Shema

10A NCAC 09 .1102 · Violation

Name of Operation: SHEMA Facility ID: 11000877 Consultant: KAORU EDDINS Operation Type: Family CC Home Case Number: Visit Date: 2/20/2026 Number Present: 5 Completed Date: 2/20/2026 Age: From 0 To 2 Total Minutes: 311 Time In: 09:04 AM Time Out: 02:15 PM Time In: Time Out: List to Use: Family CC Home 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 Martha Quinones, Owner/Operator, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to you. Today, Ms. Quinones 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 ninety-one (91) percent as of today prior to this visit. Permit type – five-star family child care home license issued on 8/28/25. Special Services/Restrictions – daytime care, 2nd shift, maximum of five (5) preschool children at any time, no more than three (3) children less than one (1) year old, children in care on ground level only. The last annual compliance visit was conducted on 3/10/25. The last fire drill was practiced on 1/23/26. The last lockdown drill was practiced on 12/19/25. The last playground inspection was documented on 1/23/26. The Emergency Medical Care plan was posted and current. The owner operator and a substitute staff member was listed. The approved curriculum is Creative Curriculum. Lead water testing was completed on 6/11/24 without hazards. Lead paint survey is currently reviewed by RTI. Enrollment survey for asbestos testing was started. Two (2) family members and one (1) staff member were listed on the Automated Criminal Background Check Management System (ABCMS) roster. Per Ms. Quinones, no children were currently enrolled in the 2nd shift. Upon arrival, I announced my presence and the purpose of the visit. Four (4) children, ranging in age from infants to two (2) years old, were present, and one (1) additional infant arrived shortly thereafter. Following handwashing, four (4) children were seated in high chairs and served breakfast/morning snacks. One (1) child was provided with a bottle and crackers, while another child received a banana and crackers. Ms. Quinones fed baby food to one (1) child using a spoon. Supervision during mealtimes was adequate. Children bring their own food from home. Nutrition Opt-out form was on file for all children. After breakfast, Ms. Quinones changed the diapers of three (3) children. Each child’s hands were washed after their diaper change. Ms. Quinones washed her hands both before and after each diaper change. The changing table was sanitized and disinfected, and a timer was set to ensure proper disinfectant contact time. During free play, children played with balls, cars and instruments. Then, they played on the porch area. When they came back inside, all children’s hands were washed, and Ms. Quinones placed two (2) children in the cribs. Ms. Quinones monitored infants every fifteen (15) minutes while they slept. Fire extinguisher was maintained on the kitchen counter by the microwave. The refrigerator temperature was 42 degrees. Some diaper creams and a hand lotion were maintained in the cabinet above five (5) feet. Permission forms were reviewed in the children’s files. FCCH Verification of Required Information form was not submitted prior or during the visit. Ms. Quinones submitted FCCH Operator’s Statements of Responsibility form during the visit. I reminded Ms. Quinones that the Verification of Required Information form was required for her and substitute providers and needed to submit them as soon as possible. The playground was briefly monitored, and no safety concerns were observed. There was a Lasko heater placed on top of the children’s cubbies in the space where children sleep as well as on the kitchen counter. The heaters were not in use during the visit. The door to stairs leading upstairs had a sliding latch, but it was not latched. Ms. Quinones and I discussed smoke detectors. The circular device – smoke detector, is installed in the hallway between the space children sleep and the space children play. It was in working order. I asked Ms. Quinones if it was operated by batteries or was electrically wired. She was not certain but thought it was operated by batteries. During the visit, I asked Ms. Quinones how non-mobile children were evacuated for fire drills. Per current EPR plan, it is stated that “infants and non-mobile children will be placed in mobile pack and play”. However, Ms. Quinones stated that they were transported in the evacuation crib. Since two (2) children were taking a nap, I asked Ms. Quinones to send me a picture of the device when the cover for the smoke detector is removed. This task is recommended while children are not in her care. Per Ms. Quinones, one (1) substitute staff member who is also her family member, only works during summer time. The other substitute staff members work 2-3 days each month, though it changes from time to time. Criminal background qualification letters for family members who resided at this residence. Due to lack of current verification forms for Ms. Quinones and one (1) substitute staff member, the verification form submitted in March 2025 was used to verify the information. Two (2) family members currently resides at this residence, and both of them had current criminal background letters. Ms. Quinones’ following training was verified during the visit: CPR/FA: completed on 2/28/25 and expires in February 2027. EPR in Child Care training was completed on 12/10/28 and Playground Safety training on 2/8/19. ITS/SIDS training was current and will expire on 1/22/27. Health and Safety training was completed on 3/7/22. Ms. Quinones met on-going training requirements by completing three (3) semester hours of ECE class at Community College the lasted from 1/8/24 – 5/7/24. criminal background letter was also current and will expire on 4/26/26. A Substitute staff member had current ITS/SIDS training completed on 9/10/25 and criminal background letter is valid through 5/3/26. The current CPR/FA certificate was not on file. All children’s files were monitored. Four (4) children had Written Plan of Care and one (1) child did not. However, Ms. Quinones does not contact routine task that require Written Plan of Care for children. One (1) child did not have documentation of discussion of parent participation and operational policies on file. Shema currently follows FCCH capacity option - a maximum of eight children, with no more than five children who are from birth to 5 years of age, plus three school-age children. Additionally, this facility follow no more than three (3) infants. I used the Family Child Care Home 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 706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. A can of Pledge Clean spray was maintained in an unlocked cabinet by the refridgerator. .1719 (a)(7) 708 Indoor stairs with more than two steps were not made inaccessible to children two years of age or younger. The latch for the door to stairs that lead upstairs was not latched while five (5) children two (2) years of age and under were present. The stairs have more than two (2) steps. 10 A NCAC 09 .1719(a)(29) 716 Electrical outlets not in use were not covered. An outlet by the recliner was not covered by a safety covers. 10A NCAC .1719(a)(27) 729 Appliances with heating elements, such as bottle warmers, crock pots, curling irons, and electrical cords were accessible to children. One (1) Lasko heater and its cord were accessible to the children. The heater was placed on the kitchen counter. 10A NCAC .1719(a)(28) 1404 Medication remaining after the course of treatment is completed, after authorization is withdrawn. or after authorization has expired, was not returned to the parent/guardian. Any medication not retrieved by parent/guardian within 72 hours of completion of treatment, or withdrawal of authorization, was not discarded. The authorization form for Aquaphor hand cream for a child, who was two (2) years of age, expired on 8/28/25 but the product was not returned to the parent or discarded. 10A NCAC 09 .1720(c)(5) 1405 Authorization for up to 12 months to apply over-the-counter medications, topical ointment, topical teething ointment or gel, insect repellents, fluoridated toothpaste, lotions, creams, and powders; such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed, was not in writing and did not contain information required by rule .1720(b)(7). Parent Choice diaper cream was maintained at facility for a child without authorization form. 10A NCAC 09 .1720(c)(4) 1875 The EPR Plan did not include the location of the Ready to Go File and/or required information. Evacuation method for infants and non-mobile children were changed from pack-N-play to evacuation crib, but the EPR plan was not updated. .1714(d)(10) 1921 Commercially manufactured equipment and furnishings were not assembled and installed according to procedures specified by the manufacturer. Two (2) Lasko portable heaters were present - one (1) on the kitchen counter by the recliner and the other one (1) on top of the children's cubbies in the sleeping area. .1719(a )(24) Technical assistance was provided as follows: 706: Aerosol spray Aerosol products must be stored in locked storage. Ms. Quinones stated that Pledge Clean spray would be removed from the unlocked kitchen cabinet and moved out of the space used by children. During the visit, a family member stopped by and took the aerosol can with her. This item was corrected during the visit. 708: Access to stairs Stairs with more than two (2) steps must not be accessible to children who are two (2) years of age and younger. The sliding latch to the door to stairs must be closed at all times. Ms. Quinones closed the latch during the visit. She also stated that it would be closed while children were in care. This item is corrected during the visit. 716: Electrical outlet Non-tampered Electrical outlets must be covered with safety covers. Ms. Quinones covered the outlet by the recliner during the visit. This item was corrected during the visit. 729: Electrical cord Electrical cords of appliances with heating elements cannot be accessible to the children. The electrical cord of Lasko portable heater on the kitchen counter was hanging down by the recliner where a child, who was two (2) years of age sat and read during the visit. I recommend removing the heater out of the child care space as there is no safe way to operate the device. A family member stopped by and removed both heaters from the child care space. This violation was corrected during the visit. 1404: Medication authorization Medication must be returned to the parents or discarded after permission form expires. The permission form for Aquaphor healing ointment for a child expired on 8/28/25. The medication must be returned to the parents immediately. Ms. Quinones stated that she wants to get updated permission form. I advised her to remove the ointment out of child care space until the permission form is obtained. In your compliance letter, please verify that the ointment was removed from the space. 1405: Medication authorization Operator must obtain a permission form for each medication. Parent Choice diaper cream was maintained for a child without a permission form. Ms. Quinones stated that she would send the diaper cream home with the parents. In your compliance letter, please verify the correction. 1875: EPR plan The program’s EPR plan must be updated annually on NC Risk Management Portal. Upon reviewing the EPR plan, you can sign on the title page, if you would like. You must update how you evacuate non-mobile infants upon emergency on the EPR plan. Additionally, you must consider a safe place to evacuate the children. In case of emergency, you must consider evacuating children further than front porch area. It is safe for infants and young toddlers to be in the evacuation crib for their safety. Your evacuation crib, if it is plan to be used in emergency, must be ready to be used. All materials stored inside of the crib must be removed. Ms. Quinones stated that she would try to update the EPR plan. She took a picture of NC Risk Management Portal website. Please log on to https://staging.ncem.org/portal/ 1921: Manufacture’s Instructions Any commercially manufactured equipment must be installed according to specifics to manufacture’s instruction. Lasko portable heater must not be maintained or used on other furniture. The heater placed on top of kitchen cabinet and the one on top of children’s cubbies in the sleeping area must be placed on the ground. However, appliances with heating elements cannot be accessible to the children. Therefore, Lasko portable heater shall not be used to heat child care home space that is used by children. A family member stopped by and removed both Lasko heaters from the child care space. This item was corrected during the 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 3/6/26. 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: Criminal background check: Most of your criminal background letters will expire between April – June 2026. Please plan to renew criminal background check promptly without lapse. Verification of information for Operator and additional caregivers: Please complete the form for yourself and a substitute provider and submit them to me as soon as possible. Lead Paint and Asbestos Testing: Please complete the enrollment survey for asbestos. 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 was required to be completed by May 31, 2025. New and terminated staff notification requirement: Please add yourself to the ABCMS roster. 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. 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. Questions: Ms. Quinones asked about changing porch to covered space with a permanent wall. I need additional researches and promised her to reach back to her via email. Ms. Quinones and I discussed the new law for FCCH capacity as well as restrictions on the license. Due to her current enrollment with two (2) infants, two (2) one's and one (1) two (2) year old, not additional children 0-5 cannot be enrolled. We reviewed the contact information for Buncombe County subsidy and CACFP during the visit. 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. 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: SHEMA Facility ID: 11000877 Consultant: KAORU EDDINS Operation Type: Family CC Home Case Number: Visit Date: 2/20/2026 Number Present: 5 Completed Date: 2/20/2026 Age: From 0 To 2 Total Minutes: 311 Time In: 09:04 AM Time Out: 02:15 PM Time In: Time Out: List to Use: Family CC Home 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 Martha Quinones, Owner/Operator, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to you. Today, Ms. Quinones 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 ninety-one (91) percent as of today prior to this visit. Permit type – five-star family child care home license issued on 8/28/25. Special Services/Restrictions – daytime care, 2nd shift, maximum of five (5) preschool children at any time, no more than three (3) children less than one (1) year old, children in care on ground level only. The last annual compliance visit was conducted on 3/10/25. The last fire drill was practiced on 1/23/26. The last lockdown drill was practiced on 12/19/25. The last playground inspection was documented on 1/23/26. The Emergency Medical Care plan was posted and current. The owner operator and a substitute staff member was listed. The approved curriculum is Creative Curriculum. Lead water testing was completed on 6/11/24 without hazards. Lead paint survey is currently reviewed by RTI. Enrollment survey for asbestos testing was started. Two (2) family members and one (1) staff member were listed on the Automated Criminal Background Check Management System (ABCMS) roster. Per Ms. Quinones, no children were currently enrolled in the 2nd shift. Upon arrival, I announced my presence and the purpose of the visit. Four (4) children, ranging in age from infants to two (2) years old, were present, and one (1) additional infant arrived shortly thereafter. Following handwashing, four (4) children were seated in high chairs and served breakfast/morning snacks. One (1) child was provided with a bottle and crackers, while another child received a banana and crackers. Ms. Quinones fed baby food to one (1) child using a spoon. Supervision during mealtimes was adequate. Children bring their own food from home. Nutrition Opt-out form was on file for all children. After breakfast, Ms. Quinones changed the diapers of three (3) children. Each child’s hands were washed after their diaper change. Ms. Quinones washed her hands both before and after each diaper change. The changing table was sanitized and disinfected, and a timer was set to ensure proper disinfectant contact time. During free play, children played with balls, cars and instruments. Then, they played on the porch area. When they came back inside, all children’s hands were washed, and Ms. Quinones placed two (2) children in the cribs. Ms. Quinones monitored infants every fifteen (15) minutes while they slept. Fire extinguisher was maintained on the kitchen counter by the microwave. The refrigerator temperature was 42 degrees. Some diaper creams and a hand lotion were maintained in the cabinet above five (5) feet. Permission forms were reviewed in the children’s files. FCCH Verification of Required Information form was not submitted prior or during the visit. Ms. Quinones submitted FCCH Operator’s Statements of Responsibility form during the visit. I reminded Ms. Quinones that the Verification of Required Information form was required for her and substitute providers and needed to submit them as soon as possible. The playground was briefly monitored, and no safety concerns were observed. There was a Lasko heater placed on top of the children’s cubbies in the space where children sleep as well as on the kitchen counter. The heaters were not in use during the visit. The door to stairs leading upstairs had a sliding latch, but it was not latched. Ms. Quinones and I discussed smoke detectors. The circular device – smoke detector, is installed in the hallway between the space children sleep and the space children play. It was in working order. I asked Ms. Quinones if it was operated by batteries or was electrically wired. She was not certain but thought it was operated by batteries. During the visit, I asked Ms. Quinones how non-mobile children were evacuated for fire drills. Per current EPR plan, it is stated that “infants and non-mobile children will be placed in mobile pack and play”. However, Ms. Quinones stated that they were transported in the evacuation crib. Since two (2) children were taking a nap, I asked Ms. Quinones to send me a picture of the device when the cover for the smoke detector is removed. This task is recommended while children are not in her care. Per Ms. Quinones, one (1) substitute staff member who is also her family member, only works during summer time. The other substitute staff members work 2-3 days each month, though it changes from time to time. Criminal background qualification letters for family members who resided at this residence. Due to lack of current verification forms for Ms. Quinones and one (1) substitute staff member, the verification form submitted in March 2025 was used to verify the information. Two (2) family members currently resides at this residence, and both of them had current criminal background letters. Ms. Quinones’ following training was verified during the visit: CPR/FA: completed on 2/28/25 and expires in February 2027. EPR in Child Care training was completed on 12/10/28 and Playground Safety training on 2/8/19. ITS/SIDS training was current and will expire on 1/22/27. Health and Safety training was completed on 3/7/22. Ms. Quinones met on-going training requirements by completing three (3) semester hours of ECE class at Community College the lasted from 1/8/24 – 5/7/24. criminal background letter was also current and will expire on 4/26/26. A Substitute staff member had current ITS/SIDS training completed on 9/10/25 and criminal background letter is valid through 5/3/26. The current CPR/FA certificate was not on file. All children’s files were monitored. Four (4) children had Written Plan of Care and one (1) child did not. However, Ms. Quinones does not contact routine task that require Written Plan of Care for children. One (1) child did not have documentation of discussion of parent participation and operational policies on file. Shema currently follows FCCH capacity option - a maximum of eight children, with no more than five children who are from birth to 5 years of age, plus three school-age children. Additionally, this facility follow no more than three (3) infants. I used the Family Child Care Home 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 706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. A can of Pledge Clean spray was maintained in an unlocked cabinet by the refridgerator. .1719 (a)(7) 708 Indoor stairs with more than two steps were not made inaccessible to children two years of age or younger. The latch for the door to stairs that lead upstairs was not latched while five (5) children two (2) years of age and under were present. The stairs have more than two (2) steps. 10 A NCAC 09 .1719(a)(29) 716 Electrical outlets not in use were not covered. An outlet by the recliner was not covered by a safety covers. 10A NCAC .1719(a)(27) 729 Appliances with heating elements, such as bottle warmers, crock pots, curling irons, and electrical cords were accessible to children. One (1) Lasko heater and its cord were accessible to the children. The heater was placed on the kitchen counter. 10A NCAC .1719(a)(28) 1404 Medication remaining after the course of treatment is completed, after authorization is withdrawn. or after authorization has expired, was not returned to the parent/guardian. Any medication not retrieved by parent/guardian within 72 hours of completion of treatment, or withdrawal of authorization, was not discarded. The authorization form for Aquaphor hand cream for a child, who was two (2) years of age, expired on 8/28/25 but the product was not returned to the parent or discarded. 10A NCAC 09 .1720(c)(5) 1405 Authorization for up to 12 months to apply over-the-counter medications, topical ointment, topical teething ointment or gel, insect repellents, fluoridated toothpaste, lotions, creams, and powders; such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed, was not in writing and did not contain information required by rule .1720(b)(7). Parent Choice diaper cream was maintained at facility for a child without authorization form. 10A NCAC 09 .1720(c)(4) 1875 The EPR Plan did not include the location of the Ready to Go File and/or required information. Evacuation method for infants and non-mobile children were changed from pack-N-play to evacuation crib, but the EPR plan was not updated. .1714(d)(10) 1921 Commercially manufactured equipment and furnishings were not assembled and installed according to procedures specified by the manufacturer. Two (2) Lasko portable heaters were present - one (1) on the kitchen counter by the recliner and the other one (1) on top of the children's cubbies in the sleeping area. .1719(a )(24) Technical assistance was provided as follows: 706: Aerosol spray Aerosol products must be stored in locked storage. Ms. Quinones stated that Pledge Clean spray would be removed from the unlocked kitchen cabinet and moved out of the space used by children. During the visit, a family member stopped by and took the aerosol can with her. This item was corrected during the visit. 708: Access to stairs Stairs with more than two (2) steps must not be accessible to children who are two (2) years of age and younger. The sliding latch to the door to stairs must be closed at all times. Ms. Quinones closed the latch during the visit. She also stated that it would be closed while children were in care. This item is corrected during the visit. 716: Electrical outlet Non-tampered Electrical outlets must be covered with safety covers. Ms. Quinones covered the outlet by the recliner during the visit. This item was corrected during the visit. 729: Electrical cord Electrical cords of appliances with heating elements cannot be accessible to the children. The electrical cord of Lasko portable heater on the kitchen counter was hanging down by the recliner where a child, who was two (2) years of age sat and read during the visit. I recommend removing the heater out of the child care space as there is no safe way to operate the device. A family member stopped by and removed both heaters from the child care space. This violation was corrected during the visit. 1404: Medication authorization Medication must be returned to the parents or discarded after permission form expires. The permission form for Aquaphor healing ointment for a child expired on 8/28/25. The medication must be returned to the parents immediately. Ms. Quinones stated that she wants to get updated permission form. I advised her to remove the ointment out of child care space until the permission form is obtained. In your compliance letter, please verify that the ointment was removed from the space. 1405: Medication authorization Operator must obtain a permission form for each medication. Parent Choice diaper cream was maintained for a child without a permission form. Ms. Quinones stated that she would send the diaper cream home with the parents. In your compliance letter, please verify the correction. 1875: EPR plan The program’s EPR plan must be updated annually on NC Risk Management Portal. Upon reviewing the EPR plan, you can sign on the title page, if you would like. You must update how you evacuate non-mobile infants upon emergency on the EPR plan. Additionally, you must consider a safe place to evacuate the children. In case of emergency, you must consider evacuating children further than front porch area. It is safe for infants and young toddlers to be in the evacuation crib for their safety. Your evacuation crib, if it is plan to be used in emergency, must be ready to be used. All materials stored inside of the crib must be removed. Ms. Quinones stated that she would try to update the EPR plan. She took a picture of NC Risk Management Portal website. Please log on to https://staging.ncem.org/portal/ 1921: Manufacture’s Instructions Any commercially manufactured equipment must be installed according to specifics to manufacture’s instruction. Lasko portable heater must not be maintained or used on other furniture. The heater placed on top of kitchen cabinet and the one on top of children’s cubbies in the sleeping area must be placed on the ground. However, appliances with heating elements cannot be accessible to the children. Therefore, Lasko portable heater shall not be used to heat child care home space that is used by children. A family member stopped by and removed both Lasko heaters from the child care space. This item was corrected during the 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 3/6/26. 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: Criminal background check: Most of your criminal background letters will expire between April – June 2026. Please plan to renew criminal background check promptly without lapse. Verification of information for Operator and additional caregivers: Please complete the form for yourself and a substitute provider and submit them to me as soon as possible. Lead Paint and Asbestos Testing: Please complete the enrollment survey for asbestos. 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 was required to be completed by May 31, 2025. New and terminated staff notification requirement: Please add yourself to the ABCMS roster. 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. 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. Questions: Ms. Quinones asked about changing porch to covered space with a permanent wall. I need additional researches and promised her to reach back to her via email. Ms. Quinones and I discussed the new law for FCCH capacity as well as restrictions on the license. Due to her current enrollment with two (2) infants, two (2) one's and one (1) two (2) year old, not additional children 0-5 cannot be enrolled. We reviewed the contact information for Buncombe County subsidy and CACFP during the visit. 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. 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 .1720 · Violation

Name of Operation: SHEMA Facility ID: 11000877 Consultant: KAORU EDDINS Operation Type: Family CC Home Case Number: Visit Date: 2/20/2026 Number Present: 5 Completed Date: 2/20/2026 Age: From 0 To 2 Total Minutes: 311 Time In: 09:04 AM Time Out: 02:15 PM Time In: Time Out: List to Use: Family CC Home 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 Martha Quinones, Owner/Operator, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to you. Today, Ms. Quinones 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 ninety-one (91) percent as of today prior to this visit. Permit type – five-star family child care home license issued on 8/28/25. Special Services/Restrictions – daytime care, 2nd shift, maximum of five (5) preschool children at any time, no more than three (3) children less than one (1) year old, children in care on ground level only. The last annual compliance visit was conducted on 3/10/25. The last fire drill was practiced on 1/23/26. The last lockdown drill was practiced on 12/19/25. The last playground inspection was documented on 1/23/26. The Emergency Medical Care plan was posted and current. The owner operator and a substitute staff member was listed. The approved curriculum is Creative Curriculum. Lead water testing was completed on 6/11/24 without hazards. Lead paint survey is currently reviewed by RTI. Enrollment survey for asbestos testing was started. Two (2) family members and one (1) staff member were listed on the Automated Criminal Background Check Management System (ABCMS) roster. Per Ms. Quinones, no children were currently enrolled in the 2nd shift. Upon arrival, I announced my presence and the purpose of the visit. Four (4) children, ranging in age from infants to two (2) years old, were present, and one (1) additional infant arrived shortly thereafter. Following handwashing, four (4) children were seated in high chairs and served breakfast/morning snacks. One (1) child was provided with a bottle and crackers, while another child received a banana and crackers. Ms. Quinones fed baby food to one (1) child using a spoon. Supervision during mealtimes was adequate. Children bring their own food from home. Nutrition Opt-out form was on file for all children. After breakfast, Ms. Quinones changed the diapers of three (3) children. Each child’s hands were washed after their diaper change. Ms. Quinones washed her hands both before and after each diaper change. The changing table was sanitized and disinfected, and a timer was set to ensure proper disinfectant contact time. During free play, children played with balls, cars and instruments. Then, they played on the porch area. When they came back inside, all children’s hands were washed, and Ms. Quinones placed two (2) children in the cribs. Ms. Quinones monitored infants every fifteen (15) minutes while they slept. Fire extinguisher was maintained on the kitchen counter by the microwave. The refrigerator temperature was 42 degrees. Some diaper creams and a hand lotion were maintained in the cabinet above five (5) feet. Permission forms were reviewed in the children’s files. FCCH Verification of Required Information form was not submitted prior or during the visit. Ms. Quinones submitted FCCH Operator’s Statements of Responsibility form during the visit. I reminded Ms. Quinones that the Verification of Required Information form was required for her and substitute providers and needed to submit them as soon as possible. The playground was briefly monitored, and no safety concerns were observed. There was a Lasko heater placed on top of the children’s cubbies in the space where children sleep as well as on the kitchen counter. The heaters were not in use during the visit. The door to stairs leading upstairs had a sliding latch, but it was not latched. Ms. Quinones and I discussed smoke detectors. The circular device – smoke detector, is installed in the hallway between the space children sleep and the space children play. It was in working order. I asked Ms. Quinones if it was operated by batteries or was electrically wired. She was not certain but thought it was operated by batteries. During the visit, I asked Ms. Quinones how non-mobile children were evacuated for fire drills. Per current EPR plan, it is stated that “infants and non-mobile children will be placed in mobile pack and play”. However, Ms. Quinones stated that they were transported in the evacuation crib. Since two (2) children were taking a nap, I asked Ms. Quinones to send me a picture of the device when the cover for the smoke detector is removed. This task is recommended while children are not in her care. Per Ms. Quinones, one (1) substitute staff member who is also her family member, only works during summer time. The other substitute staff members work 2-3 days each month, though it changes from time to time. Criminal background qualification letters for family members who resided at this residence. Due to lack of current verification forms for Ms. Quinones and one (1) substitute staff member, the verification form submitted in March 2025 was used to verify the information. Two (2) family members currently resides at this residence, and both of them had current criminal background letters. Ms. Quinones’ following training was verified during the visit: CPR/FA: completed on 2/28/25 and expires in February 2027. EPR in Child Care training was completed on 12/10/28 and Playground Safety training on 2/8/19. ITS/SIDS training was current and will expire on 1/22/27. Health and Safety training was completed on 3/7/22. Ms. Quinones met on-going training requirements by completing three (3) semester hours of ECE class at Community College the lasted from 1/8/24 – 5/7/24. criminal background letter was also current and will expire on 4/26/26. A Substitute staff member had current ITS/SIDS training completed on 9/10/25 and criminal background letter is valid through 5/3/26. The current CPR/FA certificate was not on file. All children’s files were monitored. Four (4) children had Written Plan of Care and one (1) child did not. However, Ms. Quinones does not contact routine task that require Written Plan of Care for children. One (1) child did not have documentation of discussion of parent participation and operational policies on file. Shema currently follows FCCH capacity option - a maximum of eight children, with no more than five children who are from birth to 5 years of age, plus three school-age children. Additionally, this facility follow no more than three (3) infants. I used the Family Child Care Home 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 706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. A can of Pledge Clean spray was maintained in an unlocked cabinet by the refridgerator. .1719 (a)(7) 708 Indoor stairs with more than two steps were not made inaccessible to children two years of age or younger. The latch for the door to stairs that lead upstairs was not latched while five (5) children two (2) years of age and under were present. The stairs have more than two (2) steps. 