually check, in person, sleeping infants aged 12 months or younger at least every 15 minutes; 1835: Action Plan Action plan for asthma is required. The plan shall be renewed annually and stay valid. The action plan is valid for twelve (12) months. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/ 1890: Confidential information Confidential information (medial statement, TB results and Health Questionnaire) shall be maintained separately from the other documents in staff files. Please note that Emergency Information form is not a confidential information. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. Technical assistance was provided as follows: You will document the rule reference and specifics about the violations here. Provide your discussion with the operator and/or TA you provided. Best practice can go here too. 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 11/27/23 Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013 or email kaoru.eddins@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: Sleep check documents: 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. Staff and Training Worksheet: Item #5: Orientation Please put dates for this section. If the orientation was offered prior to two (2) weeks/six (6) weeks requirements, only the date of completion be filled. Item #11: Emergency information and Health Questionnaire: Please put dates for this section. Both forms shall be updated annually. Item #17: Health and Safety training The date of completion of the training goes here, rather than the next due date. Item #25/#26: EPR and EMC review The facility’s EPR and EMC review is included in the new staff orientation. The annual review for both documents are required for all existing staff members as well. I suggest leaving documentation of the review for each staff member. Attendance roster or acknowledgement form is suggested. Sanitation inspection: Your last sanitation inspection was completed on 11/21/22. If you don’t receive sanitation inspection soon, please contact your Environmental Health Specialist. A sanitation inspection shall be completed before 11/30/23. If you have any questions or concerns regarding the Stabilization, Expansion and Access 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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 .0801 · Violation

Name of Operation: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 11/13/2023 Number Present: 97 Completed Date: 11/13/2023 Age: From 0 To 5 Total Minutes: 315 Time In: 11:00 AM Time Out: 04:15 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 Kaoru Eddins, Child Care Consultant and also signed by Chrstine Smith, Administrator, during the visit. An electronic signed copy of the visit summary was printed and left with you. Today, Christine Smith, Administrator, was available during the visit. Limited monitoring of child care rules was conducted, including but not limited to 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 ninety (90) percentage as of 11/6/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Emmanuel Lutheran Church of Asheville, N.C, Inc., is current/active as of 11/6/23. Permit type - four-star center license issued on 6/20/19. Special Services/Restrictions - daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/17/22. The last fire drill was practiced on 10/24/23. The last lockdown drill was practiced on 10/24/23. The last playground inspection was documented on 11/7/23. The last fire inspection was approved on 3/15/23. The last sanitation inspection was conducted on 11/21/22 with four (4) demerits for a superior classification. Sanitation inspection for the lunch room was conducted on 4/24/23 and the program for the school program was on 10/24/23. Please contact your Environmental Health Specialist to schedule an inspection in November. The Emergency Medical Care plan was posted and current. The curriculum for four-year-old children is Creative Curriculum. Upon arrival, I announced my presence and the purpose of the visit. In space #1, a group of infants engaged in various activities. One (1) of the teachers took three (3) infants for a walk in the Bye Bye Buggy while the other teacher cared for three (3) infants in the classroom. One (1) child was asleep in the crib, and the other two (2) children played on the floor. Sleep check was filled out for the child. In space #2, a group of four-to-five-year-old children engaged in free play using magnetic tiles toy vehicles, blocks, Legos, connecting cubes, and other toys. In space #3, a group of two-year-old children had lunch. Today’s menu was BBQ meatballs, hush puppies, green beans, pears, and milk. The items were listed on the menu. Some children brought lunch from home, but school lunch was also served to those children. In space #4, a group of two-to-three-year-old children engaged in discussions during a group time. The children and the teacher discussed what they were thankful for. The teacher also read books to the children. In space #5, a group of four-year-old children played on the playground. The children engaged in gross motor activities with slide structure, sandbox, a climber and tricycles. The mulch was measured for seven (7) inches on the preschool playground and all equipment were in good repair. In space #6, a group of one-to-two-year-old children transitioned from lunchtime to free play/getting ready for rest time. The children washed their hands and face after the lunch and played with materials in the classroom. One (1) teacher supervised handwashing and cleaned the tables, while the other teacher supervised and interacted with children. In space #7, a group of one-year-old children played and transitioned to the rest time. One (1) teacher checked and changed the children’s diapers while the other teacher supervised and interacted with children. In space #8, a group of infants and one-year-old children engaged in various activities. One (1) child was having lunch in the high chair. One (1) child was asleep in the crib and one (1) child was being changed. The shoulder straps for the high chair were removed. The child was buckled with waist strap. In space #9, which is used as a multi-purpose room, a group of children from space #10 had a music class. The music class is held every Mondays. The children engaged in song, dance and the review of different instruments. Infant/toddler playground was inspected. There were two (2) portable slide structures, three (3) play houses, riding toys and other gross motor accessories were available . Half of the playground is grassed, and the other half is covered with astroturf. Over-the-counter medications and emergency medications were monitored. In space #3, both action plan and the permission form for an Epi-pen were expired. In space #4, a permission form for an Epi-pen was not available for review. In space #7, a permission form for a diaper cream was expired. Supervision and interaction with children were adequate. Thirteen (13) children’s files, three (3) new staff members’ files and three (3) existing staff members’ files were monitored. One (1) of the children’s incident report was not filed in the child’s file. Confidential documents were not filed separately for all staff members. 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/ This facility does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #9 (room 113), two(2) containers of Clorox disinfecting wipes were accessible to children on the shelf. In space #4, two (2) containers of Clorox disinfecting wipes were stored on the shelf by the door accessible to children. .2820(b) 847 Parent's medication authorization did not include required information. In space #3, a permission form for an Epi-pen expired on 5/18/23. In space #4, a permission form for a child with Epi-pen was not available for review. 10A NCAC 09 .0803(4)(6-9) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. Incident report for a child was logged but the report was not in the child's file. .0802 (e) 861 Prohibited styrofoam and foam rubber products were accessible to children under 3 years of age and/or approved foam products were used without proper supervision. In space #4, Laura Lynn Ziplock bags and tall kitchen trash bags were accessible to children. .0604(q) 871 Center staff did not comply with the safe sleep policy. In space #1, a child slept with a pacifier with a pacifier holder/stuffed animal. The pacifier and the holder was out of the child's mouth. In space #8, at 11:40 am, the last sleep check for the child who was asleep was logged at 11:15 am. 10A NCAC 09 .0606(a) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #3, an action plan for a child with Epi-pen expired on 8/22/23. .0801(b) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Out of six (6) staff files I reviewed, confidential information for all six (6) staff members were maintained with other documents in the staff files. .0701(d) Technical Assistance were provided as follows: 840: Hazardous Materials Potentially hazardous materials, such as cleaners with a warning “keep out of reach of children” shall be maintained at least five (5) feet or above. Staff members shall store their personal items, such as purse out of reach of children as well. 15A NCAC 18A .2820 STORAGE aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. (c) Non-aerosol sanitizing, disinfecting, and detergent solutions, hand sanitizers, and hand lotions shall be kept out of reach of children when not in use but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent (soapy water) solutions. Hand soap other than that which is in bulk containers is not required to be kept out of reach of children or in locked storage. (f) Employee purses and other personal effects shall be kept out of reach of children. 847: Medication permission form Authorization to administer medication is required for all medications including epi-pen. The teachers shall not administer any types of medication without the authorization. Both Action plan and the permission form is required for all emergency medications. The permission form for prescription medication is valid for six (6) months. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 852: Incident Report: Incident report must be maintained in each child’s file after obtaining parent signature and logged on the incident log. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (e) The child care provider shall complete an incident report each time a child is injured as a result of an incident occurring while the child is in care. This incident report shall include: (1) facility identifying information; (2) the child's name; (3) date and time of the incident; (4) witness to the incident; (5) time the parent is notified of the incident and by whom; (6) piece of equipment involved, if applicable; (7) cause of injury, if applicable; (8) type of injury, if applicable; (9) body part injured, if applicable; (10) where the child received medical treatment, if applicable; (11) description of how and where the incident occurred, and the First Aid received; and (12) steps taken to prevent reoccurrence. This report shall be signed by the person completing it and by the parent, a copy given to the parent or a parent signature declining a copy and the report maintained in the child's file. A copy of the form may be found on the Division's website at http://ncchildcare.ncdhhs.gova 861: Easily Torn Plastics Easily torn plastics, including grocery bags, Ziplock bags, plastic wrappers and trash bags must be inaccessible to children under three (3) years of age. Please store them at least five (5) feet or above. 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. 871: Safe Sleep practice Infants, children at twelve (12) months of age or younger must sleep with no objects in the crib including blankets and stuffed animals. Pacifier hold shall be removed from the crib when the child sleeps in the crib. Sleep checks for infants shall be completed at least every fifteen (15) minutes. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (2) 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 with a sleeping infant aged 12 months or younger; (6) specifies that caregivers shall visually check, in person, sleeping infants aged 12 months or younger at least every 15 minutes; 1835: Action Plan Action plan for asthma is required. The plan shall be renewed annually and stay valid. The action plan is valid for twelve (12) months. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/ 1890: Confidential information Confidential information (medial statement, TB results and Health Questionnaire) shall be maintained separately from the other documents in staff files. Please note that Emergency Information form is not a confidential information. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. Technical assistance was provided as follows: You will document the rule reference and specifics about the violations here. Provide your discussion with the operator and/or TA you provided. Best practice can go here too. 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 11/27/23 Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013 or email kaoru.eddins@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: Sleep check documents: 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. Staff and Training Worksheet: Item #5: Orientation Please put dates for this section. If the orientation was offered prior to two (2) weeks/six (6) weeks requirements, only the date of completion be filled. Item #11: Emergency information and Health Questionnaire: Please put dates for this section. Both forms shall be updated annually. Item #17: Health and Safety training The date of completion of the training goes here, rather than the next due date. Item #25/#26: EPR and EMC review The facility’s EPR and EMC review is included in the new staff orientation. The annual review for both documents are required for all existing staff members as well. I suggest leaving documentation of the review for each staff member. Attendance roster or acknowledgement form is suggested. Sanitation inspection: Your last sanitation inspection was completed on 11/21/22. If you don’t receive sanitation inspection soon, please contact your Environmental Health Specialist. A sanitation inspection shall be completed before 11/30/23. If you have any questions or concerns regarding the Stabilization, Expansion and Access 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 11/13/2023 Number Present: 97 Completed Date: 11/13/2023 Age: From 0 To 5 Total Minutes: 315 Time In: 11:00 AM Time Out: 04:15 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 Kaoru Eddins, Child Care Consultant and also signed by Chrstine Smith, Administrator, during the visit. An electronic signed copy of the visit summary was printed and left with you. Today, Christine Smith, Administrator, was available during the visit. Limited monitoring of child care rules was conducted, including but not limited to 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 ninety (90) percentage as of 11/6/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Emmanuel Lutheran Church of Asheville, N.C, Inc., is current/active as of 11/6/23. Permit type - four-star center license issued on 6/20/19. Special Services/Restrictions - daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/17/22. The last fire drill was practiced on 10/24/23. The last lockdown drill was practiced on 10/24/23. The last playground inspection was documented on 11/7/23. The last fire inspection was approved on 3/15/23. The last sanitation inspection was conducted on 11/21/22 with four (4) demerits for a superior classification. Sanitation inspection for the lunch room was conducted on 4/24/23 and the program for the school program was on 10/24/23. Please contact your Environmental Health Specialist to schedule an inspection in November. The Emergency Medical Care plan was posted and current. The curriculum for four-year-old children is Creative Curriculum. Upon arrival, I announced my presence and the purpose of the visit. In space #1, a group of infants engaged in various activities. One (1) of the teachers took three (3) infants for a walk in the Bye Bye Buggy while the other teacher cared for three (3) infants in the classroom. One (1) child was asleep in the crib, and the other two (2) children played on the floor. Sleep check was filled out for the child. In space #2, a group of four-to-five-year-old children engaged in free play using magnetic tiles toy vehicles, blocks, Legos, connecting cubes, and other toys. In space #3, a group of