10 A NCAC 09 .1719(a)(29) 716 Electrical outlets not in use were not covered. An outlet by the recliner was not covered by a safety covers. 10A NCAC .1719(a)(27) 729 Appliances with heating elements, such as bottle warmers, crock pots, curling irons, and electrical cords were accessible to children. One (1) Lasko heater and its cord were accessible to the children. The heater was placed on the kitchen counter. 10A NCAC .1719(a)(28) 1404 Medication remaining after the course of treatment is completed, after authorization is withdrawn. or after authorization has expired, was not returned to the parent/guardian. Any medication not retrieved by parent/guardian within 72 hours of completion of treatment, or withdrawal of authorization, was not discarded. The authorization form for Aquaphor hand cream for a child, who was two (2) years of age, expired on 8/28/25 but the product was not returned to the parent or discarded. 10A NCAC 09 .1720(c)(5) 1405 Authorization for up to 12 months to apply over-the-counter medications, topical ointment, topical teething ointment or gel, insect repellents, fluoridated toothpaste, lotions, creams, and powders; such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed, was not in writing and did not contain information required by rule .1720(b)(7). Parent Choice diaper cream was maintained at facility for a child without authorization form. 10A NCAC 09 .1720(c)(4) 1875 The EPR Plan did not include the location of the Ready to Go File and/or required information. Evacuation method for infants and non-mobile children were changed from pack-N-play to evacuation crib, but the EPR plan was not updated. .1714(d)(10) 1921 Commercially manufactured equipment and furnishings were not assembled and installed according to procedures specified by the manufacturer. Two (2) Lasko portable heaters were present - one (1) on the kitchen counter by the recliner and the other one (1) on top of the children's cubbies in the sleeping area. .1719(a )(24) Technical assistance was provided as follows: 706: Aerosol spray Aerosol products must be stored in locked storage. Ms. Quinones stated that Pledge Clean spray would be removed from the unlocked kitchen cabinet and moved out of the space used by children. During the visit, a family member stopped by and took the aerosol can with her. This item was corrected during the visit. 708: Access to stairs Stairs with more than two (2) steps must not be accessible to children who are two (2) years of age and younger. The sliding latch to the door to stairs must be closed at all times. Ms. Quinones closed the latch during the visit. She also stated that it would be closed while children were in care. This item is corrected during the visit. 716: Electrical outlet Non-tampered Electrical outlets must be covered with safety covers. Ms. Quinones covered the outlet by the recliner during the visit. This item was corrected during the visit. 729: Electrical cord Electrical cords of appliances with heating elements cannot be accessible to the children. The electrical cord of Lasko portable heater on the kitchen counter was hanging down by the recliner where a child, who was two (2) years of age sat and read during the visit. I recommend removing the heater out of the child care space as there is no safe way to operate the device. A family member stopped by and removed both heaters from the child care space. This violation was corrected during the visit. 1404: Medication authorization Medication must be returned to the parents or discarded after permission form expires. The permission form for Aquaphor healing ointment for a child expired on 8/28/25. The medication must be returned to the parents immediately. Ms. Quinones stated that she wants to get updated permission form. I advised her to remove the ointment out of child care space until the permission form is obtained. In your compliance letter, please verify that the ointment was removed from the space. 1405: Medication authorization Operator must obtain a permission form for each medication. Parent Choice diaper cream was maintained for a child without a permission form. Ms. Quinones stated that she would send the diaper cream home with the parents. In your compliance letter, please verify the correction. 1875: EPR plan The program’s EPR plan must be updated annually on NC Risk Management Portal. Upon reviewing the EPR plan, you can sign on the title page, if you would like. You must update how you evacuate non-mobile infants upon emergency on the EPR plan. Additionally, you must consider a safe place to evacuate the children. In case of emergency, you must consider evacuating children further than front porch area. It is safe for infants and young toddlers to be in the evacuation crib for their safety. Your evacuation crib, if it is plan to be used in emergency, must be ready to be used. All materials stored inside of the crib must be removed. Ms. Quinones stated that she would try to update the EPR plan. She took a picture of NC Risk Management Portal website. Please log on to https://staging.ncem.org/portal/ 1921: Manufacture’s Instructions Any commercially manufactured equipment must be installed according to specifics to manufacture’s instruction. Lasko portable heater must not be maintained or used on other furniture. The heater placed on top of kitchen cabinet and the one on top of children’s cubbies in the sleeping area must be placed on the ground. However, appliances with heating elements cannot be accessible to the children. Therefore, Lasko portable heater shall not be used to heat child care home space that is used by children. A family member stopped by and removed both Lasko heaters from the child care space. This item was corrected during the 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 3/6/26. 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: Criminal background check: Most of your criminal background letters will expire between April – June 2026. Please plan to renew criminal background check promptly without lapse. Verification of information for Operator and additional caregivers: Please complete the form for yourself and a substitute provider and submit them to me as soon as possible. Lead Paint and Asbestos Testing: Please complete the enrollment survey for asbestos. 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 was required to be completed by May 31, 2025. New and terminated staff notification requirement: Please add yourself to the ABCMS roster. 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. 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. Questions: Ms. Quinones asked about changing porch to covered space with a permanent wall. I need additional researches and promised her to reach back to her via email. Ms. Quinones and I discussed the new law for FCCH capacity as well as restrictions on the license. Due to her current enrollment with two (2) infants, two (2) one's and one (1) two (2) year old, not additional children 0-5 cannot be enrolled. We reviewed the contact information for Buncombe County subsidy and CACFP during the visit. 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. 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: SHEMA Facility ID: 11000877 Consultant: KAORU EDDINS Operation Type: Family CC Home Case Number: Visit Date: 2/20/2026 Number Present: 5 Completed Date: 2/20/2026 Age: From 0 To 2 Total Minutes: 311 Time In: 09:04 AM Time Out: 02:15 PM Time In: Time Out: List to Use: Family CC Home 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 Martha Quinones, Owner/Operator, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to you. Today, Ms. Quinones 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 ninety-one (91) percent as of today prior to this visit. Permit type – five-star family child care home license issued on 8/28/25. Special Services/Restrictions – daytime care, 2nd shift, maximum of five (5) preschool children at any time, no more than three (3) children less than one (1) year old, children in care on ground level only. The last annual compliance visit was conducted on 3/10/25. The last fire drill was practiced on 1/23/26. The last lockdown drill was practiced on 12/19/25. The last playground inspection was documented on 1/23/26. The Emergency Medical Care plan was posted and current. The owner operator and a substitute staff member was listed. The approved curriculum is Creative Curriculum. Lead water testing was completed on 6/11/24 without hazards. Lead paint survey is currently reviewed by RTI. Enrollment survey for asbestos testing was started. Two (2) family members and one (1) staff member were listed on the Automated Criminal Background Check Management System (ABCMS) roster. Per Ms. Quinones, no children were currently enrolled in the 2nd shift. Upon arrival, I announced my presence and the purpose of the visit. Four (4) children, ranging in age from infants to two (2) years old, were present, and one (1) additional infant arrived shortly thereafter. Following handwashing, four (4) children were seated in high chairs and served breakfast/morning snacks. One (1) child was provided with a bottle and crackers, while another child received a banana and crackers. Ms. Quinones fed baby food to one (1) child using a spoon. Supervision during mealtimes was adequate. Children bring their own food from home. Nutrition Opt-out form was on file for all children. After breakfast, Ms. Quinones changed the diapers of three (3) children. Each child’s hands were washed after their diaper change. Ms. Quinones washed her hands both before and after each diaper change. The changing table was sanitized and disinfected, and a timer was set to ensure proper disinfectant contact time. During free play, children played with balls, cars and instruments. Then, they played on the porch area. When they came back inside, all children’s hands were washed, and Ms. Quinones placed two (2) children in the cribs. Ms. Quinones monitored infants every fifteen (15) minutes while they slept. Fire extinguisher was maintained on the kitchen counter by the microwave. The refrigerator temperature was 42 degrees. Some diaper creams and a hand lotion were maintained in the cabinet above five (5) feet. Permission forms were reviewed in the children’s files. FCCH Verification of Required Information form was not submitted prior or during the visit. Ms. Quinones submitted FCCH Operator’s Statements of Responsibility form during the visit. I reminded Ms. Quinones that the Verification of Required Information form was required for her and substitute providers and needed to submit them as soon as possible. The playground was briefly monitored, and no safety concerns were observed. There was a Lasko heater placed on top of the children’s cubbies in the space where children sleep as well as on the kitchen counter. The heaters were not in use during the visit. The door to stairs leading upstairs had a sliding latch, but it was not latched. Ms. Quinones and I discussed smoke detectors. The circular device – smoke detector, is installed in the hallway between the space children sleep and the space children play. It was in working order. I asked Ms. Quinones if it was operated by batteries or was electrically wired. She was not certain but thought it was operated by batteries. During the visit, I asked Ms. Quinones how non-mobile children were evacuated for fire drills. Per current EPR plan, it is stated that “infants and non-mobile children will be placed in mobile pack and play”. However, Ms. Quinones stated that they were transported in the evacuation crib. Since two (2) children were taking a nap, I asked Ms. Quinones to send me a picture of the device when the cover for the smoke detector is removed. This task is recommended while children are not in her care. Per Ms. Quinones, one (1) substitute staff member who is also her family member, only works during summer time. The other substitute staff members work 2-3 days each month, though it changes from time to time. Criminal background qualification letters for family members who resided at this residence. Due to lack of current verification forms for Ms. Quinones and one (1) substitute staff member, the verification form submitted in March 2025 was used to verify the information. Two (2) family members currently resides at this residence, and both of them had current criminal background letters. Ms. Quinones’ following training was verified during the visit: CPR/FA: completed on 2/28/25 and expires in February 2027. EPR in Child Care training was completed on 12/10/28 and Playground Safety training on 2/8/19. ITS/SIDS training was current and will expire on 1/22/27. Health and Safety training was completed on 3/7/22. Ms. Quinones met on-going training requirements by completing three (3) semester hours of ECE class at Community College the lasted from 1/8/24 – 5/7/24. criminal background letter was also current and will expire on 4/26/26. A Substitute staff member had current ITS/SIDS training completed on 9/10/25 and criminal background letter is valid through 5/3/26. The current CPR/FA certificate was not on file. All children’s files were monitored. Four (4) children had Written Plan of Care and one (1) child did not. However, Ms. Quinones does not contact routine task that require Written Plan of Care for children. One (1) child did not have documentation of discussion of parent participation and operational policies on file. Shema currently follows FCCH capacity option - a maximum of eight children, with no more than five children who are from birth to 5 years of age, plus three school-age children. Additionally, this facility follow no more than three (3) infants. I used the Family Child Care Home 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 706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. A can of Pledge Clean spray was maintained in an unlocked cabinet by the refridgerator. .1719 (a)(7) 708 Indoor stairs with more than two steps were not made inaccessible to children two years of age or younger. The latch for the door to stairs that lead upstairs was not latched while five (5) children two (2) years of age and under were present. The stairs have more than two (2) steps. 10 A NCAC 09 .1719(a)(29) 716 Electrical outlets not in use were not covered. An outlet by the recliner was not covered by a safety covers. 10A NCAC .1719(a)(27) 729 Appliances with heating elements, such as bottle warmers, crock pots, curling irons, and electrical cords were accessible to children. One (1) Lasko heater and its cord were accessible to the children. The heater was placed on the kitchen counter. 10A NCAC .1719(a)(28) 1404 Medication remaining after the course of treatment is completed, after authorization is withdrawn. or after authorization has expired, was not returned to the parent/guardian. Any medication not retrieved by parent/guardian within 72 hours of completion of treatment, or withdrawal of authorization, was not discarded. The authorization form for Aquaphor hand cream for a child, who was two (2) years of age, expired on 8/28/25 but the product was not returned to the parent or discarded. 10A NCAC 09 .1720(c)(5) 1405 Authorization for up to 12 months to apply over-the-counter medications, topical ointment, topical teething ointment or gel, insect repellents, fluoridated toothpaste, lotions, creams, and powders; such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed, was not in writing and did not contain information required by rule .1720(b)(7). Parent Choice diaper cream was maintained at facility for a child without authorization form. 10A NCAC 09 .1720(c)(4) 1875 The EPR Plan did not include the location of the Ready to Go File and/or required information. Evacuation method for infants and non-mobile children were changed from pack-N-play to evacuation crib, but the EPR plan was not updated. .1714(d)(10) 1921 Commercially manufactured equipment and furnishings were not assembled and installed according to procedures specified by the manufacturer. Two (2) Lasko portable heaters were present - one (1) on the kitchen counter by the recliner and the other one (1) on top of the children's cubbies in the sleeping area. .1719(a )(24) Technical assistance was provided as follows: 706: Aerosol spray Aerosol products must be stored in locked storage. Ms. Quinones stated that Pledge Clean spray would be removed from the unlocked kitchen cabinet and moved out of the space used by children. During the visit, a family member stopped by and took the aerosol can with her. This item was corrected during the visit. 708: Access to stairs Stairs with more than two (2) steps must not be accessible to children who are two (2) years of age and younger. The sliding latch to the door to stairs must be closed at all times. Ms. Quinones closed the latch during the visit. She also stated that it would be closed while children were in care. This item is corrected during the visit. 716: Electrical outlet Non-tampered Electrical outlets must be covered with safety covers. Ms. Quinones covered the outlet by the recliner during the visit. This item was corrected during the visit. 729: Electrical cord Electrical cords of appliances with heating elements cannot be accessible to the children. The electrical cord of Lasko portable heater on the kitchen counter was hanging down by the recliner where a child, who was two (2) years of age sat and read during the visit. I recommend removing the heater out of the child care space as there is no safe way to operate the device. A family member stopped by and removed both heaters from the child care space. This violation was corrected during the visit. 1404: Medication authorization Medication must be returned to the parents or discarded after permission form expires. The permission form for Aquaphor healing ointment for a child expired on 8/28/25. The medication must be returned to the parents immediately. Ms. Quinones stated that she wants to get updated permission form. I advised her to remove the ointment out of child care space until the permission form is obtained. In your compliance letter, please verify that the ointment was removed from the space. 1405: Medication authorization Operator must obtain a permission form for each medication. Parent Choice diaper cream was maintained for a child without a permission form. Ms. Quinones stated that she would send the diaper cream home with the parents. In your compliance letter, please verify the correction. 1875: EPR plan The program’s EPR plan must be updated annually on NC Risk Management Portal. Upon reviewing the EPR plan, you can sign on the title page, if you would like. You must update how you evacuate non-mobile infants upon emergency on the EPR plan. Additionally, you must consider a safe place to evacuate the children. In case of emergency, you must consider evacuating children further than front porch area. It is safe for infants and young toddlers to be in the evacuation crib for their safety. Your evacuation crib, if it is plan to be used in emergency, must be ready to be used. All materials stored inside of the crib must be removed. Ms. Quinones stated that she would try to update the EPR plan. She took a picture of NC Risk Management Portal website. Please log on to https://staging.ncem.org/portal/ 1921: Manufacture’s Instructions Any commercially manufactured equipment must be installed according to specifics to manufacture’s instruction. Lasko portable heater must not be maintained or used on other furniture. The heater placed on top of kitchen cabinet and the one on top of children’s cubbies in the sleeping area must be placed on the ground. However, appliances with heating elements cannot be accessible to the children. Therefore, Lasko portable heater shall not be used to heat child care home space that is used by children. A family member stopped by and removed both Lasko heaters from the child care space. This item was corrected during the 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 3/6/26. 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: Criminal background check: Most of your criminal background letters will expire between April – June 2026. Please plan to renew criminal background check promptly without lapse. Verification of information for Operator and additional caregivers: Please complete the form for yourself and a substitute provider and submit them to me as soon as possible. Lead Paint and Asbestos Testing: Please complete the enrollment survey for asbestos. 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 was required to be completed by May 31, 2025. New and terminated staff notification requirement: Please add yourself to the ABCMS roster. 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. 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. Questions: Ms. Quinones asked about changing porch to covered space with a permanent wall. I need additional researches and promised her to reach back to her via email. Ms. Quinones and I discussed the new law for FCCH capacity as well as restrictions on the license. Due to her current enrollment with two (2) infants, two (2) one's and one (1) two (2) year old, not additional children 0-5 cannot be enrolled. We reviewed the contact information for Buncombe County subsidy and CACFP during the visit. 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. 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: SHEMA Facility ID: 11000877 Consultant: KAORU EDDINS Operation Type: Family CC Home Case Number: Visit Date: 2/20/2026 Number Present: 5 Completed Date: 2/20/2026 Age: From 0 To 2 Total Minutes: 311 Time In: 09:04 AM Time Out: 02:15 PM Time In: Time Out: List to Use: Family CC Home 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 Martha Quinones, Owner/Operator, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to you. Today, Ms. Quinones 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 ninety-one (91) percent as of today prior to this visit. Permit type – five-star family child care home license issued on 8/28/25. Special Services/Restrictions – daytime care, 2nd shift, maximum of five (5) preschool children at any time, no more than three (3) children less than one (1) year old, children in care on ground level only. The last annual compliance visit was conducted on 3/10/25. The last fire drill was practiced on 1/23/26. The last lockdown drill was practiced on 12/19/25. The last playground inspection was documented on 1/23/26. The Emergency Medical Care plan was posted and current. The owner operator and a substitute staff member was listed. The approved curriculum is Creative Curriculum. Lead water testing was completed on 6/11/24 without hazards. Lead paint survey is currently reviewed by RTI. Enrollment survey for asbestos testing was started. Two (2) family members and one (1) staff member were listed on the Automated Criminal Background Check Management System (ABCMS) roster. Per Ms. Quinones, no children were currently enrolled in the 2nd shift. Upon arrival, I announced my presence and the purpose of the visit. Four (4) children, ranging in age from infants to two (2) years old, were present, and one (1) additional infant arrived shortly thereafter. Following handwashing, four (4) children were seated in high chairs and served breakfast/morning snacks. One (1) child was provided with a bottle and crackers, while another child received a banana and crackers. Ms. Quinones fed baby food to one (1) child using a spoon. Supervision during mealtimes was adequate. Children bring their own food from home. Nutrition Opt-out form was on file for all children. After breakfast, Ms. Quinones changed the diapers of three (3) children. Each child’s hands were washed after their diaper change. Ms. Quinones washed her hands both before and after each diaper change. The changing table was sanitized and disinfected, and a timer was set to ensure proper disinfectant contact time. During free play, children played with balls, cars and instruments. Then, they played on the porch area. When they came back inside, all children’s hands were washed, and Ms. Quinones placed two (2) children in the cribs. Ms. Quinones monitored infants every fifteen (15) minutes while they slept. Fire extinguisher was maintained on the kitchen counter by the microwave. The refrigerator temperature was 42 degrees. Some diaper creams and a hand lotion were maintained in the cabinet above five (5) feet. Permission forms were reviewed in the children’s files. FCCH Verification of Required Information form was not submitted prior or during the visit. Ms. Quinones submitted FCCH Operator’s Statements of Responsibility form during the visit. I reminded Ms. Quinones that the Verification of Required Information form was required for her and substitute providers and needed to submit them as soon as possible. The playground was briefly monitored, and no safety concerns were observed. There was a Lasko heater placed on top of the children’s cubbies in the space where children sleep as well as on the kitchen counter. The heaters were not in use during the visit. The door to stairs leading upstairs had a sliding latch, but it was not latched. Ms. Quinones and I discussed smoke detectors. The circular device – smoke detector, is installed in the hallway between the space children sleep and the space children play. It was in working order. I asked Ms. Quinones if it was operated by batteries or was electrically wired. She was not certain but thought it was operated by batteries. During the visit, I asked Ms. Quinones how non-mobile children were evacuated for fire drills. Per current EPR plan, it is stated that “infants and non-mobile children will be placed in mobile pack and play”. However, Ms. Quinones stated that they were transported in the evacuation crib. Since two (2) children were taking a nap, I asked Ms. Quinones to send me a picture of the device when the cover for the smoke detector is removed. This task is recommended while children are not in her care. Per Ms. Quinones, one (1) substitute staff member who is also her family member, only works during summer time. The other substitute staff members work 2-3 days each month, though it changes from time to time. Criminal background qualification letters for family members who resided at this residence. Due to lack of current verification forms for Ms. Quinones and one (1) substitute staff member, the verification form submitted in March 2025 was used to verify the information. Two (2) family members currently resides at this residence, and both of them had current criminal background letters. Ms. Quinones’ following training was verified during the visit: CPR/FA: completed on 2/28/25 and expires in February 2027. EPR in Child Care training was completed on 12/10/28 and Playground Safety training on 2/8/19. ITS/SIDS training was current and will expire on 1/22/27. Health and Safety training was completed on 3/7/22. Ms. Quinones met on-going training requirements by completing three (3) semester hours of ECE class at Community College the lasted from 1/8/24 – 5/7/24. criminal background letter was also current and will expire on 4/26/26. A Substitute staff member had current ITS/SIDS training completed on 9/10/25 and criminal background letter is valid through 5/3/26. The current CPR/FA certificate was not on file. All children’s files were monitored. Four (4) children had Written Plan of Care and one (1) child did not. However, Ms. Quinones does not contact routine task that require Written Plan of Care for children. One (1) child did not have documentation of discussion of parent participation and operational policies on file. Shema currently follows FCCH capacity option - a maximum of eight children, with no more than five children who are from birth to 5 years of age, plus three school-age children. Additionally, this facility follow no more than three (3) infants. I used the Family Child Care Home 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 706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. A can of Pledge Clean spray was maintained in an unlocked cabinet by the refridgerator. .1719 (a)(7) 708 Indoor stairs with more than two steps were not made inaccessible to children two years of age or younger. The latch for the door to stairs that lead upstairs was not latched while five (5) children two (2) years of age and under were present. The stairs have more than two (2) steps. 10 A NCAC 09 .1719(a)(29) 716 Electrical outlets not in use were not covered. An outlet by the recliner was not covered by a safety covers. 10A NCAC .1719(a)(27) 729 Appliances with heating elements, such as bottle warmers, crock pots, curling irons, and electrical cords were accessible to children. One (1) Lasko heater and its cord were accessible to the children. The heater was placed on the kitchen counter. 10A NCAC .1719(a)(28) 1404 Medication remaining after the course of treatment is completed, after authorization is withdrawn. or after authorization has expired, was not returned to the parent/guardian. Any medication not retrieved by parent/guardian within 72 hours of completion of treatment, or withdrawal of authorization, was not discarded. The authorization form for Aquaphor hand cream for a child, who was two (2) years of age, expired on 8/28/25 but the product was not returned to the parent or discarded. 10A NCAC 09 .1720(c)(5) 1405 Authorization for up to 12 months to apply over-the-counter medications, topical ointment, topical teething ointment or gel, insect repellents, fluoridated toothpaste, lotions, creams, and powders; such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed, was not in writing and did not contain information required by rule .1720(b)(7). Parent Choice diaper cream was maintained at facility for a child without authorization form. 10A NCAC 09 .1720(c)(4) 1875 The EPR Plan did not include the location of the Ready to Go File and/or required information. Evacuation method for infants and non-mobile children were changed from pack-N-play to evacuation crib, but the EPR plan was not updated. .1714(d)(10) 1921 Commercially manufactured equipment and furnishings were not assembled and installed according to procedures specified by the manufacturer. Two (2) Lasko portable heaters were present - one (1) on the kitchen counter by the recliner and the other one (1) on top of the children's cubbies in the sleeping area. .1719(a )(24) Technical assistance was provided as follows: 706: Aerosol spray Aerosol products must be stored in locked storage. Ms. Quinones stated that Pledge Clean spray would be removed from the unlocked kitchen cabinet and moved out of the space used by children. During the visit, a family member stopped by and took the aerosol can with her. This item was corrected during the visit. 708: Access to stairs Stairs with more than two (2) steps must not be accessible to children who are two (2) years of age and younger. The sliding latch to the door to stairs must be closed at all times. Ms. Quinones closed the latch during the visit. She also stated that it would be closed while children were in care. This item is corrected during the visit. 716: Electrical outlet Non-tampered Electrical outlets must be covered with safety covers. Ms. Quinones covered the outlet by the recliner during the visit. This item was corrected during the visit. 729: Electrical cord Electrical cords of appliances with heating elements cannot be accessible to the children. The electrical cord of Lasko portable heater on the kitchen counter was hanging down by the recliner where a child, who was two (2) years of age sat and read during the visit. I recommend removing the heater out of the child care space as there is no safe way to operate the device. A family member stopped by and removed both heaters from the child care space. This violation was corrected during the visit. 