two-year-old children had lunch. Today’s menu was BBQ meatballs, hush puppies, green beans, pears, and milk. The items were listed on the menu. Some children brought lunch from home, but school lunch was also served to those children. In space #4, a group of two-to-three-year-old children engaged in discussions during a group time. The children and the teacher discussed what they were thankful for. The teacher also read books to the children. In space #5, a group of four-year-old children played on the playground. The children engaged in gross motor activities with slide structure, sandbox, a climber and tricycles. The mulch was measured for seven (7) inches on the preschool playground and all equipment were in good repair. In space #6, a group of one-to-two-year-old children transitioned from lunchtime to free play/getting ready for rest time. The children washed their hands and face after the lunch and played with materials in the classroom. One (1) teacher supervised handwashing and cleaned the tables, while the other teacher supervised and interacted with children. In space #7, a group of one-year-old children played and transitioned to the rest time. One (1) teacher checked and changed the children’s diapers while the other teacher supervised and interacted with children. In space #8, a group of infants and one-year-old children engaged in various activities. One (1) child was having lunch in the high chair. One (1) child was asleep in the crib and one (1) child was being changed. The shoulder straps for the high chair were removed. The child was buckled with waist strap. In space #9, which is used as a multi-purpose room, a group of children from space #10 had a music class. The music class is held every Mondays. The children engaged in song, dance and the review of different instruments. Infant/toddler playground was inspected. There were two (2) portable slide structures, three (3) play houses, riding toys and other gross motor accessories were available . Half of the playground is grassed, and the other half is covered with astroturf. Over-the-counter medications and emergency medications were monitored. In space #3, both action plan and the permission form for an Epi-pen were expired. In space #4, a permission form for an Epi-pen was not available for review. In space #7, a permission form for a diaper cream was expired. Supervision and interaction with children were adequate. Thirteen (13) children’s files, three (3) new staff members’ files and three (3) existing staff members’ files were monitored. One (1) of the children’s incident report was not filed in the child’s file. Confidential documents were not filed separately for all staff members. 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/ This facility does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #9 (room 113), two(2) containers of Clorox disinfecting wipes were accessible to children on the shelf. In space #4, two (2) containers of Clorox disinfecting wipes were stored on the shelf by the door accessible to children. .2820(b) 847 Parent's medication authorization did not include required information. In space #3, a permission form for an Epi-pen expired on 5/18/23. In space #4, a permission form for a child with Epi-pen was not available for review. 10A NCAC 09 .0803(4)(6-9) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. Incident report for a child was logged but the report was not in the child's file. .0802 (e) 861 Prohibited styrofoam and foam rubber products were accessible to children under 3 years of age and/or approved foam products were used without proper supervision. In space #4, Laura Lynn Ziplock bags and tall kitchen trash bags were accessible to children. .0604(q) 871 Center staff did not comply with the safe sleep policy. In space #1, a child slept with a pacifier with a pacifier holder/stuffed animal. The pacifier and the holder was out of the child's mouth. In space #8, at 11:40 am, the last sleep check for the child who was asleep was logged at 11:15 am. 10A NCAC 09 .0606(a) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #3, an action plan for a child with Epi-pen expired on 8/22/23. .0801(b) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Out of six (6) staff files I reviewed, confidential information for all six (6) staff members were maintained with other documents in the staff files. .0701(d) Technical Assistance were provided as follows: 840: Hazardous Materials Potentially hazardous materials, such as cleaners with a warning “keep out of reach of children” shall be maintained at least five (5) feet or above. Staff members shall store their personal items, such as purse out of reach of children as well. 15A NCAC 18A .2820 STORAGE aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. (c) Non-aerosol sanitizing, disinfecting, and detergent solutions, hand sanitizers, and hand lotions shall be kept out of reach of children when not in use but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent (soapy water) solutions. Hand soap other than that which is in bulk containers is not required to be kept out of reach of children or in locked storage. (f) Employee purses and other personal effects shall be kept out of reach of children. 847: Medication permission form Authorization to administer medication is required for all medications including epi-pen. The teachers shall not administer any types of medication without the authorization. Both Action plan and the permission form is required for all emergency medications. The permission form for prescription medication is valid for six (6) months. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 852: Incident Report: Incident report must be maintained in each child’s file after obtaining parent signature and logged on the incident log. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (e) The child care provider shall complete an incident report each time a child is injured as a result of an incident occurring while the child is in care. This incident report shall include: (1) facility identifying information; (2) the child's name; (3) date and time of the incident; (4) witness to the incident; (5) time the parent is notified of the incident and by whom; (6) piece of equipment involved, if applicable; (7) cause of injury, if applicable; (8) type of injury, if applicable; (9) body part injured, if applicable; (10) where the child received medical treatment, if applicable; (11) description of how and where the incident occurred, and the First Aid received; and (12) steps taken to prevent reoccurrence. This report shall be signed by the person completing it and by the parent, a copy given to the parent or a parent signature declining a copy and the report maintained in the child's file. A copy of the form may be found on the Division's website at http://ncchildcare.ncdhhs.gova 861: Easily Torn Plastics Easily torn plastics, including grocery bags, Ziplock bags, plastic wrappers and trash bags must be inaccessible to children under three (3) years of age. Please store them at least five (5) feet or above. 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. 871: Safe Sleep practice Infants, children at twelve (12) months of age or younger must sleep with no objects in the crib including blankets and stuffed animals. Pacifier hold shall be removed from the crib when the child sleeps in the crib. Sleep checks for infants shall be completed at least every fifteen (15) minutes. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (2) 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 with a sleeping infant aged 12 months or younger; (6) specifies that caregivers shall visually check, in person, sleeping infants aged 12 months or younger at least every 15 minutes; 1835: Action Plan Action plan for asthma is required. The plan shall be renewed annually and stay valid. The action plan is valid for twelve (12) months. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/ 1890: Confidential information Confidential information (medial statement, TB results and Health Questionnaire) shall be maintained separately from the other documents in staff files. Please note that Emergency Information form is not a confidential information. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. Technical assistance was provided as follows: You will document the rule reference and specifics about the violations here. Provide your discussion with the operator and/or TA you provided. Best practice can go here too. 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 11/27/23 Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013 or email kaoru.eddins@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: Sleep check documents: 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. Staff and Training Worksheet: Item #5: Orientation Please put dates for this section. If the orientation was offered prior to two (2) weeks/six (6) weeks requirements, only the date of completion be filled. Item #11: Emergency information and Health Questionnaire: Please put dates for this section. Both forms shall be updated annually. Item #17: Health and Safety training The date of completion of the training goes here, rather than the next due date. Item #25/#26: EPR and EMC review The facility’s EPR and EMC review is included in the new staff orientation. The annual review for both documents are required for all existing staff members as well. I suggest leaving documentation of the review for each staff member. Attendance roster or acknowledgement form is suggested. Sanitation inspection: Your last sanitation inspection was completed on 11/21/22. If you don’t receive sanitation inspection soon, please contact your Environmental Health Specialist. A sanitation inspection shall be completed before 11/30/23. If you have any questions or concerns regarding the Stabilization, Expansion and Access 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 11/13/2023 Number Present: 97 Completed Date: 11/13/2023 Age: From 0 To 5 Total Minutes: 315 Time In: 11:00 AM Time Out: 04:15 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 Kaoru Eddins, Child Care Consultant and also signed by Chrstine Smith, Administrator, during the visit. An electronic signed copy of the visit summary was printed and left with you. Today, Christine Smith, Administrator, was available during the visit. Limited monitoring of child care rules was conducted, including but not limited to 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 ninety (90) percentage as of 11/6/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Emmanuel Lutheran Church of Asheville, N.C, Inc., is current/active as of 11/6/23. Permit type - four-star center license issued on 6/20/19. Special Services/Restrictions - daytime care, meets enhanced space and reduced ratios. The last annual compliance visit was conducted on 11/17/22. The last fire drill was practiced on 10/24/23. The last lockdown drill was practiced on 10/24/23. The last playground inspection was documented on 11/7/23. The last fire inspection was approved on 3/15/23. The last sanitation inspection was conducted on 11/21/22 with four (4) demerits for a superior classification. Sanitation inspection for the lunch room was conducted on 4/24/23 and the program for the school program was on 10/24/23. Please contact your Environmental Health Specialist to schedule an inspection in November. The Emergency Medical Care plan was posted and current. The curriculum for four-year-old children is Creative Curriculum. Upon arrival, I announced my presence and the purpose of the visit. In space #1, a group of infants engaged in various activities. One (1) of the teachers took three (3) infants for a walk in the Bye Bye Buggy while the other teacher cared for three (3) infants in the classroom. One (1) child was asleep in the crib, and the other two (2) children played on the floor. Sleep check was filled out for the child. In space #2, a group of four-to-five-year-old children engaged in free play using magnetic tiles toy vehicles, blocks, Legos, connecting cubes, and other toys. In space #3, a group of two-year-old children had lunch. Today’s menu was BBQ meatballs, hush puppies, green beans, pears, and milk. The items were listed on the menu. Some children brought lunch from home, but school lunch was also served to those children. In space #4, a group of two-to-three-year-old children engaged in discussions during a group time. The children and the teacher discussed what they were thankful for. The teacher also read books to the children. In space #5, a group of four-year-old children played on the playground. The children engaged in gross motor activities with slide structure, sandbox, a climber and tricycles. The mulch was measured for seven (7) inches on the preschool playground and all equipment were in good repair. In space #6, a group of one-to-two-year-old children transitioned from lunchtime to free play/getting ready for rest time. The children washed their hands and face after the lunch and played with materials in the classroom. One (1) teacher supervised handwashing and cleaned the tables, while the other teacher supervised and interacted with children. In space #7, a group of one-year-old children played and transitioned to the rest time. One (1) teacher checked and changed the children’s diapers while the other teacher supervised and interacted with children. In space #8, a group of infants and one-year-old children engaged in various activities. One (1) child was having lunch in the high chair. One (1) child was asleep in the crib and one (1) child was being changed. The shoulder straps for the high chair were removed. The child was buckled with waist strap. In space #9, which is used as a multi-purpose room, a group of children from space #10 had a music class. The music class is held every Mondays. The children engaged in song, dance and the review of different instruments. Infant/toddler playground was inspected. There were two (2) portable slide structures, three (3) play houses, riding toys and other gross motor accessories were available . Half of the playground is grassed, and the other half is covered with astroturf. Over-the-counter medications and emergency medications were monitored. In space #3, both action plan and the permission form for an Epi-pen were expired. In space #4, a permission form for an Epi-pen was not available for review. In space #7, a permission form for a diaper cream was expired. Supervision and interaction with children were adequate. Thirteen (13) children’s files, three (3) new staff members’ files and three (3) existing staff members’ files were monitored. One (1) of the children’s incident report was not filed in the child’s file. Confidential documents were not filed separately for all staff members. 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/ This facility does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #9 (room 113), two(2) containers of Clorox disinfecting wipes were accessible to children on the shelf. In space #4, two (2) containers of Clorox disinfecting wipes were stored on the shelf by the door accessible to children. .2820(b) 847 Parent's medication authorization did not include required information. In space #3, a permission form for an Epi-pen expired on 5/18/23. In space #4, a permission form for a child with Epi-pen was not available for review. 10A NCAC 09 .0803(4)(6-9) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. Incident report for a child was logged but the report was not in the child's file. .0802 (e) 861 Prohibited styrofoam and foam rubber products were accessible to children under 3 years of age and/or approved foam products were used without proper supervision. In space #4, Laura Lynn Ziplock bags and tall kitchen trash bags were accessible to children. .0604(q) 871 Center staff did not comply with the safe sleep policy. In space #1, a child slept with a pacifier with a pacifier holder/stuffed animal. The pacifier and the holder was out of the child's mouth. In space #8, at 11:40 am, the last sleep check for the child who was asleep was logged at 11:15 am. 10A NCAC 09 .0606(a) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #3, an action plan for a child with Epi-pen expired on 8/22/23. .0801(b) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Out of six (6) staff files I reviewed, confidential information for all six (6) staff members were maintained with other documents in the staff files. .0701(d) Technical Assistance were provided as follows: 840: Hazardous Materials Potentially hazardous materials, such as cleaners with a warning “keep out of reach of children” shall be maintained at least five (5) feet or above. Staff members shall store their personal items, such as purse out of reach of children as well. 15A NCAC 18A .2820 STORAGE aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. (c) Non-aerosol sanitizing, disinfecting, and detergent solutions, hand sanitizers, and hand lotions shall be kept out of reach of children when not in use but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent (soapy water) solutions. Hand soap other than that which is in bulk containers is not required to be kept out of reach of children or in locked storage. (f) Employee purses and other personal effects shall be kept out of reach of children. 