1404: Medication authorization Medication must be returned to the parents or discarded after permission form expires. The permission form for Aquaphor healing ointment for a child expired on 8/28/25. The medication must be returned to the parents immediately. Ms. Quinones stated that she wants to get updated permission form. I advised her to remove the ointment out of child care space until the permission form is obtained. In your compliance letter, please verify that the ointment was removed from the space. 1405: Medication authorization Operator must obtain a permission form for each medication. Parent Choice diaper cream was maintained for a child without a permission form. Ms. Quinones stated that she would send the diaper cream home with the parents. In your compliance letter, please verify the correction. 1875: EPR plan The program’s EPR plan must be updated annually on NC Risk Management Portal. Upon reviewing the EPR plan, you can sign on the title page, if you would like. You must update how you evacuate non-mobile infants upon emergency on the EPR plan. Additionally, you must consider a safe place to evacuate the children. In case of emergency, you must consider evacuating children further than front porch area. It is safe for infants and young toddlers to be in the evacuation crib for their safety. Your evacuation crib, if it is plan to be used in emergency, must be ready to be used. All materials stored inside of the crib must be removed. Ms. Quinones stated that she would try to update the EPR plan. She took a picture of NC Risk Management Portal website. Please log on to https://staging.ncem.org/portal/ 1921: Manufacture’s Instructions Any commercially manufactured equipment must be installed according to specifics to manufacture’s instruction. Lasko portable heater must not be maintained or used on other furniture. The heater placed on top of kitchen cabinet and the one on top of children’s cubbies in the sleeping area must be placed on the ground. However, appliances with heating elements cannot be accessible to the children. Therefore, Lasko portable heater shall not be used to heat child care home space that is used by children. A family member stopped by and removed both Lasko heaters from the child care space. This item was corrected during the 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 3/6/26. 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: Criminal background check: Most of your criminal background letters will expire between April – June 2026. Please plan to renew criminal background check promptly without lapse. Verification of information for Operator and additional caregivers: Please complete the form for yourself and a substitute provider and submit them to me as soon as possible. Lead Paint and Asbestos Testing: Please complete the enrollment survey for asbestos. 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 was required to be completed by May 31, 2025. New and terminated staff notification requirement: Please add yourself to the ABCMS roster. 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. 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. Questions: Ms. Quinones asked about changing porch to covered space with a permanent wall. I need additional researches and promised her to reach back to her via email. Ms. Quinones and I discussed the new law for FCCH capacity as well as restrictions on the license. Due to her current enrollment with two (2) infants, two (2) one's and one (1) two (2) year old, not additional children 0-5 cannot be enrolled. We reviewed the contact information for Buncombe County subsidy and CACFP during the visit. 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. 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: SHEMA Facility ID: 11000877 Consultant: KAORU EDDINS Operation Type: Family CC Home Case Number: Visit Date: 2/20/2026 Number Present: 5 Completed Date: 2/20/2026 Age: From 0 To 2 Total Minutes: 311 Time In: 09:04 AM Time Out: 02:15 PM Time In: Time Out: List to Use: Family CC Home 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 Martha Quinones, Owner/Operator, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to you. Today, Ms. Quinones 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 ninety-one (91) percent as of today prior to this visit. Permit type – five-star family child care home license issued on 8/28/25. Special Services/Restrictions – daytime care, 2nd shift, maximum of five (5) preschool children at any time, no more than three (3) children less than one (1) year old, children in care on ground level only. The last annual compliance visit was conducted on 3/10/25. The last fire drill was practiced on 1/23/26. The last lockdown drill was practiced on 12/19/25. The last playground inspection was documented on 1/23/26. The Emergency Medical Care plan was posted and current. The owner operator and a substitute staff member was listed. The approved curriculum is Creative Curriculum. Lead water testing was completed on 6/11/24 without hazards. Lead paint survey is currently reviewed by RTI. Enrollment survey for asbestos testing was started. Two (2) family members and one (1) staff member were listed on the Automated Criminal Background Check Management System (ABCMS) roster. Per Ms. Quinones, no children were currently enrolled in the 2nd shift. Upon arrival, I announced my presence and the purpose of the visit. Four (4) children, ranging in age from infants to two (2) years old, were present, and one (1) additional infant arrived shortly thereafter. Following handwashing, four (4) children were seated in high chairs and served breakfast/morning snacks. One (1) child was provided with a bottle and crackers, while another child received a banana and crackers. Ms. Quinones fed baby food to one (1) child using a spoon. Supervision during mealtimes was adequate. Children bring their own food from home. Nutrition Opt-out form was on file for all children. After breakfast, Ms. Quinones changed the diapers of three (3) children. Each child’s hands were washed after their diaper change. Ms. Quinones washed her hands both before and after each diaper change. The changing table was sanitized and disinfected, and a timer was set to ensure proper disinfectant contact time. During free play, children played with balls, cars and instruments. Then, they played on the porch area. When they came back inside, all children’s hands were washed, and Ms. Quinones placed two (2) children in the cribs. Ms. Quinones monitored infants every fifteen (15) minutes while they slept. Fire extinguisher was maintained on the kitchen counter by the microwave. The refrigerator temperature was 42 degrees. Some diaper creams and a hand lotion were maintained in the cabinet above five (5) feet. Permission forms were reviewed in the children’s files. FCCH Verification of Required Information form was not submitted prior or during the visit. Ms. Quinones submitted FCCH Operator’s Statements of Responsibility form during the visit. I reminded Ms. Quinones that the Verification of Required Information form was required for her and substitute providers and needed to submit them as soon as possible. The playground was briefly monitored, and no safety concerns were observed. There was a Lasko heater placed on top of the children’s cubbies in the space where children sleep as well as on the kitchen counter. The heaters were not in use during the visit. The door to stairs leading upstairs had a sliding latch, but it was not latched. Ms. Quinones and I discussed smoke detectors. The circular device – smoke detector, is installed in the hallway between the space children sleep and the space children play. It was in working order. I asked Ms. Quinones if it was operated by batteries or was electrically wired. She was not certain but thought it was operated by batteries. During the visit, I asked Ms. Quinones how non-mobile children were evacuated for fire drills. Per current EPR plan, it is stated that “infants and non-mobile children will be placed in mobile pack and play”. However, Ms. Quinones stated that they were transported in the evacuation crib. Since two (2) children were taking a nap, I asked Ms. Quinones to send me a picture of the device when the cover for the smoke detector is removed. This task is recommended while children are not in her care. Per Ms. Quinones, one (1) substitute staff member who is also her family member, only works during summer time. The other substitute staff members work 2-3 days each month, though it changes from time to time. Criminal background qualification letters for family members who resided at this residence. Due to lack of current verification forms for Ms. Quinones and one (1) substitute staff member, the verification form submitted in March 2025 was used to verify the information. Two (2) family members currently resides at this residence, and both of them had current criminal background letters. Ms. Quinones’ following training was verified during the visit: CPR/FA: completed on 2/28/25 and expires in February 2027. EPR in Child Care training was completed on 12/10/28 and Playground Safety training on 2/8/19. ITS/SIDS training was current and will expire on 1/22/27. Health and Safety training was completed on 3/7/22. Ms. Quinones met on-going training requirements by completing three (3) semester hours of ECE class at Community College the lasted from 1/8/24 – 5/7/24. criminal background letter was also current and will expire on 4/26/26. A Substitute staff member had current ITS/SIDS training completed on 9/10/25 and criminal background letter is valid through 5/3/26. The current CPR/FA certificate was not on file. All children’s files were monitored. Four (4) children had Written Plan of Care and one (1) child did not. However, Ms. Quinones does not contact routine task that require Written Plan of Care for children. One (1) child did not have documentation of discussion of parent participation and operational policies on file. Shema currently follows FCCH capacity option - a maximum of eight children, with no more than five children who are from birth to 5 years of age, plus three school-age children. Additionally, this facility follow no more than three (3) infants. I used the Family Child Care Home 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 706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. A can of Pledge Clean spray was maintained in an unlocked cabinet by the refridgerator. .1719 (a)(7) 708 Indoor stairs with more than two steps were not made inaccessible to children two years of age or younger. The latch for the door to stairs that lead upstairs was not latched while five (5) children two (2) years of age and under were present. The stairs have more than two (2) steps. 10 A NCAC 09 .1719(a)(29) 716 Electrical outlets not in use were not covered. An outlet by the recliner was not covered by a safety covers. 10A NCAC .1719(a)(27) 729 Appliances with heating elements, such as bottle warmers, crock pots, curling irons, and electrical cords were accessible to children. One (1) Lasko heater and its cord were accessible to the children. The heater was placed on the kitchen counter. 10A NCAC .1719(a)(28) 1404 Medication remaining after the course of treatment is completed, after authorization is withdrawn. or after authorization has expired, was not returned to the parent/guardian. Any medication not retrieved by parent/guardian within 72 hours of completion of treatment, or withdrawal of authorization, was not discarded. The authorization form for Aquaphor hand cream for a child, who was two (2) years of age, expired on 8/28/25 but the product was not returned to the parent or discarded. 10A NCAC 09 .1720(c)(5) 1405 Authorization for up to 12 months to apply over-the-counter medications, topical ointment, topical teething ointment or gel, insect repellents, fluoridated toothpaste, lotions, creams, and powders; such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed, was not in writing and did not contain information required by rule .1720(b)(7). Parent Choice diaper cream was maintained at facility for a child without authorization form. 10A NCAC 09 .1720(c)(4) 1875 The EPR Plan did not include the location of the Ready to Go File and/or required information. Evacuation method for infants and non-mobile children were changed from pack-N-play to evacuation crib, but the EPR plan was not updated. .1714(d)(10) 1921 Commercially manufactured equipment and furnishings were not assembled and installed according to procedures specified by the manufacturer. Two (2) Lasko portable heaters were present - one (1) on the kitchen counter by the recliner and the other one (1) on top of the children's cubbies in the sleeping area. .1719(a )(24) Technical assistance was provided as follows: 706: Aerosol spray Aerosol products must be stored in locked storage. Ms. Quinones stated that Pledge Clean spray would be removed from the unlocked kitchen cabinet and moved out of the space used by children. During the visit, a family member stopped by and took the aerosol can with her. This item was corrected during the visit. 708: Access to stairs Stairs with more than two (2) steps must not be accessible to children who are two (2) years of age and younger. The sliding latch to the door to stairs must be closed at all times. Ms. Quinones closed the latch during the visit. She also stated that it would be closed while children were in care. This item is corrected during the visit. 716: Electrical outlet Non-tampered Electrical outlets must be covered with safety covers. Ms. Quinones covered the outlet by the recliner during the visit. This item was corrected during the visit. 729: Electrical cord Electrical cords of appliances with heating elements cannot be accessible to the children. The electrical cord of Lasko portable heater on the kitchen counter was hanging down by the recliner where a child, who was two (2) years of age sat and read during the visit. I recommend removing the heater out of the child care space as there is no safe way to operate the device. A family member stopped by and removed both heaters from the child care space. This violation was corrected during the visit. 1404: Medication authorization Medication must be returned to the parents or discarded after permission form expires. The permission form for Aquaphor healing ointment for a child expired on 8/28/25. The medication must be returned to the parents immediately. Ms. Quinones stated that she wants to get updated permission form. I advised her to remove the ointment out of child care space until the permission form is obtained. In your compliance letter, please verify that the ointment was removed from the space. 1405: Medication authorization Operator must obtain a permission form for each medication. Parent Choice diaper cream was maintained for a child without a permission form. Ms. Quinones stated that she would send the diaper cream home with the parents. In your compliance letter, please verify the correction. 1875: EPR plan The program’s EPR plan must be updated annually on NC Risk Management Portal. Upon reviewing the EPR plan, you can sign on the title page, if you would like. You must update how you evacuate non-mobile infants upon emergency on the EPR plan. Additionally, you must consider a safe place to evacuate the children. In case of emergency, you must consider evacuating children further than front porch area. It is safe for infants and young toddlers to be in the evacuation crib for their safety. Your evacuation crib, if it is plan to be used in emergency, must be ready to be used. All materials stored inside of the crib must be removed. Ms. Quinones stated that she would try to update the EPR plan. She took a picture of NC Risk Management Portal website. Please log on to https://staging.ncem.org/portal/ 1921: Manufacture’s Instructions Any commercially manufactured equipment must be installed according to specifics to manufacture’s instruction. Lasko portable heater must not be maintained or used on other furniture. The heater placed on top of kitchen cabinet and the one on top of children’s cubbies in the sleeping area must be placed on the ground. However, appliances with heating elements cannot be accessible to the children. Therefore, Lasko portable heater shall not be used to heat child care home space that is used by children. A family member stopped by and removed both Lasko heaters from the child care space. This item was corrected during the 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 3/6/26. 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: Criminal background check: Most of your criminal background letters will expire between April – June 2026. Please plan to renew criminal background check promptly without lapse. Verification of information for Operator and additional caregivers: Please complete the form for yourself and a substitute provider and submit them to me as soon as possible. Lead Paint and Asbestos Testing: Please complete the enrollment survey for asbestos. 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 was required to be completed by May 31, 2025. New and terminated staff notification requirement: Please add yourself to the ABCMS roster. 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. 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. Questions: Ms. Quinones asked about changing porch to covered space with a permanent wall. I need additional researches and promised her to reach back to her via email. Ms. Quinones and I discussed the new law for FCCH capacity as well as restrictions on the license. Due to her current enrollment with two (2) infants, two (2) one's and one (1) two (2) year old, not additional children 0-5 cannot be enrolled. We reviewed the contact information for Buncombe County subsidy and CACFP during the visit. 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. 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: SHEMA Facility ID: 11000877 Consultant: KAORU EDDINS Operation Type: Family CC Home Case Number: Visit Date: 6/26/2025 Number Present: 3 Completed Date: 6/26/2025 Age: From 0 To 2 Total Minutes: 271 Time In: 10:18 AM Time Out: 02:49 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Rated License Assessment Announced/Unannounced: Announced The purpose of today’s visit was to monitor compliance during a Rated License Assessment 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 Martha Quinones, Owner/Operator, during the visit. A signed copy of the visit summary was left on-site with you. Ms. Quinones was available during the visit. 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. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-three (93) percent as of today prior to this visit. Permit type – one-star Family Child Care Home license issued on 7/18/22. Special Services/Restrictions – 1st and 2nd shift, maximum of five (5) preschool children at any time. Children in care on ground level only. The last annual compliance visit was conducted on 3/10/25. The last fire drill was practiced on 5/23/25. The last lockdown drill was practiced on 6/10/25. The last playground inspection was documented on 5/23/25. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 6/7/24 and 6/11/24 without hazards. No results were found for Lead paint and asbestos testing. Per Ms. Quinones, she is in communication with representatives from Clean Classroom for Carolina Kids regarding lead paint and asbestos. Upon arrival, I greeted Ms. Quinones. Three (3) children, ranging in age from infancy to two (2) years, were present during the visit. Upon arrival, the infant was asleep in the crib. Two (2) children were seated at the table near the entrance having their morning snacks. One (1) child had strawberries, peas, and water, while the other child had bananas, rice, and water. All children had a nutrition opt-out form on file. Ms. Quinones conducted sleep checks on the infant and logged both the time and the sleeping position. When the infant woke up, Ms. Quinones changed all children’s diapers before transitioning the group to the playground. No safety hazards were observed outdoors. Children were provided with water throughout outdoor play. Upon returning inside, the children washed their hands at the sink and engaged in free exploration. The infant scooted around the play space, while the other children participated in a reading activity. Afterward, all children were served lunch. Two (2) staff files were reviewed for compliance. Both contained documentation of criminal background check letters, ITS/SIDS training certificates, and current CPR/First Aid certifications. In addition, criminal background letters for three (3) family members were verified. Diaper creams were monitored and met all the requirements. Rated License Assessment: The Rated License Assessment application was initially submitted via email on June 19, 2025. However, the self-study component had not been completed at that time. I requested that Ms. Quinones resubmit the complete application, including the self-study. She submitted the completed self-study earlier today via email. The updated application was received during the visit. I used the Family Child Care Home 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 706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. A pack of Ingles AA batteries were stored on the top shelf, Many bottles of hand sanitizers were stored in the middle shelf and containers of Clorox disinfecting wipes were stored on the bottom shelf in the cabinet behind the high chair in the main room. The height of the middle shelf is approximately thirty-seven (37) inches high. In room 2, two (2) aerosol hair spray and one (1) aerosol cleaner were stored in the top shelf. The cabinet was not locked. .1719 (a)(7) 716 Electrical outlets not in use were not covered. One electrical outlet under the bulletin board was not covered with a safety cover. 10A NCAC .1719(a)(27) 1986 Breast milk, formula, and other bottled beverages sent from home were not fully prepared, dated, and labeled with individual child's names. One (1) bottle of human milk was stored in the refrigerator. The bottle was labeled with a child's name but not date was found. .1706(l) Technical assistance was provided as follows: 706: Potentially Hazardous items. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (7) keep all corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product that 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 area when not in use. Locked areas shall include those that 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 in this Paragraph that 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; 716: electrical outlet Electrical outlets must be covered by safety covers when they are not in use. Refer to .1719(a)(27). 1986: beverages sent from home Breast milk, formula, and other bottled beverages sent from home were not fully prepared, dated, and labeled with individual child's names. .1706(l). 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 was required to be completed by May 31, 2025. 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. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 7/10/25. 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: Rated License Assessment Summary Quality Point Ms. Quinones recently obtained the Infant/Toddler Certificate and submitted her transcripts to the WORKS account. A new status letter reflecting this change has been issued. Based on this updated status, the program has earned a Quality Point. Display Please display some posters and artwork at the children’s eye level. Children’s artwork should be included in the display. Be sure to discuss the displays with the children to encourage engagement and conversation. Conversation with Children Even though young children may not fully respond, continue to ask open-ended questions and model answers for them. Narrating your actions throughout the day is also an effective strategy to support language development. Blocks For younger children, provide a variety of blocks such as soft blocks, sensory blocks, and stacking blocks. Ensure there are at least ten (10) block accessories available, such as pretend animals, toy vehicles, and road signs. Blocks offer great opportunities to support math-related conversations. Sand and Water Play Sand and water play are required for children two (2) years of age and older, either indoors or outdoors. Please include science-related books in your environment, such as those featuring animals, weather, health, weight, or other related topics. Accessibility Materials stored on high shelves are not considered accessible to children. Additionally, toys should not be stacked together; they must be arranged so children can access them independently. The orchid in the glass vase on top of the pretend refrigerator should be removed from the licensed space or placed at least five (5) feet high. Puzzles currently stored on top of the cubby must be relocated to lower shelves within children’s reach. Tables in the rest area must be cleared so children can use the space for play. Any office supplies or personal adult items stored in children’s play areas may limit access and are not considered usable by children. Diaper Changing Area This area must be kept free of unrelated materials to maintain sanitation and safety. Good Hygiene The operator must take active measures to prevent the spread of germs. This includes frequent handwashing for both staff and children. If a child touches materials or the floor after handwashing, they must wash their hands again before eating. If staff members touch materials or children before meals, they must wash their hands before serving food. Timeline and Next Steps Following today’s Rated License Assessment visit: All violations cited during today’s visit must be corrected. Once corrections are complete, I will submit the application for the FCCERS-3 assessment. Then a scheduler will then contact you to arrange the FCCERS-3 assessment visit. After the FCCERS-3 score is released, I will conduct an ERS visit to review your scores with you. Any violations cited during the ERS visit must be corrected before a new permit can be issued. Curriculum Requirement Programs earning a four (4) or five (5) star license are required to adopt an approved curriculum. While the final star rating is not yet determined, please begin researching approved curricula you may want to implement in your program. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division”. As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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: SHEMA Facility ID: 11000877 Consultant: KAORU EDDINS Operation Type: Family CC Home Case Number: Visit Date: 6/26/2025 Number Present: 3 Completed Date: 6/26/2025 Age: From 0 To 2 Total Minutes: 271 Time In: 10:18 AM Time Out: 02:49 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Rated License Assessment Announced/Unannounced: Announced The purpose of today’s visit was to monitor compliance during a Rated License Assessment 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 Martha Quinones, Owner/Operator, during the visit. A signed copy of the visit summary was left on-site with you. Ms. Quinones was available during the visit. 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. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-three (93) percent as of today prior to this visit. Permit type – one-star Family Child Care Home license issued on 7/18/22. Special Services/Restrictions – 1st and 2nd shift, maximum of five (5) preschool children at any time. Children in care on ground level only. The last annual compliance visit was conducted on 3/10/25. The last fire drill was practiced on 5/23/25. The last lockdown drill was practiced on 6/10/25. The last playground inspection was documented on 5/23/25. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 6/7/24 and 6/11/24 without hazards. No results were found for Lead paint and asbestos testing. Per Ms. Quinones, she is in communication with representatives from Clean Classroom for Carolina Kids regarding lead paint and asbestos. Upon arrival, I greeted Ms. Quinones. Three (3) children, ranging in age from infancy to two (2) years, were present during the visit. Upon arrival, the infant was asleep in the crib. Two (2) children were seated at the table near the entrance having their morning snacks. One (1) child had strawberries, peas, and water, while the other child had bananas, rice, and water. All children had a nutrition opt-out form on file. Ms. Quinones conducted sleep checks on the infant and logged both the time and the sleeping position. When the infant woke up, Ms. Quinones changed all children’s diapers before transitioning the group to the playground. No safety hazards were observed outdoors. Children were provided with water throughout outdoor play. Upon returning inside, the children washed their hands at the sink and engaged in free exploration. The infant scooted around the play space, while the other children participated in a reading activity. Afterward, all children were served lunch. Two (2) staff files were reviewed for compliance. Both contained documentation of criminal background check letters, ITS/SIDS training certificates, and current CPR/First Aid certifications. In addition, criminal background letters for three (3) family members were verified. Diaper creams were monitored and met all the requirements. Rated License Assessment: The Rated License Assessment application was initially submitted via email on June 19, 2025. However, the self-study component had not been completed at that time. I requested that Ms. Quinones resubmit the complete application, including the self-study. She submitted the completed self-study earlier today via email. The updated application was received during the visit. I used the Family Child Care Home 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 706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. A pack of Ingles AA batteries were stored on the top shelf, Many bottles of hand sanitizers were stored in the middle shelf and containers of Clorox disinfecting wipes were stored on the bottom shelf in the cabinet behind the high chair in the main room. The height of the middle shelf is approximately thirty-seven (37) inches high. In room 2, two (2) aerosol hair spray and one (1) aerosol cleaner were stored in the top shelf. The cabinet was not locked. .1719 (a)(7) 716 Electrical outlets not in use were not covered. One electrical outlet under the bulletin board was not covered with a safety cover. 10A NCAC .1719(a)(27) 1986 Breast milk, formula, and other bottled beverages sent from home were not fully prepared, dated, and labeled with individual child's names. One (1) bottle of human milk was stored in the refrigerator. The bottle was labeled with a child's name but not date was found. .1706(l) Technical assistance was provided as follows: 706: Potentially Hazardous items. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (7) keep all corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product that 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 area when not in use. Locked areas shall include those that 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 in this Paragraph that 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; 716: electrical outlet Electrical outlets must be covered by safety covers when they are not in use. Refer to .1719(a)(27). 1986: beverages sent from home Breast milk, formula, and other bottled beverages sent from home were not fully prepared, dated, and labeled with individual child's names. .1706(l). 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 was required to be completed by May 31, 2025. 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. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 7/10/25. 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: Rated License Assessment Summary Quality Point Ms. Quinones recently obtained the Infant/Toddler Certificate and submitted her transcripts to the WORKS account. A new status letter reflecting this change has been issued. Based on this updated status, the program has earned a Quality Point. Display Please display some posters and artwork at the children’s eye level. Children’s artwork should be included in the display. Be sure to discuss the displays with the children to encourage engagement and conversation. Conversation with Children Even though young children may not fully respond, continue to ask open-ended questions and model answers for them. Narrating your actions throughout the day is also an effective strategy to support language development. Blocks For younger children, provide a variety of blocks such as soft blocks, sensory blocks, and stacking blocks. Ensure there are at least ten (10) block accessories available, such as pretend animals, toy vehicles, and road signs. Blocks offer great opportunities to support math-related conversations. Sand and Water Play Sand and water play are required for children two (2) years of age and older, either indoors or outdoors. Please include science-related books in your environment, such as those featuring animals, weather, health, weight, or other related topics. Accessibility Materials stored on high shelves are not considered accessible to children. Additionally, toys should not be stacked together; they must be arranged so children can access them independently. The orchid in the glass vase on top of the pretend refrigerator should be removed from the licensed space or placed at least five (5) feet high. Puzzles currently stored on top of the cubby must be relocated to lower shelves within children’s reach. Tables in the rest area must be cleared so children can use the space for play. Any office supplies or personal adult items stored in children’s play areas may limit access and are not considered usable by children. Diaper Changing Area This area must be kept free of unrelated materials to maintain sanitation and safety. Good Hygiene The operator must take active measures to prevent the spread of germs. This includes frequent handwashing for both staff and children. If a child touches materials or the floor after handwashing, they must wash their hands again before eating. If staff members touch materials or children before meals, they must wash their hands before serving food. Timeline and Next Steps Following today’s Rated License Assessment visit: All violations cited during today’s visit must be corrected. Once corrections are complete, I will submit the application for the FCCERS-3 assessment. Then a scheduler will then contact you to arrange the FCCERS-3 assessment visit. After the FCCERS-3 score is released, I will conduct an ERS visit to review your scores with you. Any violations cited during the ERS visit must be corrected before a new permit can be issued. Curriculum Requirement Programs earning a four (4) or five (5) star license are required to adopt an approved curriculum. While the final star rating is not yet determined, please begin researching approved curricula you may want to implement in your program. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division”. As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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: SHEMA Facility ID: 11000877 Consultant: KAORU EDDINS Operation Type: Family CC Home Case Number: Visit Date: 6/26/2025 Number Present: 3 Completed Date: 6/26/2025 Age: From 0 To 2 Total Minutes: 271 Time In: 10:18 AM Time Out: 02:49 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Rated License Assessment Announced/Unannounced: Announced The purpose of today’s visit was to monitor compliance during a Rated License Assessment 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 Martha Quinones, Owner/Operator, during the visit. A signed copy of the visit summary was left on-site with you. Ms. Quinones was available during the visit. 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. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-three (93) percent as of today prior to this visit. Permit type – one-star Family Child Care Home license issued on 7/18/22. Special Services/Restrictions – 1st and 2nd shift, maximum of five (5) preschool children at any time. Children in care on ground level only. The last annual compliance visit was conducted on 3/10/25. The last fire drill was practiced on 5/23/25. The last lockdown drill was practiced on 6/10/25. The last playground inspection was documented on 5/23/25. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 6/7/24 and 6/11/24 without hazards. No results were found for Lead paint and asbestos testing. Per Ms. Quinones, she is in communication with representatives from Clean Classroom for Carolina Kids regarding lead paint and asbestos. Upon arrival, I greeted Ms. Quinones. Three (3) children, ranging in age from infancy to two (2) years, were present during the visit. Upon arrival, the infant was asleep in the crib. Two (2) children were seated at the table near the entrance having their morning snacks. One (1) child had strawberries, peas, and water, while the other child had bananas, rice, and water. All children had a nutrition opt-out form on file. Ms. Quinones conducted sleep checks on the infant and logged both the time and the sleeping position. When the infant woke up, Ms. Quinones changed all children’s diapers before transitioning the group to the playground. No safety hazards were observed outdoors. Children were provided with water throughout outdoor play. Upon returning inside, the children washed their hands at the sink and engaged in free exploration. The infant scooted around the play space, while the other children participated in a reading activity. Afterward, all children were served lunch. Two (2) staff files were reviewed for compliance. Both contained documentation of criminal background check letters, ITS/SIDS training certificates, and current CPR/First Aid certifications. In addition, criminal background letters for three (3) family members were verified. Diaper creams were monitored and met all the requirements. Rated License Assessment: The Rated License Assessment application was initially submitted via email on June 19, 2025. However, the self-study component had not been completed at that time. I requested that Ms. Quinones resubmit the complete application, including the self-study. She submitted the completed self-study earlier today via email. The updated application was received during the visit. I used the Family Child Care Home 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 706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. A pack of Ingles AA batteries were stored on the top shelf, Many bottles of hand sanitizers were stored in the middle shelf and containers of Clorox disinfecting wipes were stored on the bottom shelf in the cabinet behind the high chair in the main room. The height of the middle shelf is approximately thirty-seven (37) inches high. In room 2, two (2) aerosol hair spray and one (1) aerosol cleaner were stored in the top shelf. The cabinet was not locked. .1719 (a)(7) 716 Electrical outlets not in use were not covered. One electrical outlet under the bulletin board was not covered with a safety cover. 10A NCAC .1719(a)(27) 1986 Breast milk, formula, and other bottled beverages sent from home were not fully prepared, dated, and labeled with individual child's names. One (1) bottle of human milk was stored in the refrigerator. The bottle was labeled with a child's name but not date was found. .1706(l) Technical assistance was provided as follows: 706: Potentially Hazardous items. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (7) keep all corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product that 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 area when not in use. Locked areas shall include those that 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 in this Paragraph that 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; 716: electrical outlet Electrical outlets must be covered by safety covers when they are not in use. Refer to .1719(a)(27). 1986: beverages sent from home Breast milk, formula, and other bottled beverages sent from home were not fully prepared, dated, and labeled with individual child's names. .1706(l). 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 was required to be completed by May 31, 2025. 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. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 7/10/25. 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: Rated License Assessment Summary Quality Point Ms. Quinones recently obtained the Infant/Toddler Certificate and submitted her transcripts to the WORKS account. A new status letter reflecting this change has been issued. Based on this updated status, the program has earned a Quality Point. Display Please display some posters and artwork at the children’s eye level. Children’s artwork should be included in the display. Be sure to discuss the displays with the children to encourage engagement and conversation. Conversation with Children Even though young children may not fully respond, continue to ask open-ended questions and model answers for them. Narrating your actions throughout the day is also an effective strategy to support language development. Blocks For younger children, provide a variety of blocks such as soft blocks, sensory blocks, and stacking blocks. Ensure there are at least ten (10) block accessories available, such as pretend animals, toy vehicles, and road signs. Blocks offer great opportunities to support math-related conversations. Sand and Water Play Sand and water play are required for children two (2) years of age and older, either indoors or outdoors. Please include science-related books in your environment, such as those featuring animals, weather, health, weight, or other related topics. Accessibility Materials stored on high shelves are not considered accessible to children. Additionally, toys should not be stacked together; they must be arranged so children can access them independently. The orchid in the glass vase on top of the pretend refrigerator should be removed from the licensed space or placed at least five (5) feet high. Puzzles currently stored on top of the cubby must be relocated to lower shelves within children’s reach. Tables in the rest area must be cleared so children can use the space for play. Any office supplies or personal adult items stored in children’s play areas may limit access and are not considered usable by children. Diaper Changing Area This area must be kept free of unrelated materials to maintain sanitation and safety. Good Hygiene The operator must take active measures to prevent the spread of germs. This includes frequent handwashing for both staff and children. If a child touches materials or the floor after handwashing, they must wash their hands again before eating. If staff members touch materials or children before meals, they must wash their hands before serving food. Timeline and Next Steps Following today’s Rated License Assessment visit: All violations cited during today’s visit must be corrected. Once corrections are complete, I will submit the application for the FCCERS-3 assessment. Then a scheduler will then contact you to arrange the FCCERS-3 assessment visit. After the FCCERS-3 score is released, I will conduct an ERS visit to review your scores with you. Any violations cited during the ERS visit must be corrected before a new permit can be issued. Curriculum Requirement Programs earning a four (4) or five (5) star license are required to adopt an approved curriculum. While the final star rating is not yet determined, please begin researching approved curricula you may want to implement in your program. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division”. As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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 .1719 · Violation

Name of Operation: SHEMA Facility ID: 11000877 Consultant: KAORU EDDINS Operation Type: Family CC Home Case Number: Visit Date: 6/26/2025 Number Present: 3 Completed Date: 6/26/2025 Age: From 0 To 2 Total Minutes: 271 Time In: 10:18 AM Time Out: 02:49 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Rated License Assessment Announced/Unannounced: Announced The purpose of today’s visit was to monitor compliance during a Rated License Assessment 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 Martha Quinones, Owner/Operator, during the visit. A signed copy of the visit summary was left on-site with you. Ms. Quinones was available during the visit. 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. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-three (93) percent as of today prior to this visit. Permit type – one-star Family Child Care Home license issued on 7/18/22. Special Services/Restrictions – 1st and 2nd shift, maximum of five (5) preschool children at any time. Children in care on ground level only. The last annual compliance visit was conducted on 3/10/25. The last fire drill was practiced on 5/23/25. The last lockdown drill was practiced on 6/10/25. The last playground inspection was documented on 5/23/25. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 6/7/24 and 6/11/24 without hazards. No results were found for Lead paint and asbestos testing. Per Ms. Quinones, she is in communication with representatives from Clean Classroom for Carolina Kids regarding lead paint and asbestos. Upon arrival, I greeted Ms. Quinones. Three (3) children, ranging in age from infancy to two (2) years, were present during the visit. Upon arrival, the infant was asleep in the crib. Two (2) children were seated at the table near the entrance having their morning snacks. One (1) child had strawberries, peas, and water, while the other child had bananas, rice, and water. All children had a nutrition opt-out form on file. Ms. Quinones conducted sleep checks on the infant and logged both the time and the sleeping position. When the infant woke up, Ms. Quinones changed all children’s diapers before transitioning the group to the playground. No safety hazards were observed outdoors. Children were provided with water throughout outdoor play. Upon returning inside, the children washed their hands at the sink and engaged in free exploration. The infant scooted around the play space, while the other children participated in a reading activity. Afterward, all children were served lunch. Two (2) staff files were reviewed for compliance. Both contained documentation of criminal background check letters, ITS/SIDS training certificates, and current CPR/First Aid certifications. In addition, criminal background letters for three (3) family members were verified. Diaper creams were monitored and met all the requirements. Rated License Assessment: The Rated License Assessment application was initially submitted via email on June 19, 2025. However, the self-study component had not been completed at that time. I requested that Ms. Quinones resubmit the complete application, including the self-study. She submitted the completed self-study earlier today via email. The updated application was received during the visit. I used the Family Child Care Home 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 706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. A pack of Ingles AA batteries were stored on the top shelf, Many bottles of hand sanitizers were stored in the middle shelf and containers of Clorox disinfecting wipes were stored on the bottom shelf in the cabinet behind the high chair in the main room. The height of the middle shelf is approximately thirty-seven (37) inches high. In room 2, two (2) aerosol hair spray and one (1) aerosol cleaner were stored in the top shelf. The cabinet was not locked. .1719 (a)(7) 716 Electrical outlets not in use were not covered. One electrical outlet under the bulletin board was not covered with a safety cover. 10A NCAC .1719(a)(27) 1986 Breast milk, formula, and other bottled beverages sent from home were not fully prepared, dated, and labeled with individual child's names. One (1) bottle of human milk was stored in the refrigerator. The bottle was labeled with a child's name but not date was found. .1706(l) Technical assistance was provided as follows: 706: Potentially Hazardous items. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (7) keep all corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product that 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 area when not in use. Locked areas shall include those that 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 in this Paragraph that 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; 716: electrical outlet Electrical outlets must be covered by safety covers when they are not in use. Refer to .1719(a)(27). 1986: beverages sent from home Breast milk, formula, and other bottled beverages sent from home were not fully prepared, dated, and labeled with individual child's names. .1706(l). 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 was required to be completed by May 31, 2025. 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. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 7/10/25. 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: Rated License Assessment Summary Quality Point Ms. Quinones recently obtained the Infant/Toddler Certificate and submitted her transcripts to the WORKS account. A new status letter reflecting this change has been issued. Based on this updated status, the program has earned a Quality Point. Display Please display some posters and artwork at the children’s eye level. Children’s artwork should be included in the display. Be sure to discuss the displays with the children to encourage engagement and conversation. Conversation with Children Even though young children may not fully respond, continue to ask open-ended questions and model answers for them. Narrating your actions throughout the day is also an effective strategy to support language development. Blocks For younger children, provide a variety of blocks such as soft blocks, sensory blocks, and stacking blocks. Ensure there are at least ten (10) block accessories available, such as pretend animals, toy vehicles, and road signs. Blocks offer great opportunities to support math-related conversations. Sand and Water Play Sand and water play are required for children two (2) years of age and older, either indoors or outdoors. Please include science-related books in your environment, such as those featuring animals, weather, health, weight, or other related topics. Accessibility Materials stored on high shelves are not considered accessible to children. Additionally, toys should not be stacked together; they must be arranged so children can access them independently. The orchid in the glass vase on top of the pretend refrigerator should be removed from the licensed space or placed at least five (5) feet high. Puzzles currently stored on top of the cubby must be relocated to lower shelves within children’s reach. Tables in the rest area must be cleared so children can use the space for play. Any office supplies or personal adult items stored in children’s play areas may limit access and are not considered usable by children. Diaper Changing Area This area must be kept free of unrelated materials to maintain sanitation and safety. Good Hygiene The operator must take active measures to prevent the spread of germs. This includes frequent handwashing for both staff and children. If a child touches materials or the floor after handwashing, they must wash their hands again before eating. If staff members touch materials or children before meals, they must wash their hands before serving food. Timeline and Next Steps Following today’s Rated License Assessment visit: All violations cited during today’s visit must be corrected. Once corrections are complete, I will submit the application for the FCCERS-3 assessment. Then a scheduler will then contact you to arrange the FCCERS-3 assessment visit. After the FCCERS-3 score is released, I will conduct an ERS visit to review your scores with you. Any violations cited during the ERS visit must be corrected before a new permit can be issued. Curriculum Requirement Programs earning a four (4) or five (5) star license are required to adopt an approved curriculum. While the final star rating is not yet determined, please begin researching approved curricula you may want to implement in your program. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division”. As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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: SHEMA Facility ID: 11000877 Consultant: KAORU EDDINS Operation Type: Family CC Home Case Number: Visit Date: 6/26/2025 Number Present: 3 Completed Date: 6/26/2025 Age: From 0 To 2 Total Minutes: 271 Time In: 10:18 AM Time Out: 02:49 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Rated License Assessment Announced/Unannounced: Announced The purpose of today’s visit was to monitor compliance during a Rated License Assessment 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 Martha Quinones, Owner/Operator, during the visit. A signed copy of the visit summary was left on-site with you. Ms. Quinones was available during the visit. 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. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-three (93) percent as of today prior to this visit. Permit type – one-star Family Child Care Home license issued on 7/18/22. Special Services/Restrictions – 1st and 2nd shift, maximum of five (5) preschool children at any time. Children in care on ground level only. The last annual compliance visit was conducted on 3/10/25. The last fire drill was practiced on 5/23/25. The last lockdown drill was practiced on 6/10/25. The last playground inspection was documented on 5/23/25. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 6/7/24 and 6/11/24 without hazards. No results were found for Lead paint and asbestos testing. Per Ms. Quinones, she is in communication with representatives from Clean Classroom for Carolina Kids regarding lead paint and asbestos. Upon arrival, I greeted Ms. Quinones. Three (3) children, ranging in age from infancy to two (2) years, were present during the visit. Upon arrival, the infant was asleep in the crib. Two (2) children were seated at the table near the entrance having their morning snacks. One (1) child had strawberries, peas, and water, while the other child had bananas, rice, and water. All children had a nutrition opt-out form on file. Ms. Quinones conducted sleep checks on the infant and logged both the time and the sleeping position. When the infant woke up, Ms. Quinones changed all children’s diapers before transitioning the group to the playground. No safety hazards were observed outdoors. Children were provided with water throughout outdoor play. Upon returning inside, the children washed their hands at the sink and engaged in free exploration. The infant scooted around the play space, while the other children participated in a reading activity. Afterward, all children were served lunch. Two (2) staff files were reviewed for compliance. Both contained documentation of criminal background check letters, ITS/SIDS training certificates, and current CPR/First Aid certifications. In addition, criminal background letters for three (3) family members were verified. Diaper creams were monitored and met all the requirements. Rated License Assessment: The Rated License Assessment application was initially submitted via email on June 19, 2025. However, the self-study component had not been completed at that time. I requested that Ms. Quinones resubmit the complete application, including the self-study. She submitted the completed self-study earlier today via email. The updated application was received during the visit. I used the Family Child Care Home 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 706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. A pack of Ingles AA batteries were stored on the top shelf, Many bottles of hand sanitizers were stored in the middle shelf and containers of Clorox disinfecting wipes were stored on the bottom shelf in the cabinet behind the high chair in the main room. The height of the middle shelf is approximately thirty-seven (37) inches high. In room 2, two (2) aerosol hair spray and one (1) aerosol cleaner were stored in the top shelf. The cabinet was not locked. .1719 (a)(7) 716 Electrical outlets not in use were not covered. One electrical outlet under the bulletin board was not covered with a safety cover. 10A NCAC .1719(a)(27) 1986 Breast milk, formula, and other bottled beverages sent from home were not fully prepared, dated, and labeled with individual child's names. One (1) bottle of human milk was stored in the refrigerator. The bottle was labeled with a child's name but not date was found. .1706(l) Technical assistance was provided as follows: 706: Potentially Hazardous items. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (7) keep all corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product that 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 area when not in use. Locked areas shall include those that 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 in this Paragraph that 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; 716: electrical outlet Electrical outlets must be covered by safety covers when they are not in use. Refer to .1719(a)(27). 1986: beverages sent from home Breast milk, formula, and other bottled beverages sent from home were not fully prepared, dated, and labeled with individual child's names. .1706(l). 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 was required to be completed by May 31, 2025. 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. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 7/10/25. 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: Rated License Assessment Summary Quality Point Ms. Quinones recently obtained the Infant/Toddler Certificate and submitted her transcripts to the WORKS account. A new status letter reflecting this change has been issued. Based on this updated status, the program has earned a Quality Point. Display Please display some posters and artwork at the children’s eye level. Children’s artwork should be included in the display. Be sure to discuss the displays with the children to encourage engagement and conversation. Conversation with Children Even though young children may not fully respond, continue to ask open-ended questions and model answers for them. Narrating your actions throughout the day is also an effective strategy to support language development. Blocks For younger children, provide a variety of blocks such as soft blocks, sensory blocks, and stacking blocks. Ensure there are at least ten (10) block accessories available, such as pretend animals, toy vehicles, and road signs. Blocks offer great opportunities to support math-related conversations. Sand and Water Play Sand and water play are required for children two (2) years of age and older, either indoors or outdoors. Please include science-related books in your environment, such as those featuring animals, weather, health, weight, or other related topics. Accessibility Materials stored on high shelves are not considered accessible to children. Additionally, toys should not be stacked together; they must be arranged so children can access them independently. The orchid in the glass vase on top of the pretend refrigerator should be removed from the licensed space or placed at least five (5) feet high. Puzzles currently stored on top of the cubby must be relocated to lower shelves within children’s reach. Tables in the rest area must be cleared so children can use the space for play. Any office supplies or personal adult items stored in children’s play areas may limit access and are not considered usable by children. Diaper Changing Area This area must be kept free of unrelated materials to maintain sanitation and safety. Good Hygiene The operator must take active measures to prevent the spread of germs. This includes frequent handwashing for both staff and children. If a child touches materials or the floor after handwashing, they must wash their hands again before eating. If staff members touch materials or children before meals, they must wash their hands before serving food. Timeline and Next Steps Following today’s Rated License Assessment visit: All violations cited during today’s visit must be corrected. Once corrections are complete, I will submit the application for the FCCERS-3 assessment. Then a scheduler will then contact you to arrange the FCCERS-3 assessment visit. After the FCCERS-3 score is released, I will conduct an ERS visit to review your scores with you. Any violations cited during the ERS visit must be corrected before a new permit can be issued. Curriculum Requirement Programs earning a four (4) or five (5) star license are required to adopt an approved curriculum. While the final star rating is not yet determined, please begin researching approved curricula you may want to implement in your program. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division”. As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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: SHEMA Facility ID: 11000877 Consultant: KAORU EDDINS Operation Type: Family CC Home Case Number: Visit Date: 6/26/2025 Number Present: 3 Completed Date: 6/26/2025 Age: From 0 To 2 Total Minutes: 271 Time In: 10:18 AM Time Out: 02:49 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Rated License Assessment Announced/Unannounced: Announced The purpose of today’s visit was to monitor compliance during a Rated License Assessment 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 Martha Quinones, Owner/Operator, during the visit. A signed copy of the visit summary was left on-site with you. Ms. Quinones was available during the visit. 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. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-three (93) percent as of today prior to this visit. Permit type – one-star Family Child Care Home license issued on 7/18/22. Special Services/Restrictions – 1st and 2nd shift, maximum of five (5) preschool children at any time. Children in care on ground level only. The last annual compliance visit was conducted on 3/10/25. The last fire drill was practiced on 5/23/25. The last lockdown drill was practiced on 6/10/25. The last playground inspection was documented on 5/23/25. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 6/7/24 and 6/11/24 without hazards. No results were found for Lead paint and asbestos testing. Per Ms. Quinones, she is in communication with representatives from Clean Classroom for Carolina Kids regarding lead paint and asbestos. Upon arrival, I greeted Ms. Quinones. Three (3) children, ranging in age from infancy to two (2) years, were present during the visit. Upon arrival, the infant was asleep in the crib. Two (2) children were seated at the table near the entrance having their morning snacks. One (1) child had strawberries, peas, and water, while the other child had bananas, rice, and water. All children had a nutrition opt-out form on file. Ms. Quinones conducted sleep checks on the infant and logged both the time and the sleeping position. When the infant woke up, Ms. Quinones changed all children’s diapers before transitioning the group to the playground. No safety hazards were observed outdoors. Children were provided with water throughout outdoor play. Upon returning inside, the children washed their hands at the sink and engaged in free exploration. The infant scooted around the play space, while the other children participated in a reading activity. Afterward, all children were served lunch. Two (2) staff files were reviewed for compliance. Both contained documentation of criminal background check letters, ITS/SIDS training certificates, and current CPR/First Aid certifications. In addition, criminal background letters for three (3) family members were verified. Diaper creams were monitored and met all the requirements. Rated License Assessment: The Rated License Assessment application was initially submitted via email on June 19, 2025. However, the self-study component had not been completed at that time. I requested that Ms. Quinones resubmit the complete application, including the self-study. She submitted the completed self-study earlier today via email. The updated application was received during the visit. I used the Family Child Care Home 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 706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. A pack of Ingles AA batteries were stored on the top shelf, Many bottles of hand sanitizers were stored in the middle shelf and containers of Clorox disinfecting wipes were stored on the bottom shelf in the cabinet behind the high chair in the main room. The height of the middle shelf is approximately thirty-seven (37) inches high. In room 2, two (2) aerosol hair spray and one (1) aerosol cleaner were stored in the top shelf. The cabinet was not locked. .1719 (a)(7) 716 Electrical outlets not in use were not covered. One electrical outlet under the bulletin board was not covered with a safety cover. 10A NCAC .1719(a)(27) 1986 Breast milk, formula, and other bottled beverages sent from home were not fully prepared, dated, and labeled with individual child's names. One (1) bottle of human milk was stored in the refrigerator. The bottle was labeled with a child's name but not date was found. .1706(l) Technical assistance was provided as follows: 706: Potentially Hazardous items. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (7) keep all corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product that 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 area when not in use. Locked areas shall include those that 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 in this Paragraph that 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; 716: electrical outlet Electrical outlets must be covered by safety covers when they are not in use. Refer to .1719(a)(27). 1986: beverages sent from home Breast milk, formula, and other bottled beverages sent from home were not fully prepared, dated, and labeled with individual child's names. .1706(l). 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 was required to be completed by May 31, 2025. 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. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 7/10/25. 