847: Medication permission form Authorization to administer medication is required for all medications including epi-pen. The teachers shall not administer any types of medication without the authorization. Both Action plan and the permission form is required for all emergency medications. The permission form for prescription medication is valid for six (6) months. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 852: Incident Report: Incident report must be maintained in each child’s file after obtaining parent signature and logged on the incident log. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (e) The child care provider shall complete an incident report each time a child is injured as a result of an incident occurring while the child is in care. This incident report shall include: (1) facility identifying information; (2) the child's name; (3) date and time of the incident; (4) witness to the incident; (5) time the parent is notified of the incident and by whom; (6) piece of equipment involved, if applicable; (7) cause of injury, if applicable; (8) type of injury, if applicable; (9) body part injured, if applicable; (10) where the child received medical treatment, if applicable; (11) description of how and where the incident occurred, and the First Aid received; and (12) steps taken to prevent reoccurrence. This report shall be signed by the person completing it and by the parent, a copy given to the parent or a parent signature declining a copy and the report maintained in the child's file. A copy of the form may be found on the Division's website at http://ncchildcare.ncdhhs.gova 861: Easily Torn Plastics Easily torn plastics, including grocery bags, Ziplock bags, plastic wrappers and trash bags must be inaccessible to children under three (3) years of age. Please store them at least five (5) feet or above. 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. 871: Safe Sleep practice Infants, children at twelve (12) months of age or younger must sleep with no objects in the crib including blankets and stuffed animals. Pacifier hold shall be removed from the crib when the child sleeps in the crib. Sleep checks for infants shall be completed at least every fifteen (15) minutes. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (2) 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 with a sleeping infant aged 12 months or younger; (6) specifies that caregivers shall visually check, in person, sleeping infants aged 12 months or younger at least every 15 minutes; 1835: Action Plan Action plan for asthma is required. The plan shall be renewed annually and stay valid. The action plan is valid for twelve (12) months. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/ 1890: Confidential information Confidential information (medial statement, TB results and Health Questionnaire) shall be maintained separately from the other documents in staff files. Please note that Emergency Information form is not a confidential information. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. Technical assistance was provided as follows: You will document the rule reference and specifics about the violations here. Provide your discussion with the operator and/or TA you provided. Best practice can go here too. 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 11/27/23 Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013 or email kaoru.eddins@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: Sleep check documents: 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. Staff and Training Worksheet: Item #5: Orientation Please put dates for this section. If the orientation was offered prior to two (2) weeks/six (6) weeks requirements, only the date of completion be filled. Item #11: Emergency information and Health Questionnaire: Please put dates for this section. Both forms shall be updated annually. Item #17: Health and Safety training The date of completion of the training goes here, rather than the next due date. Item #25/#26: EPR and EMC review The facility’s EPR and EMC review is included in the new staff orientation. The annual review for both documents are required for all existing staff members as well. I suggest leaving documentation of the review for each staff member. Attendance roster or acknowledgement form is suggested. Sanitation inspection: Your last sanitation inspection was completed on 11/21/22. If you don’t receive sanitation inspection soon, please contact your Environmental Health Specialist. A sanitation inspection shall be completed before 11/30/23. If you have any questions or concerns regarding the Stabilization, Expansion and Access 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. 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: 1023-012L Visit Date: 10/6/2023 Number Present: 112 Completed Date: 10/6/2023 Age: From 0 To 5 Total Minutes: 214 Time In: 08:56 AM Time Out: 12:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a complaint visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Christine Smith, Administrator, during the visit. An electronic signed copy of the visit summary was printed and left on-site with you. Today, Christine Smith, Administrator, was available during today’s visit. Limited monitoring of child care rules was conducted during today’s visit including but not limited to developmentally appropriate environment, supervision, nutrition, sanitation and health. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89) percentage as of 10/3/23. Emmanuel Lutheran School operates with four-star center license issue on 6/20/19 with restrictions: daytime care, meets enhanced space and reduced ratios. The report was received by the Division of Child Development and Early Education (DCDEE) on 10/2/23 and sent to me on the same day. The concerns are regarding a developmentally appropriate environment, supervision, nutrition, sanitation and health in a two-year-old classroom. For developmentally appropriate environment, the reporter stated that the appropriate teaching is not occurring in the classroom. No structure or proper schedule are followed by the teacher. Children receive inappropriate amounts of screen time. For supervision, the reporter states that the teacher in the classroom sits around and plays on the mobile device. There are several cases of severe injuries that occurred in the classroom due to lack of supervision, and there are no explanations to parents. In regard to nutrition, the reporter stated that the teacher gives the children inappropriate food and drinks that are the teacher’s personal food/drink. For the concerns for sanitation and health, the reporter stated that the room is not maintained clean, children are not kept clean and/or wear soiled diaper/pull-up, and the teacher rubs his/her nose with children as a gesture of affection. In order to investigate the allegations, I observed the classroom in the report and interviewed teachers and Ms. Smith. Upon arrival, I announced my presence and the purpose of the visit. I observed the classroom in room 101, space #3. There were thirteen (13) children present and one (1) child arrived during the visit. On the sign in/out sheet, eleven (11) children were signed in for today. Upon arrival in the classroom, the group of two-year-old children engaged in group time. The lead teacher led the group time by singing songs and reading books while the other teacher cleaned the tables and prepared for morning snack. The children washed their hands in the sink in the classroom, sat at the table and had a morning snack. Today’s snacks were cornflakes and milk. One of the children brought yogurt, blackberries and cut grapes for the snack. The items were listed on the menu. The lead teacher sat with the children and gave prompts to stay seated and aided children ate. Around 9:40 am, some of the children finished up breakfast and started roaming. The lead teacher directed the children to wash their hands. Children washed their hands in the bathroom and started playing in the centers. The lead teacher joined the children in the housekeeping center. One (1) of the children started throwing a pretend orange. The teacher prompted and told the child “That’s not a ball, that’s an orange”. He/she added colors and numbers in the conversation with children. Then the group of children shifted to a science center, lined chairs up and pretended it to be a train. The lead teacher moved to the science area with the children and facilitated pretend play. When children became restless, he/she read books and sang songs. When all the children cleaned up breakfast, the lead teacher reminded them that it was time to go outside. The children gathered in front of the door and transitioned to the playground. During transition, the lead teacher walked backwards to supervise the group of children, while the other teacher held two children’s hands and stayed at the end of the group. As the group went through the gate to the playground, the lead teacher took head counts. On the playground, the children played with a slide structure, tricycles, toy vehicles, a sandbox with buckets, shovels and other accessories. The teachers were spread apart, and the supervision was adequate. I interviewed the other teacher in the classroom and Ms. Smith. Per interview, neither one (1) of them confirmed ever seeing the lead teacher use a laptop to provide children screen time, give personal food to the children, or spend significant amount of time looking at the personal phone. I interviewed Ms. Smith. She does not recall any occasions when she received a complaint regarding the lead teacher. The staff member on the report started the lead teacher role this school year, therefore, technical assistance, mentoring and frequent monitoring is provided by a teacher from another classroom and by Ms. Smith. Incident log and incident reports were monitored. The log was maintained in the administrator’s office. Per incident log, there were two incidents this school year, one (1) of which occurred on 7/27/23 and the other occurred on 10/5/23. Neither of the incidents involved the children in space #3. Per Ms. Smith, teachers are instructed to create incident report when visible markings were observed due to injuries and communicate the incident with parents. There was some running and climbing in the classroom, but teachers gave prompts to children to walk and other actions to stay safe. No significant behavioral issues were observed in the classroom. The children seemed happy to play and participate in the activities. The children were friendly and did not have any apparent bruises or cuts. Per interview with the other teacher in the classroom, two (2) children are potty-trained with occasional accidents, four (4) children are wearing pull-ups, and the rest of the children wear diapers. There are nineteen (19) children enrolled in this classroom. Between 9:00 am to 10:30 am , children’s diapers were not checked or changed. Per interview, children’s diaper/pull-ups are checked upon arrival. The child who arrived at 9:00am was not checked. For the violation of developmentally appropriate environment, the allegation is unsubstantiated. The lead teacher was attentive to the children. The teacher sand songs, read books, facilitated play and learning. The lesson plan was current and posted and North Carolina Foundation objectives were included in the plan. Screen time or any inappropriate activities were observed during the visit. The other teacher and Ms. Smith stated that they had not witnessed children being offered screen time in the classroom. For the violation of nutrition, the allegation of the teacher serving his/her personal food is unsubstantiated. The children age food provided by the facility, and the other teacher denied witnessing such action. For the violation of supervision, the allegation is unsubstantiated. By observation, the teachers were attentive to children in the classroom, and appropriate prompts were given to children. I did not observe apparent injuries on the children, concerning behaviors or lack of supervision. The teacher did not use cell phone during the visit, and the other teacher and Ms. Smith stated that they did not witness the lead teacher spend significant amount of time looking at his/her phone. For the violation of sanitation and health, the allegation is substantiated due to diaper change being completed on the schedule. On the schedule, diaper change is scheduled to be completed between 9:40 am – 10:00 am. Children were not checked by either teacher for soiled diaper during observation. The teachers stated that the children’s diapers/pull-up are checked upon arrival. Children shall be monitored for soiled diapers throughout the day and changed as needed. The classroom is messy with toys scattered but is appropriate for the two-year-old classroom. Food on the floor was swept after the morning snack and tables were cleaned and sanitized. Bathroom was maintained clean. I did not witness any unsanitary practice from either teacher. 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 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. In space #3, there were fourteen (14) children present, and eleven (11) children were signed in on the log. 10A NCAC 09 .0302(d)(4) 401 Diapers were not changed whenever they were soiled or wet and/or were changed on a shift basis. Between 9:00 am - 10:35 am, no children were checked for soiled diaper/pull-up. Per schedule, diaper changing is done from 9:40 am - 10:00 am. Per teacher interview, the diapers/pull-up are checked upon each child's arrival and after playground time. 10A NCAC 09 .0806(a) 861 Prohibited styrofoam and foam rubber products were accessible to children under 3 years of age and/or approved foam products were used without proper supervision. In space #3, a bag of diaper/pull-up are accessible to children. One (1) bag of diaper/pull-up in plastic wrapper was stored on the floor next to a shelf, the other bag on the shelf by the changing station, one bag in the top shelf. Two (2) bags of wipe were also stored on top of the changing station on the wall. .0604(q) Technical assistance was provided as follows: 125: arrival and departure time Arrival and departure time shall be recorded as children arrive and departure. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (4) daily records of arrival and departure times at the center for each child which shall be maintained as children arrive and depart; 401: Diaper change Diapers shall be changed based on each child’s needs. 10A NCAC 09 .0806 TOILETING, CLOTHING AND LINENS (a) Diapers shall be changed whenever they become soiled or wet and not on a shift basis. 861: easily torn plastics Easily torn plastics, including plastic wrapper for diapers/pull-ups, wipe in a plastic bag, Ziplock bags and grocery bags shall not be accessible to children who is younger than three (3). 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. 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 10/20/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013 or email kaoru.eddins@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: Use of appropriate sink: Please follow sanitation rules to use appropriate sinks for appropriate purposes. The sink used for toileting shall be disinfected when the sink is used for other purposes. The step stool for the children for the sink in the classroom is not appropriate size for some children, and the teachers had to lift children to use the sink. Appropriate furniture to aid children use the sink is advised. Trash can: The trash can the children use to throw away food items is too tall for children to use it hand-free. Children had to lift the lids to throw away food. Appropriate, child-sized trash cans are strongly recommended. Transition process: I observed the transition of the group from the classroom to outside. The teachers did not take head counts of the children out loud. Two (2)-year-old children may not be capable of lining up, but accurate head counts should be taken by both teachers. Communications between teachers should occur to make sure that everyone is accounted for before leaving the classroom to prevent supervision/transition mistakes. If you have any questions or concerns regarding the Stabilization, Expansion and Access 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. 