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: Rated License Assessment Summary Quality Point Ms. Quinones recently obtained the Infant/Toddler Certificate and submitted her transcripts to the WORKS account. A new status letter reflecting this change has been issued. Based on this updated status, the program has earned a Quality Point. Display Please display some posters and artwork at the children’s eye level. Children’s artwork should be included in the display. Be sure to discuss the displays with the children to encourage engagement and conversation. Conversation with Children Even though young children may not fully respond, continue to ask open-ended questions and model answers for them. Narrating your actions throughout the day is also an effective strategy to support language development. Blocks For younger children, provide a variety of blocks such as soft blocks, sensory blocks, and stacking blocks. Ensure there are at least ten (10) block accessories available, such as pretend animals, toy vehicles, and road signs. Blocks offer great opportunities to support math-related conversations. Sand and Water Play Sand and water play are required for children two (2) years of age and older, either indoors or outdoors. Please include science-related books in your environment, such as those featuring animals, weather, health, weight, or other related topics. Accessibility Materials stored on high shelves are not considered accessible to children. Additionally, toys should not be stacked together; they must be arranged so children can access them independently. The orchid in the glass vase on top of the pretend refrigerator should be removed from the licensed space or placed at least five (5) feet high. Puzzles currently stored on top of the cubby must be relocated to lower shelves within children’s reach. Tables in the rest area must be cleared so children can use the space for play. Any office supplies or personal adult items stored in children’s play areas may limit access and are not considered usable by children. Diaper Changing Area This area must be kept free of unrelated materials to maintain sanitation and safety. Good Hygiene The operator must take active measures to prevent the spread of germs. This includes frequent handwashing for both staff and children. If a child touches materials or the floor after handwashing, they must wash their hands again before eating. If staff members touch materials or children before meals, they must wash their hands before serving food. Timeline and Next Steps Following today’s Rated License Assessment visit: All violations cited during today’s visit must be corrected. Once corrections are complete, I will submit the application for the FCCERS-3 assessment. Then a scheduler will then contact you to arrange the FCCERS-3 assessment visit. After the FCCERS-3 score is released, I will conduct an ERS visit to review your scores with you. Any violations cited during the ERS visit must be corrected before a new permit can be issued. Curriculum Requirement Programs earning a four (4) or five (5) star license are required to adopt an approved curriculum. While the final star rating is not yet determined, please begin researching approved curricula you may want to implement in your program. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division”. As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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: SHEMA Facility ID: 11000877 Consultant: KAORU EDDINS Operation Type: Family CC Home Case Number: Visit Date: 3/10/2025 Number Present: 4 Completed Date: 3/10/2025 Age: From 0 To 2 Total Minutes: 225 Time In: 12:15 PM Time Out: 04:00 PM Time In: Time Out: List to Use: Family CC Home 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 Martha Quinones, Owner/Operator during the visit. An electronic signed copy of the visit summary was printed and left with you. Today, Ms. Quinones was available during the visit. 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 reviewe with the operator. The program’s compliance history was eighty-nine (89) percent as of today prior to this visit. Permit type – One-star Family Child Care Home License issued on 7/18/22. Special Services/Restrictions – daytime care, 2nd shift, children in care on ground level only, maximum of five (5) preschool children at any time. The last annual compliance visit was conducted on 3/18/24. The last fire drill was practiced on 2/20/25. The last lockdown drill was practiced on 12/20/24. The last playground inspection was documented on 2/20/25. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. Four (4) children aged under twelve (12) months to two (2) years of age were present. The children had lunch brought from home and transitioned to free play. After everyone’s diapers were changed, the children were placed in the cribs for rest time. All children’s files were monitored including plan of care, animal acknowledgement form and emergency medical information. Ms. Quinones does not take children to any routine outings during the operating hours. Ms. Quinones’ vehicle is used for emergencies only. The vehicle was used by a family member and was not on-site during the visit. There was a truck and a sedan for emergency. No children are currently enrolled in the 2nd shift. Three (3) over-the-counter diaper creams are maintained. The storage, authorization form and the expiration dates of the creams were in compliance. Three (3) staff member’s files were monitored. M. Vega works as a substitute and one (1) other staff member. The other staff members are on leave, and he/she may or may not return. All family members, Ms. Quinones and the substitute staff member have current criminal background letters in file. Ms. Quinones and the substitute staff member have current ITS/SIDS, CPR and First aid certificates. Ms. Quinones' verification form and operator statements of responsibility was submitted during the visit. There is a dog that lives with the family upstairs. The vaccination is up to date, though the dogs were not around the children during the visit. I used the Family Child Care Homes 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 908 Health questionnaire was not completed annually. Health Questionnaire for a substitute staff member who was hired in 2018 was last updated on 2/20/23. .1703(a)(1) 1891 Individuals providing care to children did not receive 16 hours of orientation prior to beginning caregiving activities. There was no record of orientation for a staff member hired in 2018. .1729( c) 2009 Copies of the required information for an additional caregiver was not on file in the home and/or made available for review. Verification form and Statement of Responsibility form for a substitute staff member hired in 2018 was not available for review. .1729(a) Technical assistance was provided as follows: 908: Health Questionnaire M. Vega’s Health Questionnaire was last updated on 2/20/23. Health questionnaire was not completed annually. Refer to 10A NCAC 09 .1703(a)(1). 1891: Orientation for additional staff The following topics must be reviewed with all caregivers prior to them providing care for children. Please review the following topics with M. Vega. After the review, M. Vega shall sign and date the document. 10A NCAC 09 .1729 ADDITIONAL CAREGIVER AND SUBSTITUTE PROVIDER QUALIFICATIONS (c)The operator shall conduct 16 hours of orientation with all caregivers, prior to the individual caring for children, including substitute providers, volunteers, and uncompensated providers, who are providing care. The orientation shall include an overview of the following topics, specifically focusing on the operation of the facility: (1)recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301; (2)review of the home's operational policies, including the written plan of care, safe sleep policy, the transportation policy, identification of building and premises safety issues, the emergency medical care plan, and the Emergency Preparedness and Response Plan; (3)adequate supervision of children in accordance with Rule .1711(a) of this Section; (4)information regarding prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; (5)prevention and control of infectious diseases, including immunization; (6)firsthand observation of the home's daily operations; (7)instruction regarding assigned duties; (8)instruction in the maintenance of a safe and healthy environment; (9)instruction in the administration of medication to children in accordance with Rule .1720(b) of this Section; (10)review of the home's purposes and goals; (11)review of G.S. 110, Article 7 and 10A NCAC 09; (12)review of Section .2800 of this Chapter if the operator has a two- through five- star license at the time of employment; (13)an explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource; (14)an explanation of the individual's obligation to cooperate with representatives of State and local government agencies during visits and investigations; (15)prevention of and response to emergencies due to food and allergic reactions; and (16)review of the home's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. The operator and individual providing care shall sign and date a statement that attests that this review was completed. This statement shall be kept on file in the home and available for review by the Division. 2009: Documents for review Copies of the required information for additional caregiver was not on file in the home and/or made available for review. M. Vega shall complete “FCCH and CLIAR Verification of Required Information for Operator and Additional Caregivers” and “FCCH” and CLAIR Operator’s Statement of Responsibility” and submit it to me. Refer to 10A NCAC 09 .1729(a). 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 3/24/25. 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: Reminder: Please conduct a lockdown drill or a shelter-in-place drill this month. Ms. Quinone’s Health Questionnaire shall be reviewed and signed off on or before 3/18/25. Written Plan of Care: Currently, Ms. Quinones does not have plans to take the children to routine tasks during the operating hours. However, this may change in the future, per Ms. Quinones. Before you make this change, I must inspect your vehicle as well as reviewing children’s written plan of care. Before you make this change, please reach out to me and discuss the details. Safe sleep requirements: Per conversation with Ms. Quinones, the thermometer for central heating is located upstairs and not always possible to check the room temperature. Indoor areas used by children must be adequately heated when the temperature was below 65, and ventilated when the temperature is above 85 degrees. This requirements are particularly important for infants. 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) 814-8401 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. 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: SHEMA Facility ID: 11000877 Consultant: KAORU EDDINS Operation Type: Family CC Home Case Number: Visit Date: 3/10/2025 Number Present: 4 Completed Date: 3/10/2025 Age: From 0 To 2 Total Minutes: 225 Time In: 12:15 PM Time Out: 04:00 PM Time In: Time Out: List to Use: Family CC Home 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 Martha Quinones, Owner/Operator during the visit. An electronic signed copy of the visit summary was printed and left with you. Today, Ms. Quinones was available during the visit. 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 reviewe with the operator. The program’s compliance history was eighty-nine (89) percent as of today prior to this visit. Permit type – One-star Family Child Care Home License issued on 7/18/22. Special Services/Restrictions – daytime care, 2nd shift, children in care on ground level only, maximum of five (5) preschool children at any time. The last annual compliance visit was conducted on 3/18/24. The last fire drill was practiced on 2/20/25. The last lockdown drill was practiced on 12/20/24. The last playground inspection was documented on 2/20/25. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. Four (4) children aged under twelve (12) months to two (2) years of age were present. The children had lunch brought from home and transitioned to free play. After everyone’s diapers were changed, the children were placed in the cribs for rest time. All children’s files were monitored including plan of care, animal acknowledgement form and emergency medical information. Ms. Quinones does not take children to any routine outings during the operating hours. Ms. Quinones’ vehicle is used for emergencies only. The vehicle was used by a family member and was not on-site during the visit. There was a truck and a sedan for emergency. No children are currently enrolled in the 2nd shift. Three (3) over-the-counter diaper creams are maintained. The storage, authorization form and the expiration dates of the creams were in compliance. Three (3) staff member’s files were monitored. M. Vega works as a substitute and one (1) other staff member. The other staff members are on leave, and he/she may or may not return. All family members, Ms. Quinones and the substitute staff member have current criminal background letters in file. Ms. Quinones and the substitute staff member have current ITS/SIDS, CPR and First aid certificates. Ms. Quinones' verification form and operator statements of responsibility was submitted during the visit. There is a dog that lives with the family upstairs. The vaccination is up to date, though the dogs were not around the children during the visit. I used the Family Child Care Homes 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 908 Health questionnaire was not completed annually. Health Questionnaire for a substitute staff member who was hired in 2018 was last updated on 2/20/23. .1703(a)(1) 1891 Individuals providing care to children did not receive 16 hours of orientation prior to beginning caregiving activities. There was no record of orientation for a staff member hired in 2018. .1729( c) 2009 Copies of the required information for an additional caregiver was not on file in the home and/or made available for review. Verification form and Statement of Responsibility form for a substitute staff member hired in 2018 was not available for review. .1729(a) Technical assistance was provided as follows: 908: Health Questionnaire M. Vega’s Health Questionnaire was last updated on 2/20/23. Health questionnaire was not completed annually. Refer to 10A NCAC 09 .1703(a)(1). 1891: Orientation for additional staff The following topics must be reviewed with all caregivers prior to them providing care for children. Please review the following topics with M. Vega. After the review, M. Vega shall sign and date the document. 10A NCAC 09 .1729 ADDITIONAL CAREGIVER AND SUBSTITUTE PROVIDER QUALIFICATIONS (c)The operator shall conduct 16 hours of orientation with all caregivers, prior to the individual caring for children, including substitute providers, volunteers, and uncompensated providers, who are providing care. The orientation shall include an overview of the following topics, specifically focusing on the operation of the facility: (1)recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301; (2)review of the home's operational policies, including the written plan of care, safe sleep policy, the transportation policy, identification of building and premises safety issues, the emergency medical care plan, and the Emergency Preparedness and Response Plan; (3)adequate supervision of children in accordance with Rule .1711(a) of this Section; (4)information regarding prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; (5)prevention and control of infectious diseases, including immunization; (6)firsthand observation of the home's daily operations; (7)instruction regarding assigned duties; (8)instruction in the maintenance of a safe and healthy environment; (9)instruction in the administration of medication to children in accordance with Rule .1720(b) of this Section; (10)review of the home's purposes and goals; (11)review of G.S. 110, Article 7 and 10A NCAC 09; (12)review of Section .2800 of this Chapter if the operator has a two- through five- star license at the time of employment; (13)an explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource; (14)an explanation of the individual's obligation to cooperate with representatives of State and local government agencies during visits and investigations; (15)prevention of and response to emergencies due to food and allergic reactions; and (16)review of the home's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. The operator and individual providing care shall sign and date a statement that attests that this review was completed. This statement shall be kept on file in the home and available for review by the Division. 2009: Documents for review Copies of the required information for additional caregiver was not on file in the home and/or made available for review. M. Vega shall complete “FCCH and CLIAR Verification of Required Information for Operator and Additional Caregivers” and “FCCH” and CLAIR Operator’s Statement of Responsibility” and submit it to me. Refer to 10A NCAC 09 .1729(a). 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 3/24/25. 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: Reminder: Please conduct a lockdown drill or a shelter-in-place drill this month. Ms. Quinone’s Health Questionnaire shall be reviewed and signed off on or before 3/18/25. Written Plan of Care: Currently, Ms. Quinones does not have plans to take the children to routine tasks during the operating hours. However, this may change in the future, per Ms. Quinones. Before you make this change, I must inspect your vehicle as well as reviewing children’s written plan of care. Before you make this change, please reach out to me and discuss the details. Safe sleep requirements: Per conversation with Ms. Quinones, the thermometer for central heating is located upstairs and not always possible to check the room temperature. Indoor areas used by children must be adequately heated when the temperature was below 65, and ventilated when the temperature is above 85 degrees. This requirements are particularly important for infants. 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) 814-8401 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. 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: SHEMA Facility ID: 11000877 Consultant: KAORU EDDINS Operation Type: Family CC Home Case Number: Visit Date: 3/10/2025 Number Present: 4 Completed Date: 3/10/2025 Age: From 0 To 2 Total Minutes: 225 Time In: 12:15 PM Time Out: 04:00 PM Time In: Time Out: List to Use: Family CC Home 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 Martha Quinones, Owner/Operator during the visit. An electronic signed copy of the visit summary was printed and left with you. Today, Ms. Quinones was available during the visit. 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 reviewe with the operator. The program’s compliance history was eighty-nine (89) percent as of today prior to this visit. Permit type – One-star Family Child Care Home License issued on 7/18/22. Special Services/Restrictions – daytime care, 2nd shift, children in care on ground level only, maximum of five (5) preschool children at any time. The last annual compliance visit was conducted on 3/18/24. The last fire drill was practiced on 2/20/25. The last lockdown drill was practiced on 12/20/24. The last playground inspection was documented on 2/20/25. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. Four (4) children aged under twelve (12) months to two (2) years of age were present. The children had lunch brought from home and transitioned to free play. After everyone’s diapers were changed, the children were placed in the cribs for rest time. All children’s files were monitored including plan of care, animal acknowledgement form and emergency medical information. Ms. Quinones does not take children to any routine outings during the operating hours. Ms. Quinones’ vehicle is used for emergencies only. The vehicle was used by a family member and was not on-site during the visit. There was a truck and a sedan for emergency. No children are currently enrolled in the 2nd shift. Three (3) over-the-counter diaper creams are maintained. The storage, authorization form and the expiration dates of the creams were in compliance. Three (3) staff member’s files were monitored. M. Vega works as a substitute and one (1) other staff member. The other staff members are on leave, and he/she may or may not return. All family members, Ms. Quinones and the substitute staff member have current criminal background letters in file. Ms. Quinones and the substitute staff member have current ITS/SIDS, CPR and First aid certificates. Ms. Quinones' verification form and operator statements of responsibility was submitted during the visit. There is a dog that lives with the family upstairs. The vaccination is up to date, though the dogs were not around the children during the visit. I used the Family Child Care Homes 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 908 Health questionnaire was not completed annually. Health Questionnaire for a substitute staff member who was hired in 2018 was last updated on 2/20/23. .1703(a)(1) 1891 Individuals providing care to children did not receive 16 hours of orientation prior to beginning caregiving activities. There was no record of orientation for a staff member hired in 2018. .1729( c) 2009 Copies of the required information for an additional caregiver was not on file in the home and/or made available for review. Verification form and Statement of Responsibility form for a substitute staff member hired in 2018 was not available for review. .1729(a) Technical assistance was provided as follows: 908: Health Questionnaire M. Vega’s Health Questionnaire was last updated on 2/20/23. Health questionnaire was not completed annually. Refer to 10A NCAC 09 .1703(a)(1). 1891: Orientation for additional staff The following topics must be reviewed with all caregivers prior to them providing care for children. Please review the following topics with M. Vega. After the review, M. Vega shall sign and date the document. 10A NCAC 09 .1729 ADDITIONAL CAREGIVER AND SUBSTITUTE PROVIDER QUALIFICATIONS (c)The operator shall conduct 16 hours of orientation with all caregivers, prior to the individual caring for children, including substitute providers, volunteers, and uncompensated providers, who are providing care. The orientation shall include an overview of the following topics, specifically focusing on the operation of the facility: (1)recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301; (2)review of the home's operational policies, including the written plan of care, safe sleep policy, the transportation policy, identification of building and premises safety issues, the emergency medical care plan, and the Emergency Preparedness and Response Plan; (3)adequate supervision of children in accordance with Rule .1711(a) of this Section; (4)information regarding prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; (5)prevention and control of infectious diseases, including immunization; (6)firsthand observation of the home's daily operations; (7)instruction regarding assigned duties; (8)instruction in the maintenance of a safe and healthy environment; (9)instruction in the administration of medication to children in accordance with Rule .1720(b) of this Section; (10)review of the home's purposes and goals; (11)review of G.S. 110, Article 7 and 10A NCAC 09; (12)review of Section .2800 of this Chapter if the operator has a two- through five- star license at the time of employment; (13)an explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource; (14)an explanation of the individual's obligation to cooperate with representatives of State and local government agencies during visits and investigations; (15)prevention of and response to emergencies due to food and allergic reactions; and (16)review of the home's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. The operator and individual providing care shall sign and date a statement that attests that this review was completed. This statement shall be kept on file in the home and available for review by the Division. 2009: Documents for review Copies of the required information for additional caregiver was not on file in the home and/or made available for review. M. Vega shall complete “FCCH and CLIAR Verification of Required Information for Operator and Additional Caregivers” and “FCCH” and CLAIR Operator’s Statement of Responsibility” and submit it to me. Refer to 10A NCAC 09 .1729(a). 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 3/24/25. 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: Reminder: Please conduct a lockdown drill or a shelter-in-place drill this month. Ms. Quinone’s Health Questionnaire shall be reviewed and signed off on or before 3/18/25. Written Plan of Care: Currently, Ms. Quinones does not have plans to take the children to routine tasks during the operating hours. However, this may change in the future, per Ms. Quinones. Before you make this change, I must inspect your vehicle as well as reviewing children’s written plan of care. Before you make this change, please reach out to me and discuss the details. Safe sleep requirements: Per conversation with Ms. Quinones, the thermometer for central heating is located upstairs and not always possible to check the room temperature. Indoor areas used by children must be adequately heated when the temperature was below 65, and ventilated when the temperature is above 85 degrees. This requirements are particularly important for infants. 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) 814-8401 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. 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 .1729 · Violation

Name of Operation: SHEMA Facility ID: 11000877 Consultant: KAORU EDDINS Operation Type: Family CC Home Case Number: Visit Date: 3/10/2025 Number Present: 4 Completed Date: 3/10/2025 Age: From 0 To 2 Total Minutes: 225 Time In: 12:15 PM Time Out: 04:00 PM Time In: Time Out: List to Use: Family CC Home 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 Martha Quinones, Owner/Operator during the visit. An electronic signed copy of the visit summary was printed and left with you. Today, Ms. Quinones was available during the visit. 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 reviewe with the operator. The program’s compliance history was eighty-nine (89) percent as of today prior to this visit. Permit type – One-star Family Child Care Home License issued on 7/18/22. Special Services/Restrictions – daytime care, 2nd shift, children in care on ground level only, maximum of five (5) preschool children at any time. The last annual compliance visit was conducted on 3/18/24. The last fire drill was practiced on 2/20/25. The last lockdown drill was practiced on 12/20/24. The last playground inspection was documented on 2/20/25. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. Four (4) children aged under twelve (12) months to two (2) years of age were present. The children had lunch brought from home and transitioned to free play. After everyone’s diapers were changed, the children were placed in the cribs for rest time. All children’s files were monitored including plan of care, animal acknowledgement form and emergency medical information. Ms. Quinones does not take children to any routine outings during the operating hours. Ms. Quinones’ vehicle is used for emergencies only. The vehicle was used by a family member and was not on-site during the visit. There was a truck and a sedan for emergency. No children are currently enrolled in the 2nd shift. Three (3) over-the-counter diaper creams are maintained. The storage, authorization form and the expiration dates of the creams were in compliance. Three (3) staff member’s files were monitored. M. Vega works as a substitute and one (1) other staff member. The other staff members are on leave, and he/she may or may not return. All family members, Ms. Quinones and the substitute staff member have current criminal background letters in file. Ms. Quinones and the substitute staff member have current ITS/SIDS, CPR and First aid certificates. Ms. Quinones' verification form and operator statements of responsibility was submitted during the visit. There is a dog that lives with the family upstairs. The vaccination is up to date, though the dogs were not around the children during the visit. I used the Family Child Care Homes 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 908 Health questionnaire was not completed annually. Health Questionnaire for a substitute staff member who was hired in 2018 was last updated on 2/20/23. .1703(a)(1) 1891 Individuals providing care to children did not receive 16 hours of orientation prior to beginning caregiving activities. There was no record of orientation for a staff member hired in 2018. .1729( c) 2009 Copies of the required information for an additional caregiver was not on file in the home and/or made available for review. Verification form and Statement of Responsibility form for a substitute staff member hired in 2018 was not available for review. .1729(a) Technical assistance was provided as follows: 908: Health Questionnaire M. Vega’s Health Questionnaire was last updated on 2/20/23. Health questionnaire was not completed annually. Refer to 10A NCAC 09 .1703(a)(1). 1891: Orientation for additional staff The following topics must be reviewed with all caregivers prior to them providing care for children. Please review the following topics with M. Vega. After the review, M. Vega shall sign and date the document. 10A NCAC 09 .1729 ADDITIONAL CAREGIVER AND SUBSTITUTE PROVIDER QUALIFICATIONS (c)The operator shall conduct 16 hours of orientation with all caregivers, prior to the individual caring for children, including substitute providers, volunteers, and uncompensated providers, who are providing care. The orientation shall include an overview of the following topics, specifically focusing on the operation of the facility: (1)recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301; (2)review of the home's operational policies, including the written plan of care, safe sleep policy, the transportation policy, identification of building and premises safety issues, the emergency medical care plan, and the Emergency Preparedness and Response Plan; (3)adequate supervision of children in accordance with Rule .1711(a) of this Section; (4)information regarding prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; (5)prevention and control of infectious diseases, including immunization; (6)firsthand observation of the home's daily operations; (7)instruction regarding assigned duties; (8)instruction in the maintenance of a safe and healthy environment; (9)instruction in the administration of medication to children in accordance with Rule .1720(b) of this Section; (10)review of the home's purposes and goals; (11)review of G.S. 110, Article 7 and 10A NCAC 09; (12)review of Section .2800 of this Chapter if the operator has a two- through five- star license at the time of employment; (13)an explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource; (14)an explanation of the individual's obligation to cooperate with representatives of State and local government agencies during visits and investigations; (15)prevention of and response to emergencies due to food and allergic reactions; and (16)review of the home's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. The operator and individual providing care shall sign and date a statement that attests that this review was completed. This statement shall be kept on file in the home and available for review by the Division. 2009: Documents for review Copies of the required information for additional caregiver was not on file in the home and/or made available for review. M. Vega shall complete “FCCH and CLIAR Verification of Required Information for Operator and Additional Caregivers” and “FCCH” and CLAIR Operator’s Statement of Responsibility” and submit it to me. Refer to 10A NCAC 09 .1729(a). 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 3/24/25. 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: Reminder: Please conduct a lockdown drill or a shelter-in-place drill this month. Ms. Quinone’s Health Questionnaire shall be reviewed and signed off on or before 3/18/25. Written Plan of Care: Currently, Ms. Quinones does not have plans to take the children to routine tasks during the operating hours. However, this may change in the future, per Ms. Quinones. Before you make this change, I must inspect your vehicle as well as reviewing children’s written plan of care. Before you make this change, please reach out to me and discuss the details. Safe sleep requirements: Per conversation with Ms. Quinones, the thermometer for central heating is located upstairs and not always possible to check the room temperature. Indoor areas used by children must be adequately heated when the temperature was below 65, and ventilated when the temperature is above 85 degrees. This requirements are particularly important for infants. 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) 814-8401 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. 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. 110-105 · Violation