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 to 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: 1023-012L Visit Date: 10/6/2023 Number Present: 112 Completed Date: 10/6/2023 Age: From 0 To 5 Total Minutes: 214 Time In: 08:56 AM Time Out: 12:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a complaint visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Christine Smith, Administrator, during the visit. An electronic signed copy of the visit summary was printed and left on-site with you. Today, Christine Smith, Administrator, was available during today’s visit. Limited monitoring of child care rules was conducted during today’s visit including but not limited to developmentally appropriate environment, supervision, nutrition, sanitation and health. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89) percentage as of 10/3/23. Emmanuel Lutheran School operates with four-star center license issue on 6/20/19 with restrictions: daytime care, meets enhanced space and reduced ratios. The report was received by the Division of Child Development and Early Education (DCDEE) on 10/2/23 and sent to me on the same day. The concerns are regarding a developmentally appropriate environment, supervision, nutrition, sanitation and health in a two-year-old classroom. For developmentally appropriate environment, the reporter stated that the appropriate teaching is not occurring in the classroom. No structure or proper schedule are followed by the teacher. Children receive inappropriate amounts of screen time. For supervision, the reporter states that the teacher in the classroom sits around and plays on the mobile device. There are several cases of severe injuries that occurred in the classroom due to lack of supervision, and there are no explanations to parents. In regard to nutrition, the reporter stated that the teacher gives the children inappropriate food and drinks that are the teacher’s personal food/drink. For the concerns for sanitation and health, the reporter stated that the room is not maintained clean, children are not kept clean and/or wear soiled diaper/pull-up, and the teacher rubs his/her nose with children as a gesture of affection. In order to investigate the allegations, I observed the classroom in the report and interviewed teachers and Ms. Smith. Upon arrival, I announced my presence and the purpose of the visit. I observed the classroom in room 101, space #3. There were thirteen (13) children present and one (1) child arrived during the visit. On the sign in/out sheet, eleven (11) children were signed in for today. Upon arrival in the classroom, the group of two-year-old children engaged in group time. The lead teacher led the group time by singing songs and reading books while the other teacher cleaned the tables and prepared for morning snack. The children washed their hands in the sink in the classroom, sat at the table and had a morning snack. Today’s snacks were cornflakes and milk. One of the children brought yogurt, blackberries and cut grapes for the snack. The items were listed on the menu. The lead teacher sat with the children and gave prompts to stay seated and aided children ate. Around 9:40 am, some of the children finished up breakfast and started roaming. The lead teacher directed the children to wash their hands. Children washed their hands in the bathroom and started playing in the centers. The lead teacher joined the children in the housekeeping center. One (1) of the children started throwing a pretend orange. The teacher prompted and told the child “That’s not a ball, that’s an orange”. He/she added colors and numbers in the conversation with children. Then the group of children shifted to a science center, lined chairs up and pretended it to be a train. The lead teacher moved to the science area with the children and facilitated pretend play. When children became restless, he/she read books and sang songs. When all the children cleaned up breakfast, the lead teacher reminded them that it was time to go outside. The children gathered in front of the door and transitioned to the playground. During transition, the lead teacher walked backwards to supervise the group of children, while the other teacher held two children’s hands and stayed at the end of the group. As the group went through the gate to the playground, the lead teacher took head counts. On the playground, the children played with a slide structure, tricycles, toy vehicles, a sandbox with buckets, shovels and other accessories. The teachers were spread apart, and the supervision was adequate. I interviewed the other teacher in the classroom and Ms. Smith. Per interview, neither one (1) of them confirmed ever seeing the lead teacher use a laptop to provide children screen time, give personal food to the children, or spend significant amount of time looking at the personal phone. I interviewed Ms. Smith. She does not recall any occasions when she received a complaint regarding the lead teacher. The staff member on the report started the lead teacher role this school year, therefore, technical assistance, mentoring and frequent monitoring is provided by a teacher from another classroom and by Ms. Smith. Incident log and incident reports were monitored. The log was maintained in the administrator’s office. Per incident log, there were two incidents this school year, one (1) of which occurred on 7/27/23 and the other occurred on 10/5/23. Neither of the incidents involved the children in space #3. Per Ms. Smith, teachers are instructed to create incident report when visible markings were observed due to injuries and communicate the incident with parents. There was some running and climbing in the classroom, but teachers gave prompts to children to walk and other actions to stay safe. No significant behavioral issues were observed in the classroom. The children seemed happy to play and participate in the activities. The children were friendly and did not have any apparent bruises or cuts. Per interview with the other teacher in the classroom, two (2) children are potty-trained with occasional accidents, four (4) children are wearing pull-ups, and the rest of the children wear diapers. There are nineteen (19) children enrolled in this classroom. Between 9:00 am to 10:30 am , children’s diapers were not checked or changed. Per interview, children’s diaper/pull-ups are checked upon arrival. The child who arrived at 9:00am was not checked. For the violation of developmentally appropriate environment, the allegation is unsubstantiated. The lead teacher was attentive to the children. The teacher sand songs, read books, facilitated play and learning. The lesson plan was current and posted and North Carolina Foundation objectives were included in the plan. Screen time or any inappropriate activities were observed during the visit. The other teacher and Ms. Smith stated that they had not witnessed children being offered screen time in the classroom. For the violation of nutrition, the allegation of the teacher serving his/her personal food is unsubstantiated. The children age food provided by the facility, and the other teacher denied witnessing such action. For the violation of supervision, the allegation is unsubstantiated. By observation, the teachers were attentive to children in the classroom, and appropriate prompts were given to children. I did not observe apparent injuries on the children, concerning behaviors or lack of supervision. The teacher did not use cell phone during the visit, and the other teacher and Ms. Smith stated that they did not witness the lead teacher spend significant amount of time looking at his/her phone. For the violation of sanitation and health, the allegation is substantiated due to diaper change being completed on the schedule. On the schedule, diaper change is scheduled to be completed between 9:40 am – 10:00 am. Children were not checked by either teacher for soiled diaper during observation. The teachers stated that the children’s diapers/pull-up are checked upon arrival. Children shall be monitored for soiled diapers throughout the day and changed as needed. The classroom is messy with toys scattered but is appropriate for the two-year-old classroom. Food on the floor was swept after the morning snack and tables were cleaned and sanitized. Bathroom was maintained clean. I did not witness any unsanitary practice from either teacher. 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 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. In space #3, there were fourteen (14) children present, and eleven (11) children were signed in on the log. 10A NCAC 09 .0302(d)(4) 401 Diapers were not changed whenever they were soiled or wet and/or were changed on a shift basis. Between 9:00 am - 10:35 am, no children were checked for soiled diaper/pull-up. Per schedule, diaper changing is done from 9:40 am - 10:00 am. Per teacher interview, the diapers/pull-up are checked upon each child's arrival and after playground time. 10A NCAC 09 .0806(a) 861 Prohibited styrofoam and foam rubber products were accessible to children under 3 years of age and/or approved foam products were used without proper supervision. In space #3, a bag of diaper/pull-up are accessible to children. One (1) bag of diaper/pull-up in plastic wrapper was stored on the floor next to a shelf, the other bag on the shelf by the changing station, one bag in the top shelf. Two (2) bags of wipe were also stored on top of the changing station on the wall. .0604(q) Technical assistance was provided as follows: 125: arrival and departure time Arrival and departure time shall be recorded as children arrive and departure. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (4) daily records of arrival and departure times at the center for each child which shall be maintained as children arrive and depart; 401: Diaper change Diapers shall be changed based on each child’s needs. 10A NCAC 09 .0806 TOILETING, CLOTHING AND LINENS (a) Diapers shall be changed whenever they become soiled or wet and not on a shift basis. 861: easily torn plastics Easily torn plastics, including plastic wrapper for diapers/pull-ups, wipe in a plastic bag, Ziplock bags and grocery bags shall not be accessible to children who is younger than three (3). 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. 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 10/20/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013 or email kaoru.eddins@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: Use of appropriate sink: Please follow sanitation rules to use appropriate sinks for appropriate purposes. The sink used for toileting shall be disinfected when the sink is used for other purposes. The step stool for the children for the sink in the classroom is not appropriate size for some children, and the teachers had to lift children to use the sink. Appropriate furniture to aid children use the sink is advised. Trash can: The trash can the children use to throw away food items is too tall for children to use it hand-free. Children had to lift the lids to throw away food. Appropriate, child-sized trash cans are strongly recommended. Transition process: I observed the transition of the group from the classroom to outside. The teachers did not take head counts of the children out loud. Two (2)-year-old children may not be capable of lining up, but accurate head counts should be taken by both teachers. Communications between teachers should occur to make sure that everyone is accounted for before leaving the classroom to prevent supervision/transition mistakes. If you have any questions or concerns regarding the Stabilization, Expansion and Access 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. 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 to 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: 1023-012L Visit Date: 10/6/2023 Number Present: 112 Completed Date: 10/6/2023 Age: From 0 To 5 Total Minutes: 214 Time In: 08:56 AM Time Out: 12:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a complaint visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Christine Smith, Administrator, during the visit. An electronic signed copy of the visit summary was printed and left on-site with you. Today, Christine Smith, Administrator, was available during today’s visit. Limited monitoring of child care rules was conducted during today’s visit including but not limited to developmentally appropriate environment, supervision, nutrition, sanitation and health. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89) percentage as of 10/3/23. Emmanuel Lutheran School operates with four-star center license issue on 6/20/19 with restrictions: daytime care, meets enhanced space and reduced ratios. The report was received by the Division of Child Development and Early Education (DCDEE) on 10/2/23 and sent to me on the same day. The concerns are regarding a developmentally appropriate environment, supervision, nutrition, sanitation and health in a two-year-old classroom. For developmentally appropriate environment, the reporter stated that the appropriate teaching is not occurring in the classroom. No structure or proper schedule are followed by the teacher. Children receive inappropriate amounts of screen time. For supervision, the reporter states that the teacher in the classroom sits around and plays on the mobile device. There are several cases of severe injuries that occurred in the classroom due to lack of supervision, and there are no explanations to parents. In regard to nutrition, the reporter stated that the teacher gives the children inappropriate food and drinks that are the teacher’s personal food/drink. For the concerns for sanitation and health, the reporter stated that the room is not maintained clean, children are not kept clean and/or wear soiled diaper/pull-up, and the teacher rubs his/her nose with children as a gesture of affection. In order to investigate the allegations, I observed the classroom in the report and interviewed teachers and Ms. Smith. Upon arrival, I announced my presence and the purpose of the visit. I observed the classroom in room 101, space #3. There were thirteen (13) children present and one (1) child arrived during the visit. On the sign in/out sheet, eleven (11) children were signed in for today. Upon arrival in the classroom, the group of two-year-old children engaged in group time. The lead teacher led the group time by singing songs and reading books while the other teacher cleaned the tables and prepared for morning snack. The children washed their hands in the sink in the classroom, sat at the table and had a morning snack. Today’s snacks were cornflakes and milk. One of the children brought yogurt, blackberries and cut grapes for the snack. The items were listed on the menu. The lead teacher sat with the children and gave prompts to stay seated and aided children ate. Around 9:40 am, some of the children finished up breakfast and started roaming. The lead teacher directed the children to wash their hands. Children washed their hands in the bathroom and started playing in the centers. The lead teacher joined the children in the housekeeping center. One (1) of the children started throwing a pretend orange. The teacher prompted and told the child “That’s not a ball, that’s an orange”. He/she added colors and numbers in the conversation with children. Then the group of children shifted to a science center, lined chairs up and pretended it to be a train. The lead teacher moved to the science area with the children and facilitated pretend play. When children became restless, he/she read books and sang songs. When all the children cleaned up breakfast, the lead teacher reminded them that it was time to go outside. The children gathered in front of the door and transitioned to the playground. During transition, the lead teacher walked backwards to supervise the group of children, while the other teacher held two children’s hands and stayed at the end of the group. As the group went through the gate to the playground, the lead teacher took head counts. On the playground, the children played with a