Name of Operation: SHEMA Facility ID: 11000877 Consultant: KAORU EDDINS Operation Type: Family CC Home Case Number: Visit Date: 3/10/2025 Number Present: 4 Completed Date: 3/10/2025 Age: From 0 To 2 Total Minutes: 225 Time In: 12:15 PM Time Out: 04:00 PM Time In: Time Out: List to Use: Family CC Home 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 Martha Quinones, Owner/Operator during the visit. An electronic signed copy of the visit summary was printed and left with you. Today, Ms. Quinones was available during the visit. 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 reviewe with the operator. The program’s compliance history was eighty-nine (89) percent as of today prior to this visit. Permit type – One-star Family Child Care Home License issued on 7/18/22. Special Services/Restrictions – daytime care, 2nd shift, children in care on ground level only, maximum of five (5) preschool children at any time. The last annual compliance visit was conducted on 3/18/24. The last fire drill was practiced on 2/20/25. The last lockdown drill was practiced on 12/20/24. The last playground inspection was documented on 2/20/25. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. Four (4) children aged under twelve (12) months to two (2) years of age were present. The children had lunch brought from home and transitioned to free play. After everyone’s diapers were changed, the children were placed in the cribs for rest time. All children’s files were monitored including plan of care, animal acknowledgement form and emergency medical information. Ms. Quinones does not take children to any routine outings during the operating hours. Ms. Quinones’ vehicle is used for emergencies only. The vehicle was used by a family member and was not on-site during the visit. There was a truck and a sedan for emergency. No children are currently enrolled in the 2nd shift. Three (3) over-the-counter diaper creams are maintained. The storage, authorization form and the expiration dates of the creams were in compliance. Three (3) staff member’s files were monitored. M. Vega works as a substitute and one (1) other staff member. The other staff members are on leave, and he/she may or may not return. All family members, Ms. Quinones and the substitute staff member have current criminal background letters in file. Ms. Quinones and the substitute staff member have current ITS/SIDS, CPR and First aid certificates. Ms. Quinones' verification form and operator statements of responsibility was submitted during the visit. There is a dog that lives with the family upstairs. The vaccination is up to date, though the dogs were not around the children during the visit. I used the Family Child Care Homes 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 908 Health questionnaire was not completed annually. Health Questionnaire for a substitute staff member who was hired in 2018 was last updated on 2/20/23. .1703(a)(1) 1891 Individuals providing care to children did not receive 16 hours of orientation prior to beginning caregiving activities. There was no record of orientation for a staff member hired in 2018. .1729( c) 2009 Copies of the required information for an additional caregiver was not on file in the home and/or made available for review. Verification form and Statement of Responsibility form for a substitute staff member hired in 2018 was not available for review. .1729(a) Technical assistance was provided as follows: 908: Health Questionnaire M. Vega’s Health Questionnaire was last updated on 2/20/23. Health questionnaire was not completed annually. Refer to 10A NCAC 09 .1703(a)(1). 1891: Orientation for additional staff The following topics must be reviewed with all caregivers prior to them providing care for children. Please review the following topics with M. Vega. After the review, M. Vega shall sign and date the document. 10A NCAC 09 .1729 ADDITIONAL CAREGIVER AND SUBSTITUTE PROVIDER QUALIFICATIONS (c)The operator shall conduct 16 hours of orientation with all caregivers, prior to the individual caring for children, including substitute providers, volunteers, and uncompensated providers, who are providing care. The orientation shall include an overview of the following topics, specifically focusing on the operation of the facility: (1)recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301; (2)review of the home's operational policies, including the written plan of care, safe sleep policy, the transportation policy, identification of building and premises safety issues, the emergency medical care plan, and the Emergency Preparedness and Response Plan; (3)adequate supervision of children in accordance with Rule .1711(a) of this Section; (4)information regarding prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; (5)prevention and control of infectious diseases, including immunization; (6)firsthand observation of the home's daily operations; (7)instruction regarding assigned duties; (8)instruction in the maintenance of a safe and healthy environment; (9)instruction in the administration of medication to children in accordance with Rule .1720(b) of this Section; (10)review of the home's purposes and goals; (11)review of G.S. 110, Article 7 and 10A NCAC 09; (12)review of Section .2800 of this Chapter if the operator has a two- through five- star license at the time of employment; (13)an explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource; (14)an explanation of the individual's obligation to cooperate with representatives of State and local government agencies during visits and investigations; (15)prevention of and response to emergencies due to food and allergic reactions; and (16)review of the home's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. The operator and individual providing care shall sign and date a statement that attests that this review was completed. This statement shall be kept on file in the home and available for review by the Division. 2009: Documents for review Copies of the required information for additional caregiver was not on file in the home and/or made available for review. M. Vega shall complete “FCCH and CLIAR Verification of Required Information for Operator and Additional Caregivers” and “FCCH” and CLAIR Operator’s Statement of Responsibility” and submit it to me. Refer to 10A NCAC 09 .1729(a). 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 3/24/25. 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: Reminder: Please conduct a lockdown drill or a shelter-in-place drill this month. Ms. Quinone’s Health Questionnaire shall be reviewed and signed off on or before 3/18/25. Written Plan of Care: Currently, Ms. Quinones does not have plans to take the children to routine tasks during the operating hours. However, this may change in the future, per Ms. Quinones. Before you make this change, I must inspect your vehicle as well as reviewing children’s written plan of care. Before you make this change, please reach out to me and discuss the details. Safe sleep requirements: Per conversation with Ms. Quinones, the thermometer for central heating is located upstairs and not always possible to check the room temperature. Indoor areas used by children must be adequately heated when the temperature was below 65, and ventilated when the temperature is above 85 degrees. This requirements are particularly important for infants. 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) 814-8401 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. 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: SHEMA Facility ID: 11000877 Consultant: KAORU EDDINS Operation Type: Family CC Home Case Number: Visit Date: 3/10/2025 Number Present: 4 Completed Date: 3/10/2025 Age: From 0 To 2 Total Minutes: 225 Time In: 12:15 PM Time Out: 04:00 PM Time In: Time Out: List to Use: Family CC Home 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 Martha Quinones, Owner/Operator during the visit. An electronic signed copy of the visit summary was printed and left with you. Today, Ms. Quinones was available during the visit. 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 reviewe with the operator. The program’s compliance history was eighty-nine (89) percent as of today prior to this visit. Permit type – One-star Family Child Care Home License issued on 7/18/22. Special Services/Restrictions – daytime care, 2nd shift, children in care on ground level only, maximum of five (5) preschool children at any time. The last annual compliance visit was conducted on 3/18/24. The last fire drill was practiced on 2/20/25. The last lockdown drill was practiced on 12/20/24. The last playground inspection was documented on 2/20/25. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. Four (4) children aged under twelve (12) months to two (2) years of age were present. The children had lunch brought from home and transitioned to free play. After everyone’s diapers were changed, the children were placed in the cribs for rest time. All children’s files were monitored including plan of care, animal acknowledgement form and emergency medical information. Ms. Quinones does not take children to any routine outings during the operating hours. Ms. Quinones’ vehicle is used for emergencies only. The vehicle was used by a family member and was not on-site during the visit. There was a truck and a sedan for emergency. No children are currently enrolled in the 2nd shift. Three (3) over-the-counter diaper creams are maintained. The storage, authorization form and the expiration dates of the creams were in compliance. Three (3) staff member’s files were monitored. M. Vega works as a substitute and one (1) other staff member. The other staff members are on leave, and he/she may or may not return. All family members, Ms. Quinones and the substitute staff member have current criminal background letters in file. Ms. Quinones and the substitute staff member have current ITS/SIDS, CPR and First aid certificates. Ms. Quinones' verification form and operator statements of responsibility was submitted during the visit. There is a dog that lives with the family upstairs. The vaccination is up to date, though the dogs were not around the children during the visit. I used the Family Child Care Homes 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 908 Health questionnaire was not completed annually. Health Questionnaire for a substitute staff member who was hired in 2018 was last updated on 2/20/23. .1703(a)(1) 1891 Individuals providing care to children did not receive 16 hours of orientation prior to beginning caregiving activities. There was no record of orientation for a staff member hired in 2018. .1729( c) 2009 Copies of the required information for an additional caregiver was not on file in the home and/or made available for review. Verification form and Statement of Responsibility form for a substitute staff member hired in 2018 was not available for review. .1729(a) Technical assistance was provided as follows: 908: Health Questionnaire M. Vega’s Health Questionnaire was last updated on 2/20/23. Health questionnaire was not completed annually. Refer to 10A NCAC 09 .1703(a)(1). 1891: Orientation for additional staff The following topics must be reviewed with all caregivers prior to them providing care for children. Please review the following topics with M. Vega. After the review, M. Vega shall sign and date the document. 10A NCAC 09 .1729 ADDITIONAL CAREGIVER AND SUBSTITUTE PROVIDER QUALIFICATIONS (c)The operator shall conduct 16 hours of orientation with all caregivers, prior to the individual caring for children, including substitute providers, volunteers, and uncompensated providers, who are providing care. The orientation shall include an overview of the following topics, specifically focusing on the operation of the facility: (1)recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301; (2)review of the home's operational policies, including the written plan of care, safe sleep policy, the transportation policy, identification of building and premises safety issues, the emergency medical care plan, and the Emergency Preparedness and Response Plan; (3)adequate supervision of children in accordance with Rule .1711(a) of this Section; (4)information regarding prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; (5)prevention and control of infectious diseases, including immunization; (6)firsthand observation of the home's daily operations; (7)instruction regarding assigned duties; (8)instruction in the maintenance of a safe and healthy environment; (9)instruction in the administration of medication to children in accordance with Rule .1720(b) of this Section; (10)review of the home's purposes and goals; (11)review of G.S. 110, Article 7 and 10A NCAC 09; (12)review of Section .2800 of this Chapter if the operator has a two- through five- star license at the time of employment; (13)an explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource; (14)an explanation of the individual's obligation to cooperate with representatives of State and local government agencies during visits and investigations; (15)prevention of and response to emergencies due to food and allergic reactions; and (16)review of the home's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. The operator and individual providing care shall sign and date a statement that attests that this review was completed. This statement shall be kept on file in the home and available for review by the Division. 2009: Documents for review Copies of the required information for additional caregiver was not on file in the home and/or made available for review. M. Vega shall complete “FCCH and CLIAR Verification of Required Information for Operator and Additional Caregivers” and “FCCH” and CLAIR Operator’s Statement of Responsibility” and submit it to me. Refer to 10A NCAC 09 .1729(a). 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 3/24/25. 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: Reminder: Please conduct a lockdown drill or a shelter-in-place drill this month. Ms. Quinone’s Health Questionnaire shall be reviewed and signed off on or before 3/18/25. Written Plan of Care: Currently, Ms. Quinones does not have plans to take the children to routine tasks during the operating hours. However, this may change in the future, per Ms. Quinones. Before you make this change, I must inspect your vehicle as well as reviewing children’s written plan of care. Before you make this change, please reach out to me and discuss the details. Safe sleep requirements: Per conversation with Ms. Quinones, the thermometer for central heating is located upstairs and not always possible to check the room temperature. Indoor areas used by children must be adequately heated when the temperature was below 65, and ventilated when the temperature is above 85 degrees. This requirements are particularly important for infants. 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) 814-8401 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. 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: SHEMA Facility ID: 11000877 Consultant: KAORU EDDINS Operation Type: Family CC Home Case Number: Visit Date: 3/10/2025 Number Present: 4 Completed Date: 3/10/2025 Age: From 0 To 2 Total Minutes: 225 Time In: 12:15 PM Time Out: 04:00 PM Time In: Time Out: List to Use: Family CC Home 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 Martha Quinones, Owner/Operator during the visit. An electronic signed copy of the visit summary was printed and left with you. Today, Ms. Quinones was available during the visit. 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 reviewe with the operator. The program’s compliance history was eighty-nine (89) percent as of today prior to this visit. Permit type – One-star Family Child Care Home License issued on 7/18/22. Special Services/Restrictions – daytime care, 2nd shift, children in care on ground level only, maximum of five (5) preschool children at any time. The last annual compliance visit was conducted on 3/18/24. The last fire drill was practiced on 2/20/25. The last lockdown drill was practiced on 12/20/24. The last playground inspection was documented on 2/20/25. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. Four (4) children aged under twelve (12) months to two (2) years of age were present. The children had lunch brought from home and transitioned to free play. After everyone’s diapers were changed, the children were placed in the cribs for rest time. All children’s files were monitored including plan of care, animal acknowledgement form and emergency medical information. Ms. Quinones does not take children to any routine outings during the operating hours. Ms. Quinones’ vehicle is used for emergencies only. The vehicle was used by a family member and was not on-site during the visit. There was a truck and a sedan for emergency. No children are currently enrolled in the 2nd shift. Three (3) over-the-counter diaper creams are maintained. The storage, authorization form and the expiration dates of the creams were in compliance. Three (3) staff member’s files were monitored. M. Vega works as a substitute and one (1) other staff member. The other staff members are on leave, and he/she may or may not return. All family members, Ms. Quinones and the substitute staff member have current criminal background letters in file. Ms. Quinones and the substitute staff member have current ITS/SIDS, CPR and First aid certificates. Ms. Quinones' verification form and operator statements of responsibility was submitted during the visit. There is a dog that lives with the family upstairs. The vaccination is up to date, though the dogs were not around the children during the visit. I used the Family Child Care Homes 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 908 Health questionnaire was not completed annually. Health Questionnaire for a substitute staff member who was hired in 2018 was last updated on 2/20/23. .1703(a)(1) 1891 Individuals providing care to children did not receive 16 hours of orientation prior to beginning caregiving activities. There was no record of orientation for a staff member hired in 2018. .1729( c) 2009 Copies of the required information for an additional caregiver was not on file in the home and/or made available for review. Verification form and Statement of Responsibility form for a substitute staff member hired in 2018 was not available for review. .1729(a) Technical assistance was provided as follows: 908: Health Questionnaire M. Vega’s Health Questionnaire was last updated on 2/20/23. Health questionnaire was not completed annually. Refer to 10A NCAC 09 .1703(a)(1). 1891: Orientation for additional staff The following topics must be reviewed with all caregivers prior to them providing care for children. Please review the following topics with M. Vega. After the review, M. Vega shall sign and date the document. 10A NCAC 09 .1729 ADDITIONAL CAREGIVER AND SUBSTITUTE PROVIDER QUALIFICATIONS (c)The operator shall conduct 16 hours of orientation with all caregivers, prior to the individual caring for children, including substitute providers, volunteers, and uncompensated providers, who are providing care. The orientation shall include an overview of the following topics, specifically focusing on the operation of the facility: (1)recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301; (2)review of the home's operational policies, including the written plan of care, safe sleep policy, the transportation policy, identification of building and premises safety issues, the emergency medical care plan, and the Emergency Preparedness and Response Plan; (3)adequate supervision of children in accordance with Rule .1711(a) of this Section; (4)information regarding prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; (5)prevention and control of infectious diseases, including immunization; (6)firsthand observation of the home's daily operations; (7)instruction regarding assigned duties; (8)instruction in the maintenance of a safe and healthy environment; (9)instruction in the administration of medication to children in accordance with Rule .1720(b) of this Section; (10)review of the home's purposes and goals; (11)review of G.S. 110, Article 7 and 10A NCAC 09; (12)review of Section .2800 of this Chapter if the operator has a two- through five- star license at the time of employment; (13)an explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource; (14)an explanation of the individual's obligation to cooperate with representatives of State and local government agencies during visits and investigations; (15)prevention of and response to emergencies due to food and allergic reactions; and (16)review of the home's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. The operator and individual providing care shall sign and date a statement that attests that this review was completed. This statement shall be kept on file in the home and available for review by the Division. 2009: Documents for review Copies of the required information for additional caregiver was not on file in the home and/or made available for review. M. Vega shall complete “FCCH and CLIAR Verification of Required Information for Operator and Additional Caregivers” and “FCCH” and CLAIR Operator’s Statement of Responsibility” and submit it to me. Refer to 10A NCAC 09 .1729(a). 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 3/24/25. 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: Reminder: Please conduct a lockdown drill or a shelter-in-place drill this month. Ms. Quinone’s Health Questionnaire shall be reviewed and signed off on or before 3/18/25. Written Plan of Care: Currently, Ms. Quinones does not have plans to take the children to routine tasks during the operating hours. However, this may change in the future, per Ms. Quinones. Before you make this change, I must inspect your vehicle as well as reviewing children’s written plan of care. Before you make this change, please reach out to me and discuss the details. Safe sleep requirements: Per conversation with Ms. Quinones, the thermometer for central heating is located upstairs and not always possible to check the room temperature. Indoor areas used by children must be adequately heated when the temperature was below 65, and ventilated when the temperature is above 85 degrees. This requirements are particularly important for infants. 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) 814-8401 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. 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: SHEMA Facility ID: 11000877 Consultant: KAORU EDDINS Operation Type: Family CC Home Case Number: Visit Date: 12/13/2024 Number Present: 1 Completed Date: 12/13/2024 Age: From 2 To 2 Total Minutes: 202 Time In: 09:08 AM Time Out: 12:30 PM Time In: Time Out: List to Use: Family CC Home 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 me, Kaoru Eddins, Child Care Consultant and also signed by Martha Quinones, Owner/Operator, during the visit. A signed copy of the visit summary was electronically emailed to you. Ms. Quinones was available during the visit. 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. 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. Permit type – One-star Family Child Care Home License issued on 7/18/22. Special Services/Restrictions – 1st shift and 2nd shift, children in care on ground level only and maximum of five preschool children at any time. The last annual compliance visit was conducted on 3/18/24. The last fire drill was practiced on 11/20/24. The last lockdown drill was practiced on 9/16/24. Upon arrival, I announced my presence and the purpose of the visit. One (1) child, two (2) years of age, was present. Ms. Quinones and the child sang songs, painted pictures and engaged in other activities. Supervision and interaction were copious. One (1) child has a diaper cream. The storage of the cream and the permission form were in compliance. No children are currently enrolled in the second shift. Playground was inspected, and no hazard concerns were found. Criminal background letters for the people who resides in the house. All family members have current CBC letters in files. Ms. Quinones’s CPR/first aid and ITS/SIDS certificates were current. 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/ Per Ms. Quinones, the children are not transported. No routine tasks were listed on the Written Plans of Care. The following violations were documented during today’s visit Violation Number Comment Rule 1922 Plastic bags, toys, and toy parts small enough to be swallowed, including but not limited to materials that can be easily torn apart such as foam rubber and styrofoam, were accessible to children under the age of three. There was a Target grocery bag on the table against the wall. There was a Ziplock bag of pens and two (2) packets of Parent Choice diapers accessible on the table by the couch. .1719(a)(18) Technical assistance was provided as follows: 1922: plastics Per 10A NCAC 09 .1719(a)(18), easily torn plastics, such as Ziplock bags, grocery bags, plastic wrappers for paper towels, diapers and other products may not be accessible to the children. Hard plastic containers, such as shoe box containers are recommended for storage of writing tools. Take diapers out of the plastic wrappers before storing on the shelves, under the changing tables, etc. Achieving Compliance: Due to all violations being corrected during the visit, you are not required to submit a letter of compliance. Consultation is provided as follows: Shelter-in-place/lockdown drill: A shelter-in-place or a lockdown drill is due this month. Please conduct one before the end of the month. On-going training requirement: Ms. Quinones is currently taking classes at Blue Ridge Community College. Please request for transcript and maintain them in the file for the proof of on-going training. Rated License Assessment: We discussed Rated License Assessment in details. Ms. Quinones has been working on the three months study. We have reviewed how the point system works. I also discussed that the point system will go away when the new QIRS system is implemented. The tentative timeline for finalization of new QIRS system is May 2025 , though it is subject to change. We discuss adoption of approved curriculum for four (4) and five (5) star programs. Please visit the following site for the list of approved curriculum. https://ncchildcare.ncdhhs.gov/Services/NC-Pre-K-Program/Approved-Curricula. We discussed options with and without FCCERS. I strongly recommend Outreach assessment from NCRLAP. You can contact NCRLAP to request an Outreach assessment aby emailing ncrlap@uncg.edu or call 1866-362-7527. You can also visit NCRLAP website at https://www.ncrlap.org/. You can receive training for FCCERS-3 as well as three month study and other resources. WORKS account: While you are completing three-months study and preparing for the Rated License Assessment, please submit official transcripts to the WORKS account to update your education. I shared instructions to submit transcripts to WORKS electronically during the visit. 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. 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: SHEMA Facility ID: 11000877 Consultant: KAORU EDDINS Operation Type: Family CC Home Case Number: Visit Date: 12/13/2024 Number Present: 1 Completed Date: 12/13/2024 Age: From 2 To 2 Total Minutes: 202 Time In: 09:08 AM Time Out: 12:30 PM Time In: Time Out: List to Use: Family CC Home 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 me, Kaoru Eddins, Child Care Consultant and also signed by Martha Quinones, Owner/Operator, during the visit. A signed copy of the visit summary was electronically emailed to you. Ms. Quinones was available during the visit. 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. 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. Permit type – One-star Family Child Care Home License issued on 7/18/22. Special Services/Restrictions – 1st shift and 2nd shift, children in care on ground level only and maximum of five preschool children at any time. The last annual compliance visit was conducted on 3/18/24. The last fire drill was practiced on 11/20/24. The last lockdown drill was practiced on 9/16/24. Upon arrival, I announced my presence and the purpose of the visit. One (1) child, two (2) years of age, was present. Ms. Quinones and the child sang songs, painted pictures and engaged in other activities. Supervision and interaction were copious. One (1) child has a diaper cream. The storage of the cream and the permission form were in compliance. No children are currently enrolled in the second shift. Playground was inspected, and no hazard concerns were found. Criminal background letters for the people who resides in the house. All family members have current CBC letters in files. Ms. Quinones’s CPR/first aid and ITS/SIDS certificates were current. 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/ Per Ms. Quinones, the children are not transported. No routine tasks were listed on the Written Plans of Care. The following violations were documented during today’s visit Violation Number Comment Rule 1922 Plastic bags, toys, and toy parts small enough to be swallowed, including but not limited to materials that can be easily torn apart such as foam rubber and styrofoam, were accessible to children under the age of three. There was a Target grocery bag on the table against the wall. There was a Ziplock bag of pens and two (2) packets of Parent Choice diapers accessible on the table by the couch. .1719(a)(18) Technical assistance was provided as follows: 1922: plastics Per 10A NCAC 09 .1719(a)(18), easily torn plastics, such as Ziplock bags, grocery bags, plastic wrappers for paper towels, diapers and other products may not be accessible to the children. Hard plastic containers, such as shoe box containers are recommended for storage of writing tools. Take diapers out of the plastic wrappers before storing on the shelves, under the changing tables, etc. Achieving Compliance: Due to all violations being corrected during the visit, you are not required to submit a letter of compliance. Consultation is provided as follows: Shelter-in-place/lockdown drill: A shelter-in-place or a lockdown drill is due this month. Please conduct one before the end of the month. On-going training requirement: Ms. Quinones is currently taking classes at Blue Ridge Community College. Please request for transcript and maintain them in the file for the proof of on-going training. Rated License Assessment: We discussed Rated License Assessment in details. Ms. Quinones has been working on the three months study. We have reviewed how the point system works. I also discussed that the point system will go away when the new QIRS system is implemented. The tentative timeline for finalization of new QIRS system is May 2025 , though it is subject to change. We discuss adoption of approved curriculum for four (4) and five (5) star programs. Please visit the following site for the list of approved curriculum. https://ncchildcare.ncdhhs.gov/Services/NC-Pre-K-Program/Approved-Curricula. We discussed options with and without FCCERS. I strongly recommend Outreach assessment from NCRLAP. You can contact NCRLAP to request an Outreach assessment aby emailing ncrlap@uncg.edu or call 1866-362-7527. You can also visit NCRLAP website at https://www.ncrlap.org/. You can receive training for FCCERS-3 as well as three month study and other resources. WORKS account: While you are completing three-months study and preparing for the Rated License Assessment, please submit official transcripts to the WORKS account to update your education. I shared instructions to submit transcripts to WORKS electronically during the visit. 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. 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: SHEMA Facility ID: 11000877 Consultant: KAORU EDDINS Operation Type: Family CC Home Case Number: Visit Date: 12/13/2024 Number Present: 1 Completed Date: 12/13/2024 Age: From 2 To 2 Total Minutes: 202 Time In: 09:08 AM Time Out: 12:30 PM Time In: Time Out: List to Use: Family CC Home 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 me, Kaoru Eddins, Child Care Consultant and also signed by Martha Quinones, Owner/Operator, during the visit. A signed copy of the visit summary was electronically emailed to you. Ms. Quinones was available during the visit. 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. 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. Permit type – One-star Family Child Care Home License issued on 7/18/22. Special Services/Restrictions – 1st shift and 2nd shift, children in care on ground level only and maximum of five preschool children at any time. The last annual compliance visit was conducted on 3/18/24. The last fire drill was practiced on 11/20/24. The last lockdown drill was practiced on 9/16/24. Upon arrival, I announced my presence and the purpose of the visit. One (1) child, two (2) years of age, was present. Ms. Quinones and the child sang songs, painted pictures and engaged in other activities. Supervision and interaction were copious. One (1) child has a diaper cream. The storage of the cream and the permission form were in compliance. No children are currently enrolled in the second shift. Playground was inspected, and no hazard concerns were found. Criminal background letters for the people who resides in the house. All family members have current CBC letters in files. Ms. Quinones’s CPR/first aid and ITS/SIDS certificates were current. 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/ Per Ms. Quinones, the children are not transported. No routine tasks were listed on the Written Plans of Care. The following violations were documented during today’s visit Violation Number Comment Rule 1922 Plastic bags, toys, and toy parts small enough to be swallowed, including but not limited to materials that can be easily torn apart such as foam rubber and styrofoam, were accessible to children under the age of three. There was a Target grocery bag on the table against the wall. There was a Ziplock bag of pens and two (2) packets of Parent Choice diapers accessible on the table by the couch. .1719(a)(18) Technical assistance was provided as follows: 1922: plastics Per 10A NCAC 09 .1719(a)(18), easily torn plastics, such as Ziplock bags, grocery bags, plastic wrappers for paper towels, diapers and other products may not be accessible to the children. Hard plastic containers, such as shoe box containers are recommended for storage of writing tools. Take diapers out of the plastic wrappers before storing on the shelves, under the changing tables, etc. Achieving Compliance: Due to all violations being corrected during the visit, you are not required to submit a letter of compliance. Consultation is provided as follows: Shelter-in-place/lockdown drill: A shelter-in-place or a lockdown drill is due this month. Please conduct one before the end of the month. On-going training requirement: Ms. Quinones is currently taking classes at Blue Ridge Community College. Please request for transcript and maintain them in the file for the proof of on-going training. Rated License Assessment: We discussed Rated License Assessment in details. Ms. Quinones has been working on the three months study. We have reviewed how the point system works. I also discussed that the point system will go away when the new QIRS system is implemented. The tentative timeline for finalization of new QIRS system is May 2025 , though it is subject to change. We discuss adoption of approved curriculum for four (4) and five (5) star programs. Please visit the following site for the list of approved curriculum. https://ncchildcare.ncdhhs.gov/Services/NC-Pre-K-Program/Approved-Curricula. We discussed options with and without FCCERS. I strongly recommend Outreach assessment from NCRLAP. You can contact NCRLAP to request an Outreach assessment aby emailing ncrlap@uncg.edu or call 1866-362-7527. You can also visit NCRLAP website at https://www.ncrlap.org/. You can receive training for FCCERS-3 as well as three month study and other resources. WORKS account: While you are completing three-months study and preparing for the Rated License Assessment, please submit official transcripts to the WORKS account to update your education. I shared instructions to submit transcripts to WORKS electronically during the visit. 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. 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 .1719 · Violation