slide structure, tricycles, toy vehicles, a sandbox with buckets, shovels and other accessories. The teachers were spread apart, and the supervision was adequate. I interviewed the other teacher in the classroom and Ms. Smith. Per interview, neither one (1) of them confirmed ever seeing the lead teacher use a laptop to provide children screen time, give personal food to the children, or spend significant amount of time looking at the personal phone. I interviewed Ms. Smith. She does not recall any occasions when she received a complaint regarding the lead teacher. The staff member on the report started the lead teacher role this school year, therefore, technical assistance, mentoring and frequent monitoring is provided by a teacher from another classroom and by Ms. Smith. Incident log and incident reports were monitored. The log was maintained in the administrator’s office. Per incident log, there were two incidents this school year, one (1) of which occurred on 7/27/23 and the other occurred on 10/5/23. Neither of the incidents involved the children in space #3. Per Ms. Smith, teachers are instructed to create incident report when visible markings were observed due to injuries and communicate the incident with parents. There was some running and climbing in the classroom, but teachers gave prompts to children to walk and other actions to stay safe. No significant behavioral issues were observed in the classroom. The children seemed happy to play and participate in the activities. The children were friendly and did not have any apparent bruises or cuts. Per interview with the other teacher in the classroom, two (2) children are potty-trained with occasional accidents, four (4) children are wearing pull-ups, and the rest of the children wear diapers. There are nineteen (19) children enrolled in this classroom. Between 9:00 am to 10:30 am , children’s diapers were not checked or changed. Per interview, children’s diaper/pull-ups are checked upon arrival. The child who arrived at 9:00am was not checked. For the violation of developmentally appropriate environment, the allegation is unsubstantiated. The lead teacher was attentive to the children. The teacher sand songs, read books, facilitated play and learning. The lesson plan was current and posted and North Carolina Foundation objectives were included in the plan. Screen time or any inappropriate activities were observed during the visit. The other teacher and Ms. Smith stated that they had not witnessed children being offered screen time in the classroom. For the violation of nutrition, the allegation of the teacher serving his/her personal food is unsubstantiated. The children age food provided by the facility, and the other teacher denied witnessing such action. For the violation of supervision, the allegation is unsubstantiated. By observation, the teachers were attentive to children in the classroom, and appropriate prompts were given to children. I did not observe apparent injuries on the children, concerning behaviors or lack of supervision. The teacher did not use cell phone during the visit, and the other teacher and Ms. Smith stated that they did not witness the lead teacher spend significant amount of time looking at his/her phone. For the violation of sanitation and health, the allegation is substantiated due to diaper change being completed on the schedule. On the schedule, diaper change is scheduled to be completed between 9:40 am – 10:00 am. Children were not checked by either teacher for soiled diaper during observation. The teachers stated that the children’s diapers/pull-up are checked upon arrival. Children shall be monitored for soiled diapers throughout the day and changed as needed. The classroom is messy with toys scattered but is appropriate for the two-year-old classroom. Food on the floor was swept after the morning snack and tables were cleaned and sanitized. Bathroom was maintained clean. I did not witness any unsanitary practice from either teacher. 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 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. In space #3, there were fourteen (14) children present, and eleven (11) children were signed in on the log. 10A NCAC 09 .0302(d)(4) 401 Diapers were not changed whenever they were soiled or wet and/or were changed on a shift basis. Between 9:00 am - 10:35 am, no children were checked for soiled diaper/pull-up. Per schedule, diaper changing is done from 9:40 am - 10:00 am. Per teacher interview, the diapers/pull-up are checked upon each child's arrival and after playground time. 10A NCAC 09 .0806(a) 861 Prohibited styrofoam and foam rubber products were accessible to children under 3 years of age and/or approved foam products were used without proper supervision. In space #3, a bag of diaper/pull-up are accessible to children. One (1) bag of diaper/pull-up in plastic wrapper was stored on the floor next to a shelf, the other bag on the shelf by the changing station, one bag in the top shelf. Two (2) bags of wipe were also stored on top of the changing station on the wall. .0604(q) Technical assistance was provided as follows: 125: arrival and departure time Arrival and departure time shall be recorded as children arrive and departure. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (4) daily records of arrival and departure times at the center for each child which shall be maintained as children arrive and depart; 401: Diaper change Diapers shall be changed based on each child’s needs. 10A NCAC 09 .0806 TOILETING, CLOTHING AND LINENS (a) Diapers shall be changed whenever they become soiled or wet and not on a shift basis. 861: easily torn plastics Easily torn plastics, including plastic wrapper for diapers/pull-ups, wipe in a plastic bag, Ziplock bags and grocery bags shall not be accessible to children who is younger than three (3). 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. 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 10/20/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013 or email kaoru.eddins@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: Use of appropriate sink: Please follow sanitation rules to use appropriate sinks for appropriate purposes. The sink used for toileting shall be disinfected when the sink is used for other purposes. The step stool for the children for the sink in the classroom is not appropriate size for some children, and the teachers had to lift children to use the sink. Appropriate furniture to aid children use the sink is advised. Trash can: The trash can the children use to throw away food items is too tall for children to use it hand-free. Children had to lift the lids to throw away food. Appropriate, child-sized trash cans are strongly recommended. Transition process: I observed the transition of the group from the classroom to outside. The teachers did not take head counts of the children out loud. Two (2)-year-old children may not be capable of lining up, but accurate head counts should be taken by both teachers. Communications between teachers should occur to make sure that everyone is accounted for before leaving the classroom to prevent supervision/transition mistakes. If you have any questions or concerns regarding the Stabilization, Expansion and Access 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. 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 to 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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 .0806 · Violation

Name of Operation: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: 1023-012L Visit Date: 10/6/2023 Number Present: 112 Completed Date: 10/6/2023 Age: From 0 To 5 Total Minutes: 214 Time In: 08:56 AM Time Out: 12:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a complaint visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Christine Smith, Administrator, during the visit. An electronic signed copy of the visit summary was printed and left on-site with you. Today, Christine Smith, Administrator, was available during today’s visit. Limited monitoring of child care rules was conducted during today’s visit including but not limited to developmentally appropriate environment, supervision, nutrition, sanitation and health. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89) percentage as of 10/3/23. Emmanuel Lutheran School operates with four-star center license issue on 6/20/19 with restrictions: daytime care, meets enhanced space and reduced ratios. The report was received by the Division of Child Development and Early Education (DCDEE) on 10/2/23 and sent to me on the same day. The concerns are regarding a developmentally appropriate environment, supervision, nutrition, sanitation and health in a two-year-old classroom. For developmentally appropriate environment, the reporter stated that the appropriate teaching is not occurring in the classroom. No structure or proper schedule are followed by the teacher. Children receive inappropriate amounts of screen time. For supervision, the reporter states that the teacher in the classroom sits around and plays on the mobile device. There are several cases of severe injuries that occurred in the classroom due to lack of supervision, and there are no explanations to parents. In regard to nutrition, the reporter stated that the teacher gives the children inappropriate food and drinks that are the teacher’s personal food/drink. For the concerns for sanitation and health, the reporter stated that the room is not maintained clean, children are not kept clean and/or wear soiled diaper/pull-up, and the teacher rubs his/her nose with children as a gesture of affection. In order to investigate the allegations, I observed the classroom in the report and interviewed teachers and Ms. Smith. Upon arrival, I announced my presence and the purpose of the visit. I observed the classroom in room 101, space #3. There were thirteen (13) children present and one (1) child arrived during the visit. On the sign in/out sheet, eleven (11) children were signed in for today. Upon arrival in the classroom, the group of two-year-old children engaged in group time. The lead teacher led the group time by singing songs and reading books while the other teacher cleaned the tables and prepared for morning snack. The children washed their hands in the sink in the classroom, sat at the table and had a morning snack. Today’s snacks were cornflakes and milk. One of the children brought yogurt, blackberries and cut grapes for the snack. The items were listed on the menu. The lead teacher sat with the children and gave prompts to stay seated and aided children ate. Around 9:40 am, some of the children finished up breakfast and started roaming. The lead teacher directed the children to wash their hands. Children washed their hands in the bathroom and started playing in the centers. The lead teacher joined the children in the housekeeping center. One (1) of the children started throwing a pretend orange. The teacher prompted and told the child “That’s not a ball, that’s an orange”. He/she added colors and numbers in the conversation with children. Then the group of children shifted to a science center, lined chairs up and pretended it to be a train. The lead teacher moved to the science area with the children and facilitated pretend play. When children became restless, he/she read books and sang songs. When all the children cleaned up breakfast, the lead teacher reminded them that it was time to go outside. The children gathered in front of the door and transitioned to the playground. During transition, the lead teacher walked backwards to supervise the group of children, while the other teacher held two children’s hands and stayed at the end of the group. As the group went through the gate to the playground, the lead teacher took head counts. On the playground, the children played with a slide structure, tricycles, toy vehicles, a sandbox with buckets, shovels and other accessories. The teachers were spread apart, and the supervision was adequate. I interviewed the other teacher in the classroom and Ms. Smith. Per interview, neither one (1) of them confirmed ever seeing the lead teacher use a laptop to provide children screen time, give personal food to the children, or spend significant amount of time looking at the personal phone. I interviewed Ms. Smith. She does not recall any occasions when she received a complaint regarding the lead teacher. The staff member on the report started the lead teacher role this school year, therefore, technical assistance, mentoring and frequent monitoring is provided by a teacher from another classroom and by Ms. Smith. Incident log and incident reports were monitored. The log was maintained in the administrator’s office. Per incident log, there were two incidents this school year, one (1) of which occurred on 7/27/23 and the other occurred on 10/5/23. Neither of the incidents involved the children in space #3. Per Ms. Smith, teachers are instructed to create incident report when visible markings were observed due to injuries and communicate the incident with parents. There was some running and climbing in the classroom, but teachers gave prompts to children to walk and other actions to stay safe. No significant behavioral issues were observed in the classroom. The children seemed happy to play and participate in the activities. The children were friendly and did not have any apparent bruises or cuts. Per interview with the other teacher in the classroom, two (2) children are potty-trained with occasional accidents, four (4) children are wearing pull-ups, and the rest of the children wear diapers. There are nineteen (19) children enrolled in this classroom. Between 9:00 am to 10:30 am , children’s diapers were not checked or changed. Per interview, children’s diaper/pull-ups are checked upon arrival. The child who arrived at 9:00am was not checked. For the violation of developmentally appropriate environment, the allegation is unsubstantiated. The lead teacher was attentive to the children. The teacher sand songs, read books, facilitated play and learning. The lesson plan was current and posted and North Carolina Foundation objectives were included in the plan. Screen time or any inappropriate activities were observed during the visit. The other teacher and Ms. Smith stated that they had not witnessed children being offered screen time in the classroom. For the violation of nutrition, the allegation of the teacher serving his/her personal food is unsubstantiated. The children age food provided by the facility, and the other teacher denied witnessing such action. For the violation of supervision, the allegation is unsubstantiated. By observation, the teachers were attentive to children in the classroom, and appropriate prompts were given to children. I did not observe apparent injuries on the children, concerning behaviors or lack of supervision. The teacher did not use cell phone during the visit, and the other teacher and Ms. Smith stated that they did not witness the lead teacher spend significant amount of time looking at his/her phone. For the violation of sanitation and health, the allegation is substantiated due to diaper change being completed on the schedule. On the schedule, diaper change is scheduled to be completed between 9:40 am – 10:00 am. Children were not checked by either teacher for soiled diaper during observation. The teachers stated that the children’s diapers/pull-up are checked upon arrival. Children shall be monitored for soiled diapers throughout the day and changed as needed. The classroom is messy with toys scattered but is appropriate for the two-year-old classroom. Food on the floor was swept after the morning snack and tables were cleaned and sanitized. Bathroom was maintained clean. I did not witness any unsanitary practice from either teacher. 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 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. In space #3, there were fourteen (14) children present, and eleven (11) children were signed in on the log. 10A NCAC 09 .0302(d)(4) 401 Diapers were not changed whenever they were soiled or wet and/or were changed on a shift basis. Between 9:00 am - 10:35 am, no children were checked for soiled diaper/pull-up. Per schedule, diaper changing is done from 9:40 am - 10:00 am. Per teacher interview, the diapers/pull-up are checked upon each child's arrival and after playground time. 10A NCAC 09 .0806(a) 861 Prohibited styrofoam and foam rubber products were accessible to children under 3 years of age and/or approved foam products were used without proper supervision. In space #3, a bag of diaper/pull-up are accessible to children. One (1) bag of diaper/pull-up in plastic wrapper was stored on the floor next to a shelf, the other bag on the shelf by the changing station, one bag in the top shelf. Two (2) bags of wipe were also stored on top of the changing station on the wall. .0604(q) Technical assistance was provided as follows: 125: arrival and departure time Arrival and departure time shall be recorded as children arrive and departure. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (4) daily records of arrival and departure times at the center for each child which shall be maintained as children arrive and depart; 401: Diaper change Diapers shall be changed based on each child’s needs. 10A NCAC 09 .0806 TOILETING, CLOTHING AND LINENS (a) Diapers shall be changed whenever they become soiled or wet and not on a shift basis. 861: easily torn plastics Easily torn plastics, including plastic wrapper for diapers/pull-ups, wipe in a plastic bag, Ziplock bags and grocery bags shall not be accessible to children who is younger than three (3). 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. 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 10/20/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013 or email kaoru.eddins@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: Use of appropriate sink: Please follow sanitation rules to use appropriate sinks for appropriate purposes. The sink used for toileting shall be disinfected when the sink is used for other purposes. The step stool for the children for the sink in the classroom is not appropriate size for some children, and the teachers had to lift children to use the sink. Appropriate furniture to aid children use the sink is advised. Trash can: The trash can the children use to throw away food items is too tall for children to use it hand-free. Children had to lift the lids to throw away food. Appropriate, child-sized trash cans are strongly recommended. Transition process: I observed the transition of the group from the classroom to outside. The teachers did not take head counts of the children out loud. Two (2)-year-old children may not be capable of lining up, but accurate head counts should be taken by both teachers. Communications between teachers should occur to make sure that everyone is accounted for before leaving the classroom to prevent supervision/transition mistakes. If you have any questions or concerns regarding the Stabilization, Expansion and Access 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. 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 to 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: 1023-012L Visit Date: 10/6/2023 Number Present: 112 Completed Date: 10/6/2023 Age: From 0 To 5 Total Minutes: 214 Time In: 08:56 AM Time Out: 12:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a complaint visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Christine Smith, Administrator, during the visit. An electronic signed copy of the visit summary was printed and left on-site with you. Today, Christine Smith, Administrator, was available during today’s visit. Limited monitoring of child care rules was conducted during today’s visit including but not limited to developmentally appropriate environment, supervision, nutrition, sanitation and health. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89) percentage as of 10/3/23. Emmanuel Lutheran School operates with four-star center license issue on 6/20/19 with restrictions: daytime care, meets enhanced space and reduced ratios. The report was received by the Division of Child Development and Early Education (DCDEE) on 10/2/23 and sent to me on the same day. The concerns are regarding a developmentally appropriate environment, supervision, nutrition, sanitation and health in a two-year-old classroom. For developmentally appropriate environment, the reporter stated that the appropriate teaching is not occurring in the classroom. No structure or proper schedule are followed by the teacher. Children receive inappropriate amounts of screen time. For supervision, the reporter states that the teacher in the classroom sits around and plays on the mobile device. There are several cases of severe injuries that occurred in the classroom due to lack of supervision, and there are no explanations to parents. In regard to nutrition, the reporter stated that the teacher gives the children inappropriate food and drinks that are the teacher’s personal food/drink. For the concerns for sanitation and health, the reporter stated that the room is not maintained clean, children are not kept clean and/or wear soiled diaper/pull-up, and the teacher rubs his/her nose with children as a gesture of affection. In order to investigate the allegations, I observed the classroom in the report and interviewed teachers and Ms. Smith. Upon arrival, I announced my presence and the purpose of the visit. I observed the classroom in room 101, space #3. There were thirteen (13) children present and one (1) child arrived during the visit. On the sign in/out sheet, eleven (11) children were signed in for today. Upon arrival in the classroom, the group of two-year-old children engaged in group time. The lead teacher led the group time by singing songs and reading books while the other teacher cleaned the tables and prepared for morning snack. The children washed their hands in the sink in the classroom, sat at the table and had a morning snack. Today’s snacks were cornflakes and milk. One of the children brought yogurt, blackberries and cut grapes for the snack. The items were listed on the menu. The lead teacher sat with the children and gave prompts to stay seated and aided children ate. Around 9:40 am, some of the children finished up breakfast and started roaming. The lead teacher directed the children to wash their hands. Children washed their hands in the bathroom and started playing in the centers. The lead teacher joined the children in the housekeeping center. One (1) of the children started throwing a pretend orange. The teacher prompted and told the child “That’s not a ball, that’s an orange”. He/she added colors and numbers in the conversation with children. Then the group of children shifted to a science center, lined chairs up and pretended it to be a train. The lead teacher moved to the science area with the children and facilitated pretend play. When children became restless, he/she read books and sang songs. When all the children cleaned up breakfast, the lead teacher reminded them that it was time to go outside. The children gathered in front of the door and transitioned to the playground. During transition, the lead teacher walked backwards to supervise the group of children, while the other teacher held two children’s hands and stayed at the end of the group. As the group went through the gate to the playground, the lead teacher took head counts. On the playground, the children played with a slide structure, tricycles, toy vehicles, a sandbox with buckets, shovels and other accessories. The teachers were spread apart, and the supervision was adequate. I interviewed the other teacher in the classroom and Ms. Smith. Per interview, neither one (1) of them confirmed ever seeing the lead teacher use a laptop to provide children screen time, give personal food to the children, or spend significant amount of time looking at the personal phone. I interviewed Ms. Smith. She does not recall any occasions when she received a complaint regarding the lead teacher. The staff member on the report started the lead teacher role this school year, therefore, technical assistance, mentoring and frequent monitoring is provided by a teacher from another classroom and by Ms. Smith. Incident log and incident reports were monitored. The log was maintained in the administrator’s office. Per incident log, there were two incidents this school year, one (1) of which occurred on 7/27/23 and the other occurred on 10/5/23. Neither of the incidents involved the children in space #3. Per Ms. Smith, teachers are instructed to create incident report when visible markings were observed due to injuries and communicate the incident with parents. There was some running and climbing in the classroom, but teachers gave prompts to children to walk and other actions to stay safe. No significant behavioral issues were observed in the classroom. The children seemed happy to play and participate in the activities. The children were friendly and did not have any apparent bruises or cuts. Per interview with the other teacher in the classroom, two (2) children are potty-trained with occasional accidents, four (4) children are wearing pull-ups, and the rest of the children wear diapers. There are nineteen (19) children enrolled in this classroom. Between 9:00 am to 10:30 am , children’s diapers were not checked or changed. Per interview, children’s diaper/pull-ups are checked upon arrival. The child who arrived at 9:00am was not checked. For the violation of developmentally appropriate environment, the allegation is unsubstantiated. The lead teacher was attentive to the children. The teacher sand songs, read books, facilitated play and learning. The lesson plan was current and posted and North Carolina Foundation objectives were included in the plan. Screen time or any inappropriate activities were observed during the visit. The other teacher and Ms. Smith stated that they had not witnessed children being offered screen time in the classroom. For the violation of nutrition, the allegation of the teacher serving his/her personal food is unsubstantiated. The children age food provided by the facility, and the other teacher denied witnessing such action. For the violation of supervision, the allegation is unsubstantiated. By observation, the teachers were attentive to children in the classroom, and appropriate prompts were given to children. I did not observe apparent injuries on the children, concerning behaviors or lack of supervision. The teacher did not use cell phone during the visit, and the other teacher and Ms. Smith stated that they did not witness the lead teacher spend significant amount of time looking at his/her phone. For the violation of sanitation and health, the allegation is substantiated due to diaper change being completed on the schedule. On the schedule, diaper change is scheduled to be completed between 9:40 am – 10:00 am. Children were not checked by either teacher for soiled diaper during observation. The teachers stated that the children’s diapers/pull-up are checked upon arrival. Children shall be monitored for soiled diapers throughout the day and changed as needed. The classroom is messy with toys scattered but is appropriate for the two-year-old classroom. Food on the floor was swept after the morning snack and tables were cleaned and sanitized. Bathroom was maintained clean. I did not witness any unsanitary practice from either teacher. 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 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. In space #3, there were fourteen (14) children present, and eleven (11) children were signed in on the log. 10A NCAC 09 .0302(d)(4) 401 Diapers were not changed whenever they were soiled or wet and/or were changed on a shift basis. Between 9:00 am - 10:35 am, no children were checked for soiled diaper/pull-up. Per schedule, diaper changing is done from 9:40 am - 10:00 am. Per teacher interview, the diapers/pull-up are checked upon each child's arrival and after playground time. 10A NCAC 09 .0806(a) 861 Prohibited styrofoam and foam rubber products were accessible to children under 3 years of age and/or approved foam products were used without proper supervision. In space #3, a bag of diaper/pull-up are accessible to children. One (1) bag of diaper/pull-up in plastic wrapper was stored on the floor next to a shelf, the other bag on the shelf by the changing station, one bag in the top shelf. Two (2) bags of wipe were also stored on top of the changing station on the wall. .0604(q) Technical assistance was provided as follows: 125: arrival and departure time Arrival and departure time shall be recorded as children arrive and departure. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (4) daily records of arrival and departure times at the center for each child which shall be maintained as children arrive and depart; 401: Diaper change Diapers shall be changed based on each child’s needs. 10A NCAC 09 .0806 TOILETING, CLOTHING AND LINENS (a) Diapers shall be changed whenever they become soiled or wet and not on a shift basis. 861: easily torn plastics Easily torn plastics, including plastic wrapper for diapers/pull-ups, wipe in a plastic bag, Ziplock bags and grocery bags shall not be accessible to children who is younger than three (3). 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. 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 10/20/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013 or email kaoru.eddins@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: Use of appropriate sink: Please follow sanitation rules to use appropriate sinks for appropriate purposes. The sink used for toileting shall be disinfected when the sink is used for other purposes. The step stool for the children for the sink in the classroom is not appropriate size for some children, and the teachers had to lift children to use the sink. Appropriate furniture to aid children use the sink is advised. Trash can: The trash can the children use to throw away food items is too tall for children to use it hand-free. Children had to lift the lids to throw away food. Appropriate, child-sized trash cans are strongly recommended. Transition process: I observed the transition of the group from the classroom to outside. The teachers did not take head counts of the children out loud. Two (2)-year-old children may not be capable of lining up, but accurate head counts should be taken by both teachers. Communications between teachers should occur to make sure that everyone is accounted for before leaving the classroom to prevent supervision/transition mistakes. If you have any questions or concerns regarding the Stabilization, Expansion and Access 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. 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 to 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: 1023-012L Visit Date: 10/6/2023 Number Present: 112 Completed Date: 10/6/2023 Age: From 0 To 5 Total Minutes: 214 Time In: 08:56 AM Time Out: 12:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a complaint visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Christine Smith, Administrator, during the visit. An electronic signed copy of the visit summary was printed and left on-site with you. Today, Christine Smith, Administrator, was available during today’s visit. Limited monitoring of child care rules was conducted during today’s visit including but not limited to developmentally appropriate environment, supervision, nutrition, sanitation and health. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89) percentage as of 10/3/23. Emmanuel Lutheran School operates with four-star center license issue on 6/20/19 with restrictions: daytime care, meets enhanced space and reduced ratios. The report was received by the Division of Child Development and Early Education (DCDEE) on 10/2/23 and sent to me on the same day. The concerns are regarding a developmentally appropriate environment, supervision, nutrition, sanitation and health in a two-year-old classroom. For developmentally appropriate environment, the reporter stated that the appropriate teaching is not occurring in the classroom. No structure or proper schedule are followed by the teacher. Children receive inappropriate amounts of screen time. For supervision, the reporter states that the teacher in the classroom sits around and plays on the mobile device. There are several cases of severe injuries that occurred in the classroom due to lack of supervision, and there are no explanations to parents. In regard to nutrition, the reporter stated that the teacher gives the children inappropriate food and drinks that are the teacher’s personal food/drink. For the concerns for sanitation and health, the reporter stated that the room is not maintained clean, children are not kept clean and/or wear soiled diaper/pull-up, and the teacher rubs his/her nose with children as a gesture of affection. In order to investigate the allegations, I observed the classroom in the report and interviewed teachers and Ms. Smith. Upon arrival, I announced my presence and the purpose of the visit. I observed the classroom in room 101, space #3. There were thirteen (13) children present and one (1) child arrived during the visit. On the sign in/out sheet, eleven (11) children were signed in for today. Upon arrival in the classroom, the group of two-year-old children engaged in group time. The lead teacher led the group time by singing songs and reading books while the other teacher cleaned the tables and prepared for morning snack. The children washed their hands in the sink in the classroom, sat at the table and had a morning snack. Today’s snacks were cornflakes and milk. One of the children brought yogurt, blackberries and cut grapes for the snack. The items were listed on the menu. The lead teacher sat with the children and gave prompts to stay seated and aided children ate. Around 9:40 am, some of the children finished up breakfast and started roaming. The lead teacher directed the children to wash their hands. Children washed their hands in the bathroom and started playing in the centers. The lead teacher joined the children in the housekeeping center. One (1) of the children started throwing a pretend orange. The teacher prompted and told the child “That’s not a ball, that’s an orange”. He/she added colors and numbers in the conversation with children. Then the group of children shifted to a science center, lined chairs up and pretended it to be a train. The lead teacher moved to the science area with the children and facilitated pretend play. When children became restless, he/she read books and sang songs. When all the children cleaned up breakfast, the lead teacher reminded them that it was time to go outside. The children gathered in front of the door and transitioned to the playground. During transition, the lead teacher walked backwards to supervise the group of children, while the other teacher held two children’s hands and stayed at the end of the group. As the group went through the gate to the playground, the lead teacher took head counts. On the playground, the children played with a slide structure, tricycles, toy vehicles, a sandbox with buckets, shovels and other accessories. The teachers were spread apart, and the supervision was adequate. I interviewed the other teacher in the classroom and Ms. Smith. Per interview, neither one (1) of them confirmed ever seeing the lead teacher use a laptop to provide children screen time, give personal food to the children, or spend significant amount of time looking at the personal phone. I interviewed Ms. Smith. She does not recall any occasions when she received a complaint regarding the lead teacher. The staff member on the report started the lead teacher role this school year, therefore, technical assistance, mentoring and frequent monitoring is provided by a teacher from another classroom and by Ms. Smith. Incident log and incident reports were monitored. The log was maintained in the administrator’s office. Per incident log, there were two incidents this school year, one (1) of which occurred on 7/27/23 and the other occurred on 10/5/23. Neither of the incidents involved the children in space #3. Per Ms. Smith, teachers are instructed to create incident report when visible markings were observed due to injuries and communicate the incident with parents. There was some running and climbing in the classroom, but teachers gave prompts to children to walk and other actions to stay safe. No significant behavioral issues were observed in the classroom. The children seemed happy to play and participate in the activities. The children were friendly and did not have any apparent bruises or cuts. Per interview with the other teacher in the classroom, two (2) children are potty-trained with occasional accidents, four (4) children are wearing pull-ups, and the rest of the children wear diapers. There are nineteen (19) children enrolled in this classroom. Between 9:00 am to 10:30 am , children’s diapers were not checked or changed. Per interview, children’s diaper/pull-ups are checked upon arrival. The child who arrived at 9:00am was not checked. For the violation of developmentally appropriate environment, the allegation is unsubstantiated. The lead teacher was attentive to the children. The teacher sand songs, read books, facilitated play and learning. The lesson plan was current and posted and North Carolina Foundation objectives were included in the plan. Screen time or any inappropriate activities were observed during the visit. The other teacher and Ms. Smith stated that they had not witnessed children being offered screen time in the classroom. For the violation of nutrition, the allegation of the teacher serving his/her personal food is unsubstantiated. The children age food provided by the facility, and the other teacher denied witnessing such action. For the violation of supervision, the allegation is unsubstantiated. By observation, the teachers were attentive to children in the classroom, and appropriate prompts were given to children. I did not observe apparent injuries on the children, concerning behaviors or lack of supervision. The teacher did not use cell phone during the visit, and the other teacher and Ms. Smith stated that they did not witness the lead teacher spend significant amount of time looking at his/her phone. For the violation of sanitation and health, the allegation is substantiated due to diaper change being completed on the schedule. On the schedule, diaper change is scheduled to be completed between 9:40 am – 10:00 am. Children were not checked by either teacher for soiled diaper during observation. The teachers stated that the children’s diapers/pull-up are checked upon arrival. Children shall be monitored for soiled diapers throughout the day and changed as needed. The classroom is messy with toys scattered but is appropriate for the two-year-old classroom. Food on the floor was swept after the morning snack and tables were cleaned and sanitized. Bathroom was maintained clean. I did not witness any unsanitary practice from either teacher. 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 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. In space #3, there were fourteen (14) children present, and eleven (11) children were signed in on the log. 10A NCAC 09 .0302(d)(4) 401 Diapers were not changed whenever they were soiled or wet and/or were changed on a shift basis. Between 9:00 am - 10:35 am, no children were checked for soiled diaper/pull-up. Per schedule, diaper changing is done from 9:40 am - 10:00 am. Per teacher interview, the diapers/pull-up are checked upon each child's arrival and after playground time. 10A NCAC 09 .0806(a) 861 Prohibited styrofoam and foam rubber products were accessible to children under 3 years of age and/or approved foam products were used without proper supervision. In space #3, a bag of diaper/pull-up are accessible to children. One (1) bag of diaper/pull-up in plastic wrapper was stored on the floor next to a shelf, the other bag on the shelf by the changing station, one bag in the top shelf. Two (2) bags of wipe were also stored on top of the changing station on the wall. .0604(q) Technical assistance was provided as follows: 125: arrival and departure time Arrival and departure time shall be recorded as children arrive and departure. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (4) daily records of arrival and departure times at the center for each child which shall be maintained as children arrive and depart; 401: Diaper change Diapers shall be changed based on each child’s needs. 10A NCAC 09 .0806 TOILETING, CLOTHING AND LINENS (a) Diapers shall be changed whenever they become soiled or wet and not on a shift basis. 861: easily torn plastics Easily torn plastics, including plastic wrapper for diapers/pull-ups, wipe in a plastic bag, Ziplock bags and grocery bags shall not be accessible to children who is younger than three (3). 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. 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 10/20/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013 or email kaoru.eddins@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: Use of appropriate sink: Please follow sanitation rules to use appropriate sinks for appropriate purposes. The sink used for toileting shall be disinfected when the sink is used for other purposes. The step stool for the children for the sink in the classroom is not appropriate size for some children, and the teachers had to lift children to use the sink. Appropriate furniture to aid children use the sink is advised. Trash can: The trash can the children use to throw away food items is too tall for children to use it hand-free. Children had to lift the lids to throw away food. Appropriate, child-sized trash cans are strongly recommended. Transition process: I observed the transition of the group from the classroom to outside. The teachers did not take head counts of the children out loud. Two (2)-year-old children may not be capable of lining up, but accurate head counts should be taken by both teachers. Communications between teachers should occur to make sure that everyone is accounted for before leaving the classroom to prevent supervision/transition mistakes. If you have any questions or concerns regarding the Stabilization, Expansion and Access 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. 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 to 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: 1023-012L Visit Date: 10/6/2023 Number Present: 112 Completed Date: 10/6/2023 Age: From 0 To 5 Total Minutes: 214 Time In: 08:56 AM Time Out: 12:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a complaint visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Christine Smith, Administrator, during the visit. An electronic signed copy of the visit summary was printed and left on-site with you. Today, Christine Smith, Administrator, was available during today’s visit. Limited monitoring of child care rules was conducted during today’s visit including but not limited to developmentally appropriate environment, supervision, nutrition, sanitation and health. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89) percentage as of 10/3/23. Emmanuel Lutheran School operates with four-star center license issue on 6/20/19 with restrictions: daytime care, meets enhanced space and reduced ratios. The report was received by the Division of Child Development and Early Education (DCDEE) on 10/2/23 and sent to me on the same day. The concerns are regarding a developmentally appropriate environment, supervision, nutrition, sanitation and health in a two-year-old classroom. For developmentally appropriate environment, the reporter stated that the appropriate teaching is not occurring in the classroom. No structure or proper schedule are followed by the teacher. Children receive inappropriate amounts of screen time. For supervision, the reporter states that the teacher in the classroom sits around and plays on the mobile device. There are several cases of severe injuries that occurred in the classroom due to lack of supervision, and there are no explanations to parents. In regard to nutrition, the reporter stated that the teacher gives the children inappropriate food and drinks that are the teacher’s personal food/drink. For the concerns for sanitation and health, the reporter stated that the room is not maintained clean, children are not kept clean and/or wear soiled diaper/pull-up, and the teacher rubs his/her nose with children as a gesture of affection. In order to investigate the allegations, I observed the classroom in the report and interviewed teachers and Ms. Smith. Upon arrival, I announced my presence and the purpose of the visit. I observed the classroom in room 101, space #3. There were thirteen (13) children present and one (1) child arrived during the visit. On the sign in/out sheet, eleven (11) children were signed in for today. Upon arrival in the classroom, the group of two-year-old children engaged in group time. The lead teacher led the group time by singing songs and reading books while the other teacher cleaned the tables and prepared for morning snack. The children washed their hands in the sink in the classroom, sat at the table and had a morning snack. Today’s snacks were cornflakes and milk. One of the children brought yogurt, blackberries and cut grapes for the snack. The items were listed on the menu. The lead teacher sat with the children and gave prompts to stay seated and aided children ate. Around 9:40 am, some of the children finished up breakfast and started roaming. The lead teacher directed the children to wash their hands. Children washed their hands in the bathroom and started playing in the centers. The lead teacher joined the children in the housekeeping center. One (1) of the children started throwing a pretend orange. The teacher prompted and told the child “That’s not a ball, that’s an orange”. He/she added colors and numbers in the conversation with children. Then the group of children shifted to a science center, lined chairs up and pretended it to be a train. The lead teacher moved to the science area with the children and facilitated pretend play. When children became restless, he/she read books and sang songs. When all the children cleaned up breakfast, the lead teacher reminded them that it was time to go outside. The children gathered in front of the door and transitioned to the playground. During transition, the lead teacher walked backwards to supervise the group of children, while the other teacher held two children’s hands and stayed at the end of the group. As the group went through the gate to the playground, the lead teacher took head counts. On the playground, the children played with a slide structure, tricycles, toy vehicles, a sandbox with buckets, shovels and other accessories. The teachers were spread apart, and the supervision was adequate. I interviewed the other teacher in the classroom and Ms. Smith. Per interview, neither one (1) of them confirmed ever seeing the lead teacher use a laptop to provide children screen time, give personal food to the children, or spend significant amount of time looking at the personal phone. I interviewed Ms. Smith. She does not recall any occasions when she received a complaint regarding the lead teacher. The staff member on the report started the lead teacher role this school year, therefore, technical assistance, mentoring and frequent monitoring is provided by a teacher from another classroom and by Ms. Smith. Incident log and incident reports were monitored. The log was maintained in the administrator’s office. Per incident log, there were two incidents this school year, one (1) of which occurred on 7/27/23 and the other occurred on 10/5/23. Neither of the incidents involved the children in space #3. Per Ms. Smith, teachers are instructed to create incident report when visible markings were observed due to injuries and communicate the incident with parents. There was some running and climbing in the classroom, but teachers gave prompts to children to walk and other actions to stay safe. No significant behavioral issues were observed in the classroom. The children seemed happy to play and participate in the activities. The children were friendly and did not have any apparent bruises or cuts. Per interview with the other teacher in the classroom, two (2) children are potty-trained with occasional accidents, four (4) children are wearing pull-ups, and the rest of the children wear diapers. There are nineteen (19) children enrolled in this classroom. Between 9:00 am to 10:30 am , children’s diapers were not checked or changed. Per interview, children’s diaper/pull-ups are checked upon arrival. The child who arrived at 9:00am was not checked. For the violation of developmentally appropriate environment, the allegation is unsubstantiated. The lead teacher was attentive to the children. The teacher sand songs, read books, facilitated play and learning. The lesson plan was current and posted and North Carolina Foundation objectives were included in the plan. Screen time or any inappropriate activities were observed during the visit. The other teacher and Ms. Smith stated that they had not witnessed children being offered screen time in the classroom. For the violation of nutrition, the allegation of the teacher serving his/her personal food is unsubstantiated. The children age food provided by the facility, and the other teacher denied witnessing such action. For the violation of supervision, the allegation is unsubstantiated. By observation, the teachers were attentive to children in the classroom, and appropriate prompts were given to children. I did not observe apparent injuries on the children, concerning behaviors or lack of supervision. The teacher did not use cell phone during the visit, and the other teacher and Ms. Smith stated that they did not witness the lead teacher spend significant amount of time looking at his/her phone. For the violation of sanitation and health, the allegation is substantiated due to diaper change being completed on the schedule. On the schedule, diaper change is scheduled to be completed between 9:40 am – 10:00 am. Children were not checked by either teacher for soiled diaper during observation. The teachers stated that the children’s diapers/pull-up are checked upon arrival. Children shall be monitored for soiled diapers throughout the day and changed as needed. The classroom is messy with toys scattered but is appropriate for the two-year-old classroom. Food on the floor was swept after the morning snack and tables were cleaned and sanitized. Bathroom was maintained clean. I did not witness any unsanitary practice from either teacher. 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 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. In space #3, there were fourteen (14) children present, and eleven (11) children were signed in on the log. 10A NCAC 09 .0302(d)(4) 401 Diapers were not changed whenever they were soiled or wet and/or were changed on a shift basis. Between 9:00 am - 10:35 am, no children were checked for soiled diaper/pull-up. Per schedule, diaper changing is done from 9:40 am - 10:00 am. Per teacher interview, the diapers/pull-up are checked upon each child's arrival and after playground time. 10A NCAC 09 .0806(a) 861 Prohibited styrofoam and foam rubber products were accessible to children under 3 years of age and/or approved foam products were used without proper supervision. In space #3, a bag of diaper/pull-up are accessible to children. One (1) bag of diaper/pull-up in plastic wrapper was stored on the floor next to a shelf, the other bag on the shelf by the changing station, one bag in the top shelf. Two (2) bags of wipe were also stored on top of the changing station on the wall. .0604(q) Technical assistance was provided as follows: 125: arrival and departure time Arrival and departure time shall be recorded as children arrive and departure. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (4) daily records of arrival and departure times at the center for each child which shall be maintained as children arrive and depart; 401: Diaper change Diapers shall be changed based on each child’s needs. 10A NCAC 09 .0806 TOILETING, CLOTHING AND LINENS (a) Diapers shall be changed whenever they become soiled or wet and not on a shift basis. 861: easily torn plastics Easily torn plastics, including plastic wrapper for diapers/pull-ups, wipe in a plastic bag, Ziplock bags and grocery bags shall not be accessible to children who is younger than three (3). 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. 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 10/20/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013 or email kaoru.eddins@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: Use of appropriate sink: Please follow sanitation rules to use appropriate sinks for appropriate purposes. The sink used for toileting shall be disinfected when the sink is used for other purposes. The step stool for the children for the sink in the classroom is not appropriate size for some children, and the teachers had to lift children to use the sink. Appropriate furniture to aid children use the sink is advised. Trash can: The trash can the children use to throw away food items is too tall for children to use it hand-free. Children had to lift the lids to throw away food. Appropriate, child-sized trash cans are strongly recommended. Transition process: I observed the transition of the group from the classroom to outside. The teachers did not take head counts of the children out loud. Two (2)-year-old children may not be capable of lining up, but accurate head counts should be taken by both teachers. Communications between teachers should occur to make sure that everyone is accounted for before leaving the classroom to prevent supervision/transition mistakes. If you have any questions or concerns regarding the Stabilization, Expansion and Access 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. 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 to 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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: EMMANUEL LUTHERAN SCHOOL Facility ID: 1155052 Consultant: KAORU EDDINS Operation Type: Center Case Number: 1023-012L Visit Date: 10/6/2023 Number Present: 112 Completed Date: 10/6/2023 Age: From 0 To 5 Total Minutes: 214 Time In: 08:56 AM Time Out: 12:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a complaint visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Christine Smith, Administrator, during the visit. An electronic signed copy of the visit summary was printed and left on-site with you. Today, Christine Smith, Administrator, was available during today’s visit. Limited monitoring of child care rules was conducted during today’s visit including but not limited to developmentally appropriate environment, supervision, nutrition, sanitation and health. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89) percentage as of 10/3/23. Emmanuel Lutheran School operates with four-star center license issue on 6/20/19 with restrictions: daytime care, meets enhanced space and reduced ratios. The report was received by the Division of Child Development and Early Education (DCDEE) on 10/2/23 and sent to me on the same day. The concerns are regarding a developmentally appropriate environment, supervision, nutrition, sanitation and health in a two-year-old classroom. For developmentally appropriate environment, the reporter stated that the appropriate teaching is not occurring in the classroom. No structure or proper schedule are followed by the teacher. Children receive inappropriate amounts of screen time. For supervision, the reporter states that the teacher in the classroom sits around and plays on the mobile device. There are several cases of severe injuries that occurred in the classroom due to lack of supervision, and there are no explanations to parents. In regard to nutrition, the reporter stated that the teacher gives the children inappropriate food and drinks that are the teacher’s personal food/drink. For the concerns for sanitation and health, the reporter stated that the room is not maintained clean, children are not kept clean and/or wear soiled diaper/pull-up, and the teacher rubs his/her nose with children as a gesture of affection. In order to investigate the allegations, I observed the classroom in the report and interviewed teachers and Ms. Smith. Upon arrival, I announced my presence and the purpose of the visit. I observed the classroom in room 101, space #3. There were thirteen (13) children present and one (1) child arrived during the visit. On the sign in/out sheet, eleven (11) children were signed in for today. Upon arrival in the classroom, the group of two-year-old children engaged in group time. The lead teacher led the group time by singing songs and reading books while the other teacher cleaned the tables and prepared for morning snack. The children washed their hands in the sink in the classroom, sat at the table and had a morning snack. Today’s snacks were cornflakes and milk. One of the children brought yogurt, blackberries and cut grapes for the snack. The items were listed on the menu. The lead teacher sat with the children and gave prompts to stay seated and aided children ate. Around 9:40 am, some of the children finished up breakfast and started roaming. The lead teacher directed the children to wash their hands. Children washed their hands in the bathroom and started playing in the centers. The lead teacher joined the children in the housekeeping center. One (1) of the children started throwing a pretend orange. The teacher prompted and told the child “That’s not a ball, that’s an orange”. He/she added colors and numbers in the conversation with children. Then the group of children shifted to a science center, lined chairs up and pretended it to be a train. The lead teacher moved to the science area with the children and facilitated pretend play. When children became restless, he/she read books and sang songs. When all the children cleaned up breakfast, the lead teacher reminded them that it was time to go outside. The children gathered in front of the door and transitioned to the playground. During transition, the lead teacher walked backwards to supervise the group of children, while the other teacher held two children’s hands and stayed at the end of the group. As the group went through the gate to the playground, the lead teacher took head counts. On the playground, the children played with a slide structure, tricycles, toy vehicles, a sandbox with buckets, shovels and other accessories. The teachers were spread apart, and the supervision was adequate. I interviewed the other teacher in the classroom and Ms. Smith. Per interview, neither one (1) of them confirmed ever seeing the lead teacher use a laptop to provide children screen time, give personal food to the children, or spend significant amount of time looking at the personal phone. I interviewed Ms. Smith. She does not recall any occasions when she received a complaint regarding the lead teacher. The staff member on the report started the lead teacher role this school year, therefore, technical assistance, mentoring and frequent monitoring is provided by a teacher from another classroom and by Ms. Smith. Incident log and incident reports were monitored. The log was maintained in the administrator’s office. Per incident log, there were two incidents this school year, one (1) of which occurred on 7/27/23 and the other occurred on 10/5/23. Neither of the incidents involved the children in space #3. Per Ms. Smith, teachers are instructed to create incident report when visible markings were observed due to injuries and communicate the incident with parents. There was some running and climbing in the classroom, but teachers gave prompts to children to walk and other actions to stay safe. No significant behavioral issues were observed in the classroom. The children seemed happy to play and participate in the activities. The children were friendly and did not have any apparent bruises or cuts. Per interview with the other teacher in the classroom, two (2) children are potty-trained with occasional accidents, four (4) children are wearing pull-ups, and the rest of the children wear diapers. There are nineteen (19) children enrolled in this classroom. Between 9:00 am to 10:30 am , children’s diapers were not checked or changed. Per interview, children’s diaper/pull-ups are checked upon arrival. The child who arrived at 9:00am was not checked. For the violation of developmentally appropriate environment, the allegation is unsubstantiated. The lead teacher was attentive to the children. The teacher sand songs, read books, facilitated play and learning. The lesson plan was current and posted and North Carolina Foundation objectives were included in the plan. Screen time or any inappropriate activities were observed during the visit. The other teacher and Ms. Smith stated that they had not witnessed children being offered screen time in the classroom. For the violation of nutrition, the allegation of the teacher serving his/her personal food is unsubstantiated. The children age food provided by the facility, and the other teacher denied witnessing such action. For the violation of supervision, the allegation is unsubstantiated. By observation, the teachers were attentive to children in the classroom, and appropriate prompts were given to children. I did not observe apparent injuries on the children, concerning behaviors or lack of supervision. The teacher did not use cell phone during the visit, and the other teacher and Ms. Smith stated that they did not witness the lead teacher spend significant amount of time looking at his/her phone. For the violation of sanitation and health, the allegation is substantiated due to diaper change being completed on the schedule. On the schedule, diaper change is scheduled to be completed between 9:40 am – 10:00 am. Children were not checked by either teacher for soiled diaper during observation. The teachers stated that the children’s diapers/pull-up are checked upon arrival. Children shall be monitored for soiled diapers throughout the day and changed as needed. The classroom is messy with toys scattered but is appropriate for the two-year-old classroom. Food on the floor was swept after the morning snack and tables were cleaned and sanitized. Bathroom was maintained clean. I did not witness any unsanitary practice from either teacher. 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 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. In space #3, there were fourteen (14) children present, and eleven (11) children were signed in on the log. 10A NCAC 09 .0302(d)(4) 401 Diapers were not changed whenever they were soiled or wet and/or were changed on a shift basis. Between 9:00 am - 10:35 am, no children were checked for soiled diaper/pull-up. Per schedule, diaper changing is done from 9:40 am - 10:00 am. Per teacher interview, the diapers/pull-up are checked upon each child's arrival and after playground time. 10A NCAC 09 .0806(a) 861 Prohibited styrofoam and foam rubber products were accessible to children under 3 years of age and/or approved foam products were used without proper supervision. In space #3, a bag of diaper/pull-up are accessible to children. One (1) bag of diaper/pull-up in plastic wrapper was stored on the floor next to a shelf, the other bag on the shelf by the changing station, one bag in the top shelf. Two (2) bags of wipe were also stored on top of the changing station on the wall. .0604(q) Technical assistance was provided as follows: 125: arrival and departure time Arrival and departure time shall be recorded as children arrive and departure. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (4) daily records of arrival and departure times at the center for each child which shall be maintained as children arrive and depart; 401: Diaper change Diapers shall be changed based on each child’s needs. 10A NCAC 09 .0806 TOILETING, CLOTHING AND LINENS (a) Diapers shall be changed whenever they become soiled or wet and not on a shift basis. 861: easily torn plastics Easily torn plastics, including plastic wrapper for diapers/pull-ups, wipe in a plastic bag, Ziplock bags and grocery bags shall not be accessible to children who is younger than three (3). 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. 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 10/20/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013 or email kaoru.eddins@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: Use of appropriate sink: Please follow sanitation rules to use appropriate sinks for appropriate purposes. The sink used for toileting shall be disinfected when the sink is used for other purposes. The step stool for the children for the sink in the classroom is not appropriate size for some children, and the teachers had to lift children to use the sink. Appropriate furniture to aid children use the sink is advised. Trash can: The trash can the children use to throw away food items is too tall for children to use it hand-free. Children had to lift the lids to throw away food. Appropriate, child-sized trash cans are strongly recommended. Transition process: I observed the transition of the group from the classroom to outside. The teachers did not take head counts of the children out loud. Two (2)-year-old children may not be capable of lining up, but accurate head counts should be taken by both teachers. Communications between teachers should occur to make sure that everyone is accounted for before leaving the classroom to prevent supervision/transition mistakes. If you have any questions or concerns regarding the Stabilization, Expansion and Access 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. 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 to 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 kaoru.eddins@dhhs.nc.gov or 828.556.9013 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