Name of Operation: SHEMA Facility ID: 11000877 Consultant: KAORU EDDINS Operation Type: Family CC Home Case Number: Visit Date: 12/13/2024 Number Present: 1 Completed Date: 12/13/2024 Age: From 2 To 2 Total Minutes: 202 Time In: 09:08 AM Time Out: 12:30 PM Time In: Time Out: List to Use: Family CC Home 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 me, Kaoru Eddins, Child Care Consultant and also signed by Martha Quinones, Owner/Operator, during the visit. A signed copy of the visit summary was electronically emailed to you. Ms. Quinones was available during the visit. 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. 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. Permit type – One-star Family Child Care Home License issued on 7/18/22. Special Services/Restrictions – 1st shift and 2nd shift, children in care on ground level only and maximum of five preschool children at any time. The last annual compliance visit was conducted on 3/18/24. The last fire drill was practiced on 11/20/24. The last lockdown drill was practiced on 9/16/24. Upon arrival, I announced my presence and the purpose of the visit. One (1) child, two (2) years of age, was present. Ms. Quinones and the child sang songs, painted pictures and engaged in other activities. Supervision and interaction were copious. One (1) child has a diaper cream. The storage of the cream and the permission form were in compliance. No children are currently enrolled in the second shift. Playground was inspected, and no hazard concerns were found. Criminal background letters for the people who resides in the house. All family members have current CBC letters in files. Ms. Quinones’s CPR/first aid and ITS/SIDS certificates were current. 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/ Per Ms. Quinones, the children are not transported. No routine tasks were listed on the Written Plans of Care. The following violations were documented during today’s visit Violation Number Comment Rule 1922 Plastic bags, toys, and toy parts small enough to be swallowed, including but not limited to materials that can be easily torn apart such as foam rubber and styrofoam, were accessible to children under the age of three. There was a Target grocery bag on the table against the wall. There was a Ziplock bag of pens and two (2) packets of Parent Choice diapers accessible on the table by the couch. .1719(a)(18) Technical assistance was provided as follows: 1922: plastics Per 10A NCAC 09 .1719(a)(18), easily torn plastics, such as Ziplock bags, grocery bags, plastic wrappers for paper towels, diapers and other products may not be accessible to the children. Hard plastic containers, such as shoe box containers are recommended for storage of writing tools. Take diapers out of the plastic wrappers before storing on the shelves, under the changing tables, etc. Achieving Compliance: Due to all violations being corrected during the visit, you are not required to submit a letter of compliance. Consultation is provided as follows: Shelter-in-place/lockdown drill: A shelter-in-place or a lockdown drill is due this month. Please conduct one before the end of the month. On-going training requirement: Ms. Quinones is currently taking classes at Blue Ridge Community College. Please request for transcript and maintain them in the file for the proof of on-going training. Rated License Assessment: We discussed Rated License Assessment in details. Ms. Quinones has been working on the three months study. We have reviewed how the point system works. I also discussed that the point system will go away when the new QIRS system is implemented. The tentative timeline for finalization of new QIRS system is May 2025 , though it is subject to change. We discuss adoption of approved curriculum for four (4) and five (5) star programs. Please visit the following site for the list of approved curriculum. https://ncchildcare.ncdhhs.gov/Services/NC-Pre-K-Program/Approved-Curricula. We discussed options with and without FCCERS. I strongly recommend Outreach assessment from NCRLAP. You can contact NCRLAP to request an Outreach assessment aby emailing ncrlap@uncg.edu or call 1866-362-7527. You can also visit NCRLAP website at https://www.ncrlap.org/. You can receive training for FCCERS-3 as well as three month study and other resources. WORKS account: While you are completing three-months study and preparing for the Rated License Assessment, please submit official transcripts to the WORKS account to update your education. I shared instructions to submit transcripts to WORKS electronically during the visit. 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. 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: SHEMA Facility ID: 11000877 Consultant: KARLA TERRY Operation Type: Family CC Home Case Number: Visit Date: 3/18/2024 Number Present: 4 Completed Date: 3/18/2024 Age: From 0 To 2 Total Minutes: 155 Time In: 10:15 AM Time Out: 12:50 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. Upon arrival, I was greeted by Martha Quinones, Operator. Ms. Quinones was present and available to ask and answer questions through the visit today. Your program currently operates with a One (1) Star Rated License, issued 7/18/2022. The permit restrictions were in compliance including first shift (daytime care), second shift, children in care on ground level only, maximum of five preschool children at any time. This facility provides transportation and offers foreign language. 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 family child care homes was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The last annual compliance visit was conducted on 3/24/2023. The last fire drill was practiced on 12/18/2023. A fire drill was conducted during the visit at 12:08p. The last shelter-in-place drill was practiced on 12/18/2023. The last outdoor inspection was documented on 2/19/2024. The Emergency Medical Care plan was posted and current. All medications were monitored and meet requirement. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety percent (90%) as of 3/11/2024. Upon arrival, I observed three (3) children present. The group of children two years old were engaged in free play with dolls and pretend food. After free play, the children went to the table for group time. One (1) child arrived during group time at 10:30a. After group time, the children transitioned outdoors for gross motor play with the climbers and balls. While outdoors, the caregiver conducted bottle feeding for the child that had arrived late. After gross motor play, the children arrived back inside to wash hands and prepare for lunch. Before lunch a fire drill was conducted at 12:08p. After returning in the fire drill, the children washed hands and went to the table for lunch. The children enrolled have a nutritional opt out form on file and bring their food from home. You stated the following: - You stated you, your husband, and daughter live in the residence. - Criminal Record Checks were found to be current. - CPR and First Aid is current and up to date. - You do not provide transportation. You do have one (1) dog in the home that is kept inside. Vaccination records expired on 3/16/2024. You stated that you are aware the dog is late for its vaccinations but does have an appointment. - You keep children from going into un-used areas of the home through the use of closed and locked doors. Operator/Caregiver and children’s files were monitored during the visit. I monitored one (1) operator file. The verification of required information for operator and additional caregiver form was received. Operator/caregiver file concerns: health questionnaire expired on 2/15/2024 and needs to be updated for the 2024 year. I monitored five (5) children’s files. 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 705 All medicines, including refrigerated and unrefrigerated, were not kept in locked storage. Six (6) bottles of prescription medications were unlocked in the cabinet above the bottle warmer to the left of the sink. .1719(a)(5) 907 Written record of up-to-date pet vaccinations as required by NC law and local ordinances, including rabies vaccination for dogs and cats, was not available. Current pet vaccinations were not on file for review. The last pet vaccinations on file were dated 3/16/2023 and expired 3/16/2024 .1719(b)(1) 908 Health questionnaire was not completed annually. Operator MQ health questionnaire was not completed annually. The last completed health questionnaire was dated 2/15/2023. This was updated during the visit. .1703(a)(1) 1853 The operator did not conduct a monthly fire drill. Provider did not conduct a monthly fire drill for January or February 2024. The last documented fire drill was dated 12/18/2023. During the visit a fire drill was conducted at 12:08p. .1719(a)(15) & .1721( e)(2) Technical assistance was provided as follows: Item 705 All medicines, including refrigerated and unrefrigerated, were not kept in locked storage. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (a) The operator of a family child care home (operator) shall provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of children in care, including but not limited to the following: (5) medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container. Designated emergency medications shall be stored out of reach of children at least five feet high, but are not required to be in locked storage. For purposes of this Rule, designated emergency medications are those that are used or needed for the immediate recovery from a life-threatening event and include Glucagon, epinephrine auto-injector, diazepam rectal installation and albuterol; -Six (6) bottles of prescription medications were unlocked in the cabinet above the bottle warmer to the left of the sink. The prescription medications will need to be moved to a locking cabinet or a lock will need to be installed on the cabinet. Item #907 Written record of up-to-date pet vaccinations as required by NC law and local ordinances, including rabies vaccination for dogs and cats was not available. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (b) When animals are on the premises, the following shall apply: (1) all household pets shall be vaccinated with up-to-date vaccinations as required by North Carolina law and local ordinances. Rabies vaccinations are required for cats and dogs; -Current pet vaccinations were not on file for review. The last pet vaccinations on file were dated 3/16/2023 and expired 3/16/2024. The pet vaccinations will need to be updated and a file kept on-site. Item #908 Health questionnaire was not completed annually. 10A NCAC 09 .1703 ON-GOING REQUIREMENTS FOR FAMILY CHILD CARE HOME OPERATORS (a) After receiving a license, family child care home operator shall: (1) Update the health questionnaire annually. The Division may request an evaluation of the operator's emotional and physical fitness to care for children when there is reason to believe that there has been a deterioration in the operator's emotional or physical fitness to care for children. This request may be based upon factors such as observations by the director or center staff, reports of concern from family, reports from law enforcement or reports from medical personnel. The Division may require the operator to obtain written proof that he or she is free of active tuberculosis when the Division determines that the operator was exposed to a person with active tuberculosis; -Operator MQ health questionnaire was not completed annually. The last completed health questionnaire was dated 2/15/2023. I suggest documenting on your calendar as a reminder to update your health questionnaire annually. Item #1853 The operator did not conduct a monthly fire drill. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (a) The operator of a family child care home (operator) shall provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of children in care, including but not limited to the following: (15) conduct a monthly fire drill; - Provider did not conduct a monthly fire drill for January or February 2024. The last documented fire drill was dated 12/18/2023. During the visit a fire drill was conducted at 12:08p. I recommend documenting on a calendar monthly when to conduct a fire drill as a reminder. Corrective Action Plan: Family Child Care Homes are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/1/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation: Today, we discussed the following: - The possibility that you could increase your star license to a three (3) star license. Please submit your education information from your most recent coursework to WORKS. - You could increase your program points by completing the three (3) month self-study with the North Carolina Rated license Assessment Project (NCRLAP). I emailed you Understanding the Self-Study, Five (5) Key Points for NC FCCH Self-Study, and Getting Started information for you to review. You can also view additional information and webinars on the North Carolina Rated license Assessment Project (NCRLAP) website www.ncrlap.org. - If you do not plan on providing transportation and would like to remove it from your license, please submit a letter to request the removal of transportation. - Permission to administer medication forms ensure each parent documents a specific amount (example: pea size, dime size, 1 teaspoon, etc). - Print current training completion certificates to add to your on-going training file. - First Aid and CPR is due by 4/9/2024. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any 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. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Martha Quinones, Operator, during the visit. An electronic signed copy of the visit summary was left on-site to you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, 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: SHEMA Facility ID: 11000877 Consultant: KARLA TERRY Operation Type: Family CC Home Case Number: Visit Date: 3/18/2024 Number Present: 4 Completed Date: 3/18/2024 Age: From 0 To 2 Total Minutes: 155 Time In: 10:15 AM Time Out: 12:50 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. Upon arrival, I was greeted by Martha Quinones, Operator. Ms. Quinones was present and available to ask and answer questions through the visit today. Your program currently operates with a One (1) Star Rated License, issued 7/18/2022. The permit restrictions were in compliance including first shift (daytime care), second shift, children in care on ground level only, maximum of five preschool children at any time. This facility provides transportation and offers foreign language. 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 family child care homes was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The last annual compliance visit was conducted on 3/24/2023. The last fire drill was practiced on 12/18/2023. A fire drill was conducted during the visit at 12:08p. The last shelter-in-place drill was practiced on 12/18/2023. The last outdoor inspection was documented on 2/19/2024. The Emergency Medical Care plan was posted and current. All medications were monitored and meet requirement. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety percent (90%) as of 3/11/2024. Upon arrival, I observed three (3) children present. The group of children two years old were engaged in free play with dolls and pretend food. After free play, the children went to the table for group time. One (1) child arrived during group time at 10:30a. After group time, the children transitioned outdoors for gross motor play with the climbers and balls. While outdoors, the caregiver conducted bottle feeding for the child that had arrived late. After gross motor play, the children arrived back inside to wash hands and prepare for lunch. Before lunch a fire drill was conducted at 12:08p. After returning in the fire drill, the children washed hands and went to the table for lunch. The children enrolled have a nutritional opt out form on file and bring their food from home. You stated the following: - You stated you, your husband, and daughter live in the residence. - Criminal Record Checks were found to be current. - CPR and First Aid is current and up to date. - You do not provide transportation. You do have one (1) dog in the home that is kept inside. Vaccination records expired on 3/16/2024. You stated that you are aware the dog is late for its vaccinations but does have an appointment. - You keep children from going into un-used areas of the home through the use of closed and locked doors. Operator/Caregiver and children’s files were monitored during the visit. I monitored one (1) operator file. The verification of required information for operator and additional caregiver form was received. Operator/caregiver file concerns: health questionnaire expired on 2/15/2024 and needs to be updated for the 2024 year. I monitored five (5) children’s files. 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 705 All medicines, including refrigerated and unrefrigerated, were not kept in locked storage. Six (6) bottles of prescription medications were unlocked in the cabinet above the bottle warmer to the left of the sink. .1719(a)(5) 907 Written record of up-to-date pet vaccinations as required by NC law and local ordinances, including rabies vaccination for dogs and cats, was not available. Current pet vaccinations were not on file for review. The last pet vaccinations on file were dated 3/16/2023 and expired 3/16/2024 .1719(b)(1) 908 Health questionnaire was not completed annually. Operator MQ health questionnaire was not completed annually. The last completed health questionnaire was dated 2/15/2023. This was updated during the visit. .1703(a)(1) 1853 The operator did not conduct a monthly fire drill. Provider did not conduct a monthly fire drill for January or February 2024. The last documented fire drill was dated 12/18/2023. During the visit a fire drill was conducted at 12:08p. .1719(a)(15) & .1721( e)(2) Technical assistance was provided as follows: Item 705 All medicines, including refrigerated and unrefrigerated, were not kept in locked storage. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (a) The operator of a family child care home (operator) shall provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of children in care, including but not limited to the following: (5) medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container. Designated emergency medications shall be stored out of reach of children at least five feet high, but are not required to be in locked storage. For purposes of this Rule, designated emergency medications are those that are used or needed for the immediate recovery from a life-threatening event and include Glucagon, epinephrine auto-injector, diazepam rectal installation and albuterol; -Six (6) bottles of prescription medications were unlocked in the cabinet above the bottle warmer to the left of the sink. The prescription medications will need to be moved to a locking cabinet or a lock will need to be installed on the cabinet. Item #907 Written record of up-to-date pet vaccinations as required by NC law and local ordinances, including rabies vaccination for dogs and cats was not available. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (b) When animals are on the premises, the following shall apply: (1) all household pets shall be vaccinated with up-to-date vaccinations as required by North Carolina law and local ordinances. Rabies vaccinations are required for cats and dogs; -Current pet vaccinations were not on file for review. The last pet vaccinations on file were dated 3/16/2023 and expired 3/16/2024. The pet vaccinations will need to be updated and a file kept on-site. Item #908 Health questionnaire was not completed annually. 10A NCAC 09 .1703 ON-GOING REQUIREMENTS FOR FAMILY CHILD CARE HOME OPERATORS (a) After receiving a license, family child care home operator shall: (1) Update the health questionnaire annually. The Division may request an evaluation of the operator's emotional and physical fitness to care for children when there is reason to believe that there has been a deterioration in the operator's emotional or physical fitness to care for children. This request may be based upon factors such as observations by the director or center staff, reports of concern from family, reports from law enforcement or reports from medical personnel. The Division may require the operator to obtain written proof that he or she is free of active tuberculosis when the Division determines that the operator was exposed to a person with active tuberculosis; -Operator MQ health questionnaire was not completed annually. The last completed health questionnaire was dated 2/15/2023. I suggest documenting on your calendar as a reminder to update your health questionnaire annually. Item #1853 The operator did not conduct a monthly fire drill. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (a) The operator of a family child care home (operator) shall provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of children in care, including but not limited to the following: (15) conduct a monthly fire drill; - Provider did not conduct a monthly fire drill for January or February 2024. The last documented fire drill was dated 12/18/2023. During the visit a fire drill was conducted at 12:08p. I recommend documenting on a calendar monthly when to conduct a fire drill as a reminder. Corrective Action Plan: Family Child Care Homes are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/1/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation: Today, we discussed the following: - The possibility that you could increase your star license to a three (3) star license. Please submit your education information from your most recent coursework to WORKS. - You could increase your program points by completing the three (3) month self-study with the North Carolina Rated license Assessment Project (NCRLAP). I emailed you Understanding the Self-Study, Five (5) Key Points for NC FCCH Self-Study, and Getting Started information for you to review. You can also view additional information and webinars on the North Carolina Rated license Assessment Project (NCRLAP) website www.ncrlap.org. - If you do not plan on providing transportation and would like to remove it from your license, please submit a letter to request the removal of transportation. - Permission to administer medication forms ensure each parent documents a specific amount (example: pea size, dime size, 1 teaspoon, etc). - Print current training completion certificates to add to your on-going training file. - First Aid and CPR is due by 4/9/2024. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any 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. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Martha Quinones, Operator, during the visit. An electronic signed copy of the visit summary was left on-site to you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, 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 .1719 · Violation

Name of Operation: SHEMA Facility ID: 11000877 Consultant: KARLA TERRY Operation Type: Family CC Home Case Number: Visit Date: 3/18/2024 Number Present: 4 Completed Date: 3/18/2024 Age: From 0 To 2 Total Minutes: 155 Time In: 10:15 AM Time Out: 12:50 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. Upon arrival, I was greeted by Martha Quinones, Operator. Ms. Quinones was present and available to ask and answer questions through the visit today. Your program currently operates with a One (1) Star Rated License, issued 7/18/2022. The permit restrictions were in compliance including first shift (daytime care), second shift, children in care on ground level only, maximum of five preschool children at any time. This facility provides transportation and offers foreign language. 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 family child care homes was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The last annual compliance visit was conducted on 3/24/2023. The last fire drill was practiced on 12/18/2023. A fire drill was conducted during the visit at 12:08p. The last shelter-in-place drill was practiced on 12/18/2023. The last outdoor inspection was documented on 2/19/2024. The Emergency Medical Care plan was posted and current. All medications were monitored and meet requirement. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety percent (90%) as of 3/11/2024. Upon arrival, I observed three (3) children present. The group of children two years old were engaged in free play with dolls and pretend food. After free play, the children went to the table for group time. One (1) child arrived during group time at 10:30a. After group time, the children transitioned outdoors for gross motor play with the climbers and balls. While outdoors, the caregiver conducted bottle feeding for the child that had arrived late. After gross motor play, the children arrived back inside to wash hands and prepare for lunch. Before lunch a fire drill was conducted at 12:08p. After returning in the fire drill, the children washed hands and went to the table for lunch. The children enrolled have a nutritional opt out form on file and bring their food from home. You stated the following: - You stated you, your husband, and daughter live in the residence. - Criminal Record Checks were found to be current. - CPR and First Aid is current and up to date. - You do not provide transportation. You do have one (1) dog in the home that is kept inside. Vaccination records expired on 3/16/2024. You stated that you are aware the dog is late for its vaccinations but does have an appointment. - You keep children from going into un-used areas of the home through the use of closed and locked doors. Operator/Caregiver and children’s files were monitored during the visit. I monitored one (1) operator file. The verification of required information for operator and additional caregiver form was received. Operator/caregiver file concerns: health questionnaire expired on 2/15/2024 and needs to be updated for the 2024 year. I monitored five (5) children’s files. 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 705 All medicines, including refrigerated and unrefrigerated, were not kept in locked storage. Six (6) bottles of prescription medications were unlocked in the cabinet above the bottle warmer to the left of the sink. .1719(a)(5) 907 Written record of up-to-date pet vaccinations as required by NC law and local ordinances, including rabies vaccination for dogs and cats, was not available. Current pet vaccinations were not on file for review. The last pet vaccinations on file were dated 3/16/2023 and expired 3/16/2024 .1719(b)(1) 908 Health questionnaire was not completed annually. Operator MQ health questionnaire was not completed annually. The last completed health questionnaire was dated 2/15/2023. This was updated during the visit. .1703(a)(1) 1853 The operator did not conduct a monthly fire drill. Provider did not conduct a monthly fire drill for January or February 2024. The last documented fire drill was dated 12/18/2023. During the visit a fire drill was conducted at 12:08p. .1719(a)(15) & .1721( e)(2) Technical assistance was provided as follows: Item 705 All medicines, including refrigerated and unrefrigerated, were not kept in locked storage. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (a) The operator of a family child care home (operator) shall provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of children in care, including but not limited to the following: (5) medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container. Designated emergency medications shall be stored out of reach of children at least five feet high, but are not required to be in locked storage. For purposes of this Rule, designated emergency medications are those that are used or needed for the immediate recovery from a life-threatening event and include Glucagon, epinephrine auto-injector, diazepam rectal installation and albuterol; -Six (6) bottles of prescription medications were unlocked in the cabinet above the bottle warmer to the left of the sink. The prescription medications will need to be moved to a locking cabinet or a lock will need to be installed on the cabinet. Item #907 Written record of up-to-date pet vaccinations as required by NC law and local ordinances, including rabies vaccination for dogs and cats was not available. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (b) When animals are on the premises, the following shall apply: (1) all household pets shall be vaccinated with up-to-date vaccinations as required by North Carolina law and local ordinances. Rabies vaccinations are required for cats and dogs; -Current pet vaccinations were not on file for review. The last pet vaccinations on file were dated 3/16/2023 and expired 3/16/2024. The pet vaccinations will need to be updated and a file kept on-site. Item #908 Health questionnaire was not completed annually. 10A NCAC 09 .1703 ON-GOING REQUIREMENTS FOR FAMILY CHILD CARE HOME OPERATORS (a) After receiving a license, family child care home operator shall: (1) Update the health questionnaire annually. The Division may request an evaluation of the operator's emotional and physical fitness to care for children when there is reason to believe that there has been a deterioration in the operator's emotional or physical fitness to care for children. This request may be based upon factors such as observations by the director or center staff, reports of concern from family, reports from law enforcement or reports from medical personnel. The Division may require the operator to obtain written proof that he or she is free of active tuberculosis when the Division determines that the operator was exposed to a person with active tuberculosis; -Operator MQ health questionnaire was not completed annually. The last completed health questionnaire was dated 2/15/2023. I suggest documenting on your calendar as a reminder to update your health questionnaire annually. Item #1853 The operator did not conduct a monthly fire drill. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (a) The operator of a family child care home (operator) shall provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of children in care, including but not limited to the following: (15) conduct a monthly fire drill; - Provider did not conduct a monthly fire drill for January or February 2024. The last documented fire drill was dated 12/18/2023. During the visit a fire drill was conducted at 12:08p. I recommend documenting on a calendar monthly when to conduct a fire drill as a reminder. Corrective Action Plan: Family Child Care Homes are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/1/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation: Today, we discussed the following: - The possibility that you could increase your star license to a three (3) star license. Please submit your education information from your most recent coursework to WORKS. - You could increase your program points by completing the three (3) month self-study with the North Carolina Rated license Assessment Project (NCRLAP). I emailed you Understanding the Self-Study, Five (5) Key Points for NC FCCH Self-Study, and Getting Started information for you to review. You can also view additional information and webinars on the North Carolina Rated license Assessment Project (NCRLAP) website www.ncrlap.org. - If you do not plan on providing transportation and would like to remove it from your license, please submit a letter to request the removal of transportation. - Permission to administer medication forms ensure each parent documents a specific amount (example: pea size, dime size, 1 teaspoon, etc). - Print current training completion certificates to add to your on-going training file. - First Aid and CPR is due by 4/9/2024. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any 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. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Martha Quinones, Operator, during the visit. An electronic signed copy of the visit summary was left on-site to you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, 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: SHEMA Facility ID: 11000877 Consultant: KARLA TERRY Operation Type: Family CC Home Case Number: Visit Date: 3/18/2024 Number Present: 4 Completed Date: 3/18/2024 Age: From 0 To 2 Total Minutes: 155 Time In: 10:15 AM Time Out: 12:50 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. Upon arrival, I was greeted by Martha Quinones, Operator. Ms. Quinones was present and available to ask and answer questions through the visit today. Your program currently operates with a One (1) Star Rated License, issued 7/18/2022. The permit restrictions were in compliance including first shift (daytime care), second shift, children in care on ground level only, maximum of five preschool children at any time. This facility provides transportation and offers foreign language. 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 family child care homes was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The last annual compliance visit was conducted on 3/24/2023. The last fire drill was practiced on 12/18/2023. A fire drill was conducted during the visit at 12:08p. The last shelter-in-place drill was practiced on 12/18/2023. The last outdoor inspection was documented on 2/19/2024. The Emergency Medical Care plan was posted and current. All medications were monitored and meet requirement. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety percent (90%) as of 3/11/2024. Upon arrival, I observed three (3) children present. The group of children two years old were engaged in free play with dolls and pretend food. After free play, the children went to the table for group time. One (1) child arrived during group time at 10:30a. After group time, the children transitioned outdoors for gross motor play with the climbers and balls. While outdoors, the caregiver conducted bottle feeding for the child that had arrived late. After gross motor play, the children arrived back inside to wash hands and prepare for lunch. Before lunch a fire drill was conducted at 12:08p. After returning in the fire drill, the children washed hands and went to the table for lunch. The children enrolled have a nutritional opt out form on file and bring their food from home. You stated the following: - You stated you, your husband, and daughter live in the residence. - Criminal Record Checks were found to be current. - CPR and First Aid is current and up to date. - You do not provide transportation. You do have one (1) dog in the home that is kept inside. Vaccination records expired on 3/16/2024. You stated that you are aware the dog is late for its vaccinations but does have an appointment. - You keep children from going into un-used areas of the home through the use of closed and locked doors. Operator/Caregiver and children’s files were monitored during the visit. I monitored one (1) operator file. The verification of required information for operator and additional caregiver form was received. Operator/caregiver file concerns: health questionnaire expired on 2/15/2024 and needs to be updated for the 2024 year. I monitored five (5) children’s files. 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 705 All medicines, including refrigerated and unrefrigerated, were not kept in locked storage. Six (6) bottles of prescription medications were unlocked in the cabinet above the bottle warmer to the left of the sink. .1719(a)(5) 907 Written record of up-to-date pet vaccinations as required by NC law and local ordinances, including rabies vaccination for dogs and cats, was not available. Current pet vaccinations were not on file for review. The last pet vaccinations on file were dated 3/16/2023 and expired 3/16/2024 .1719(b)(1) 908 Health questionnaire was not completed annually. Operator MQ health questionnaire was not completed annually. The last completed health questionnaire was dated 2/15/2023. This was updated during the visit. .1703(a)(1) 1853 The operator did not conduct a monthly fire drill. Provider did not conduct a monthly fire drill for January or February 2024. The last documented fire drill was dated 12/18/2023. During the visit a fire drill was conducted at 12:08p. .1719(a)(15) & .1721( e)(2) Technical assistance was provided as follows: Item 705 All medicines, including refrigerated and unrefrigerated, were not kept in locked storage. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (a) The operator of a family child care home (operator) shall provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of children in care, including but not limited to the following: (5) medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container. Designated emergency medications shall be stored out of reach of children at least five feet high, but are not required to be in locked storage. For purposes of this Rule, designated emergency medications are those that are used or needed for the immediate recovery from a life-threatening event and include Glucagon, epinephrine auto-injector, diazepam rectal installation and albuterol; -Six (6) bottles of prescription medications were unlocked in the cabinet above the bottle warmer to the left of the sink. The prescription medications will need to be moved to a locking cabinet or a lock will need to be installed on the cabinet. Item #907 Written record of up-to-date pet vaccinations as required by NC law and local ordinances, including rabies vaccination for dogs and cats was not available. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (b) When animals are on the premises, the following shall apply: (1) all household pets shall be vaccinated with up-to-date vaccinations as required by North Carolina law and local ordinances. Rabies vaccinations are required for cats and dogs; -Current pet vaccinations were not on file for review. The last pet vaccinations on file were dated 3/16/2023 and expired 3/16/2024. The pet vaccinations will need to be updated and a file kept on-site. Item #908 Health questionnaire was not completed annually. 10A NCAC 09 .1703 ON-GOING REQUIREMENTS FOR FAMILY CHILD CARE HOME OPERATORS (a) After receiving a license, family child care home operator shall: (1) Update the health questionnaire annually. The Division may request an evaluation of the operator's emotional and physical fitness to care for children when there is reason to believe that there has been a deterioration in the operator's emotional or physical fitness to care for children. This request may be based upon factors such as observations by the director or center staff, reports of concern from family, reports from law enforcement or reports from medical personnel. The Division may require the operator to obtain written proof that he or she is free of active tuberculosis when the Division determines that the operator was exposed to a person with active tuberculosis; -Operator MQ health questionnaire was not completed annually. The last completed health questionnaire was dated 2/15/2023. I suggest documenting on your calendar as a reminder to update your health questionnaire annually. Item #1853 The operator did not conduct a monthly fire drill. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (a) The operator of a family child care home (operator) shall provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of children in care, including but not limited to the following: (15) conduct a monthly fire drill; - Provider did not conduct a monthly fire drill for January or February 2024. The last documented fire drill was dated 12/18/2023. During the visit a fire drill was conducted at 12:08p. I recommend documenting on a calendar monthly when to conduct a fire drill as a reminder. Corrective Action Plan: Family Child Care Homes are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/1/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation: Today, we discussed the following: - The possibility that you could increase your star license to a three (3) star license. Please submit your education information from your most recent coursework to WORKS. - You could increase your program points by completing the three (3) month self-study with the North Carolina Rated license Assessment Project (NCRLAP). I emailed you Understanding the Self-Study, Five (5) Key Points for NC FCCH Self-Study, and Getting Started information for you to review. You can also view additional information and webinars on the North Carolina Rated license Assessment Project (NCRLAP) website www.ncrlap.org. - If you do not plan on providing transportation and would like to remove it from your license, please submit a letter to request the removal of transportation. - Permission to administer medication forms ensure each parent documents a specific amount (example: pea size, dime size, 1 teaspoon, etc). - Print current training completion certificates to add to your on-going training file. - First Aid and CPR is due by 4/9/2024. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any 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. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Martha Quinones, Operator, during the visit. An electronic signed copy of the visit summary was left on-site to you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, 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: SHEMA Facility ID: 11000877 Consultant: KARLA TERRY Operation Type: Family CC Home Case Number: Visit Date: 10/16/2023 Number Present: 5 Completed Date: 10/16/2023 Age: From 0 To 2 Total Minutes: 165 Time In: 10:00 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Mercedalia Vega, Substitute. Your program currently operates with a One (1) Star Rated License, issued 7/18/2022. The permit restrictions were in compliance including first shift (daytime care), second shift, children in care on ground level only, maximum of five preschool children at any time. This facility provides transportation and offers foreign language. Mercedalia Vega, Substitute, was available to assist with questions. Martha Quinones, Operator arrived at the facility 10:30a and was able to assist with questions. The program’s annual compliance visit was conducted on 3/24/2023. The following items were monitored today: Supervision Capacity CPR / First Aid ITS-SIDS CBC Qualification General Health Administering of Medication Storage of Hazardous Products Storage of Medication General Safety General License Requirements Program Records License Posted Fire Safety Sanitation Today there were five (5) children present and five (5) children enrolled. Three children were observed engaged in play with kitchen set, toy foods and utensils, and books. One (1) infant and one (1) one year old was sleeping in the nap room. The caregiver was supervising the children and checking on the two (2) children sleeping. Ms. Quinones arrived at 10:30a to assist Ms. Vega with the visit. When Ms. Quinones arrived, the children prepared to transition outside with Ms. Vega. Once outside the children engaged in play with trikes, balls, little tikes cottage, and climbers. The caregivers interactions were loving, nurturing and positive and children were happy and engaged in developmentally appropriate activities. Toys were ample in quantity, in good condition and developmentally appropriate for the children in care. The children in care were adjusted to the daily routine, happy and secure with their caregiver. The children bring their meals and snacks from home. Limited staff file monitoring was conducted to review trainings ITS-SIDS, First Aid and CPR, and valid qualification letters. Substitute caregiver Ms. Vegas file was reviewed today. The last fire drill was practiced on 9/18/2023. The last emergency drill, lockdown drill, was practiced on 9/18/2023. The Emergency Medical Care Plan is posted and needs to be updated to reflect the substitute as the alternate person. You stated the following: - You stated you, your husband, and daughter live in the residence. - Criminal Record Checks were found to be current. - CPR and First Aid is current and up to date. - You do not provide transportation. - You do have one (1) dog in the home that is kept inside. - You keep children from going into un-used areas of the home through the use of gates, closed and locked doors. 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 following violations of child care requirements were observed today: Violation Number Comment Rule 706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. Scrubbing Bubble cleaning spray in an aerosol can was located on top of a cabinet in the sleep/nap room. Lysol disinfectant spray in an aerosol can was located on top of the refrigerator. .1719 (a)(7) 1301 Operator did not complete the required number of on-going training hours as specified in rule. Substitute caregiver hired 8/17/2018 did not complete the required fifteen (15) clock hours of on-going training by 8/17/2023. One (1) training certificate for one (1) hours was on file dated March 23, 2023. GS 110-91(11); 10A NCAC 09 .1705(b)(5) 1404 Medication remaining after the course of treatment is completed, after authorization is withdrawn. or after authorization has expired, was not returned to the parent/guardian. Any medication not retrieved by parent/guardian within 72 hours of completion of treatment, or withdrawal of authorization, was not discarded. JW permission to administer medication form expired 6/13/2023 and CW permission to administer medication form expired 10/2/2023. 10A NCAC 09 .1720(c)(5) 1821 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of 30 days. Infant RM was laid down at 10:00a and a sleep checks were not documented until 10:30a. .1724(a)(8)&(f) 1922 Plastic bags, toys, and toy parts small enough to be swallowed, including but not limited to materials that can be easily torn apart such as foam rubber and styrofoam, were accessible to children under the age of three. Two (2) plastic wipe packaging and one (1) ziploc bag was located in a child’s cubby below five (5) feet. The owner/operator corrected this during the visit. .1719(a)(18) Technical assistance was provided as follows: Item #706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (a) The operator of a family child care home (operator) shall provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of children in care, including but not limited to the following: (7) keep all corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product that 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 area when not in use. Locked areas shall include those that 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 in this Paragraph that 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; - Scrubbing Bubble cleaning spray in an aerosol can was located on top of a cabinet in the sleep/nap room. Lysol disinfectant spray in an aerosol can was located on top of the refrigerator. The owner/operator corrected this during the visit. Item #1301 Operator did not complete the required number of on-going training hours as specified in rule. 10A NCAC 09 .1703 ON-GOING REQUIREMENTS FOR FAMILY CHILD CARE HOME OPERATORS (d) After the first year of employment, the family child care home operator, and staff who work with children shall complete on-going training activities as follows: Education and Experience Four-year degree or higher advanced degree in a child care related field of study Required Training 5 clock hours Two-year degree in a child care related field of study Required Training 8 clock hours Certificate or diploma in a child care related field of study or persons with a North Carolina Early Childhood Administration Credential Required Training 10 clock hours 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement Required Training 15 clock hours - Substitute caregiver hired 8/17/2018 did not complete the required fifteen (15) clock hours of on-going training by 8/17/2023. One (1) training certificate for one (1) hours was on file dated March 23, 2023. Item #1404 Medication remaining after the course of treatment is completed, after authorization is withdrawn, or after authorization has expired, was not returned to the parent/guardian. Any medication not retrieved by parent/guardian within 72 hours of completion of treatment, or withdrawal of authorization, was not discarded. 10A NCAC 09 .1720 MEDICATION REQUIREMENTS (b) The following provisions apply to the administration of medication in family child care homes: (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. - JW permission to administer medication form expired 6/13/2023 and CW permission to administer medication form expired 10/2/2023. Item #1821 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of 30 days. 10A NCAC 09 .1724 SAFE SLEEP PRACTICES (a) Each operator licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (8) specifies how the operator shall document compliance with visually checking on sleeping infants aged 12 months or younger; -Infant RM was laid down at 10:00a and a sleep checks were not documented until 10:30a. Item #1922 Plastic bags, toys, and toy parts small enough to be swallowed, including but not limited to materials that can be easily torn apart such as foam rubber and styrofoam, were accessible to children under the age of three. The owner/operator corrected this during the visit. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (a) The operator of a family child care home (operator) shall provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of children in care, including but not limited to the following: (18) not have plastic bags, toys, and toy parts small enough to be swallowed accessible to children under three years of age. This includes materials that can be easily torn apart such as foam rubber and Styrofoam, except that Styrofoam plates may be used for food service and larger pieces of foam rubber may be used for supervised art activities; - Two (2) plastic wipe packaging and one (1) ziploc bag was located in a child’s cubby below five (5) feet. The owner/operator corrected this during the visit. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/30/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation is provided as follows: Today, we discussed the following: - Activity plans need to be current and written down for the caregiver and substitute caregiver to reference. - Substitute providers providing care for more than ten (10) days in a calendar year must complete on-going training hours and health and safety trainings. - Over the counter mediations like diaper cream and sunscreen can only be authorized to be administered for twelve (12) months. - When completing the permission to administer medication forms, ensure that each line is completed, and the specific dosage amount is listed (ex. Dime size, pea size, quarter size) instead of as needed. - Review the safe sleep requirements with your substitute caregivers to ensure they understand that the fifteen (15) minute sleep checks must be documented. - Emergency Medical Care Plan needs to be documented an alternate person in the event of an emergency when the operator is not present. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. 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 karla.terry@dhhs.nc.gov or 828-200-9952, 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: SHEMA Facility ID: 11000877 Consultant: KARLA TERRY Operation Type: Family CC Home Case Number: Visit Date: 10/16/2023 Number Present: 5 Completed Date: 10/16/2023 Age: From 0 To 2 Total Minutes: 165 Time In: 10:00 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Mercedalia Vega, Substitute. Your program currently operates with a One (1) Star Rated License, issued 7/18/2022. The permit restrictions were in compliance including first shift (daytime care), second shift, children in care on ground level only, maximum of five preschool children at any time. This facility provides transportation and offers foreign language. Mercedalia Vega, Substitute, was available to assist with questions. Martha Quinones, Operator arrived at the facility 10:30a and was able to assist with questions. The program’s annual compliance visit was conducted on 3/24/2023. The following items were monitored today: Supervision Capacity CPR / First Aid ITS-SIDS CBC Qualification General Health Administering of Medication Storage of Hazardous Products Storage of Medication General Safety General License Requirements Program Records License Posted Fire Safety Sanitation Today there were five (5) children present and five (5) children enrolled. Three children were observed engaged in play with kitchen set, toy foods and utensils, and books. One (1) infant and one (1) one year old was sleeping in the nap room. The caregiver was supervising the children and checking on the two (2) children sleeping. Ms. Quinones arrived at 10:30a to assist Ms. Vega with the visit. When Ms. Quinones arrived, the children prepared to transition outside with Ms. Vega. Once outside the children engaged in play with trikes, balls, little tikes cottage, and climbers. The caregivers interactions were loving, nurturing and positive and children were happy and engaged in developmentally appropriate activities. Toys were ample in quantity, in good condition and developmentally appropriate for the children in care. The children in care were adjusted to the daily routine, happy and secure with their caregiver. The children bring their meals and snacks from home. Limited staff file monitoring was conducted to review trainings ITS-SIDS, First Aid and CPR, and valid qualification letters. Substitute caregiver Ms. Vegas file was reviewed today. The last fire drill was practiced on 9/18/2023. The last emergency drill, lockdown drill, was practiced on 9/18/2023. The Emergency Medical Care Plan is posted and needs to be updated to reflect the substitute as the alternate person. You stated the following: - You stated you, your husband, and daughter live in the residence. - Criminal Record Checks were found to be current. - CPR and First Aid is current and up to date. - You do not provide transportation. - You do have one (1) dog in the home that is kept inside. - You keep children from going into un-used areas of the home through the use of gates, closed and locked doors. 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 following violations of child care requirements were observed today: Violation Number Comment Rule 706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. Scrubbing Bubble cleaning spray in an aerosol can was located on top of a cabinet in the sleep/nap room. Lysol disinfectant spray in an aerosol can was located on top of the refrigerator. .1719 (a)(7) 1301 Operator did not complete the required number of on-going training hours as specified in rule. Substitute caregiver hired 8/17/2018 did not complete the required fifteen (15) clock hours of on-going training by 8/17/2023. One (1) training certificate for one (1) hours was on file dated March 23, 2023. GS 110-91(11); 10A NCAC 09 .1705(b)(5) 1404 Medication remaining after the course of treatment is completed, after authorization is withdrawn. or after authorization has expired, was not returned to the parent/guardian. Any medication not retrieved by parent/guardian within 72 hours of completion of treatment, or withdrawal of authorization, was not discarded. JW permission to administer medication form expired 6/13/2023 and CW permission to administer medication form expired 10/2/2023. 10A NCAC 09 .1720(c)(5) 1821 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of 30 days. Infant RM was laid down at 10:00a and a sleep checks were not documented until 10:30a. .1724(a)(8)&(f) 1922 Plastic bags, toys, and toy parts small enough to be swallowed, including but not limited to materials that can be easily torn apart such as foam rubber and styrofoam, were accessible to children under the age of three. Two (2) plastic wipe packaging and one (1) ziploc bag was located in a child’s cubby below five (5) feet. The owner/operator corrected this during the visit. .1719(a)(18) Technical assistance was provided as follows: Item #706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (a) The operator of a family child care home (operator) shall provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of children in care, including but not limited to the following: (7) keep all corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product that 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 area when not in use. Locked areas shall include those that 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 in this Paragraph that 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; - Scrubbing Bubble cleaning spray in an aerosol can was located on top of a cabinet in the sleep/nap room. Lysol disinfectant spray in an aerosol can was located on top of the refrigerator. The owner/operator corrected this during the visit. Item #1301 Operator did not complete the required number of on-going training hours as specified in rule. 10A NCAC 09 .1703 ON-GOING REQUIREMENTS FOR FAMILY CHILD CARE HOME OPERATORS (d) After the first year of employment, the family child care home operator, and staff who work with children shall complete on-going training activities as follows: Education and Experience Four-year degree or higher advanced degree in a child care related field of study Required Training 5 clock hours Two-year degree in a child care related field of study Required Training 8 clock hours Certificate or diploma in a child care related field of study or persons with a North Carolina Early Childhood Administration Credential Required Training 10 clock hours 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement Required Training 15 clock hours - Substitute caregiver hired 8/17/2018 did not complete the required fifteen (15) clock hours of on-going training by 8/17/2023. One (1) training certificate for one (1) hours was on file dated March 23, 2023. Item #1404 Medication remaining after the course of treatment is completed, after authorization is withdrawn, or after authorization has expired, was not returned to the parent/guardian. Any medication not retrieved by parent/guardian within 72 hours of completion of treatment, or withdrawal of authorization, was not discarded. 10A NCAC 09 .1720 MEDICATION REQUIREMENTS (b) The following provisions apply to the administration of medication in family child care homes: (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. - JW permission to administer medication form expired 6/13/2023 and CW permission to administer medication form expired 10/2/2023. Item #1821 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of 30 days. 10A NCAC 09 .1724 SAFE SLEEP PRACTICES (a) Each operator licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (8) specifies how the operator shall document compliance with visually checking on sleeping infants aged 12 months or younger; -Infant RM was laid down at 10:00a and a sleep checks were not documented until 10:30a. Item #1922 Plastic bags, toys, and toy parts small enough to be swallowed, including but not limited to materials that can be easily torn apart such as foam rubber and styrofoam, were accessible to children under the age of three. The owner/operator corrected this during the visit. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (a) The operator of a family child care home (operator) shall provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of children in care, including but not limited to the following: (18) not have plastic bags, toys, and toy parts small enough to be swallowed accessible to children under three years of age. This includes materials that can be easily torn apart such as foam rubber and Styrofoam, except that Styrofoam plates may be used for food service and larger pieces of foam rubber may be used for supervised art activities; - Two (2) plastic wipe packaging and one (1) ziploc bag was located in a child’s cubby below five (5) feet. The owner/operator corrected this during the visit. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/30/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation is provided as follows: Today, we discussed the following: - Activity plans need to be current and written down for the caregiver and substitute caregiver to reference. - Substitute providers providing care for more than ten (10) days in a calendar year must complete on-going training hours and health and safety trainings. - Over the counter mediations like diaper cream and sunscreen can only be authorized to be administered for twelve (12) months. - When completing the permission to administer medication forms, ensure that each line is completed, and the specific dosage amount is listed (ex. Dime size, pea size, quarter size) instead of as needed. - Review the safe sleep requirements with your substitute caregivers to ensure they understand that the fifteen (15) minute sleep checks must be documented. - Emergency Medical Care Plan needs to be documented an alternate person in the event of an emergency when the operator is not present. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. 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 karla.terry@dhhs.nc.gov or 828-200-9952, 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 .1705 · Violation

Name of Operation: SHEMA Facility ID: 11000877 Consultant: KARLA TERRY Operation Type: Family CC Home Case Number: Visit Date: 10/16/2023 Number Present: 5 Completed Date: 10/16/2023 Age: From 0 To 2 Total Minutes: 165 Time In: 10:00 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Mercedalia Vega, Substitute. Your program currently operates with a One (1) Star Rated License, issued 7/18/2022. The permit restrictions were in compliance including first shift (daytime care), second shift, children in care on ground level only, maximum of five preschool children at any time. This facility provides transportation and offers foreign language. Mercedalia Vega, Substitute, was available to assist with questions. Martha Quinones, Operator arrived at the facility 10:30a and was able to assist with questions. The program’s annual compliance visit was conducted on 3/24/2023. The following items were monitored today: Supervision Capacity CPR / First Aid ITS-SIDS CBC Qualification General Health Administering of Medication Storage of Hazardous Products Storage of Medication General Safety General License Requirements Program Records License Posted Fire Safety Sanitation Today there were five (5) children present and five (5) children enrolled. Three children were observed engaged in play with kitchen set, toy foods and utensils, and books. One (1) infant and one (1) one year old was sleeping in the nap room. The caregiver was supervising the children and checking on the two (2) children sleeping. Ms. Quinones arrived at 10:30a to assist Ms. Vega with the visit. When Ms. Quinones arrived, the children prepared to transition outside with Ms. Vega. Once outside the children engaged in play with trikes, balls, little tikes cottage, and climbers. The caregivers interactions were loving, nurturing and positive and children were happy and engaged in developmentally appropriate activities. Toys were ample in quantity, in good condition and developmentally appropriate for the children in care. The children in care were adjusted to the daily routine, happy and secure with their caregiver. The children bring their meals and snacks from home. Limited staff file monitoring was conducted to review trainings ITS-SIDS, First Aid and CPR, and valid qualification letters. Substitute caregiver Ms. Vegas file was reviewed today. The last fire drill was practiced on 9/18/2023. The last emergency drill, lockdown drill, was practiced on 9/18/2023. The Emergency Medical Care Plan is posted and needs to be updated to reflect the substitute as the alternate person. You stated the following: - You stated you, your husband, and daughter live in the residence. - Criminal Record Checks were found to be current. - CPR and First Aid is current and up to date. - You do not provide transportation. - You do have one (1) dog in the home that is kept inside. - You keep children from going into un-used areas of the home through the use of gates, closed and locked doors. 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 following violations of child care requirements were observed today: Violation Number Comment Rule 706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. Scrubbing Bubble cleaning spray in an aerosol can was located on top of a cabinet in the sleep/nap room. Lysol disinfectant spray in an aerosol can was located on top of the refrigerator. .1719 (a)(7) 1301 Operator did not complete the required number of on-going training hours as specified in rule. Substitute caregiver hired 8/17/2018 did not complete the required fifteen (15) clock hours of on-going training by 8/17/2023. One (1) training certificate for one (1) hours was on file dated March 23, 2023. GS 110-91(11); 10A NCAC 09 .1705(b)(5) 1404 Medication remaining after the course of treatment is completed, after authorization is withdrawn. or after authorization has expired, was not returned to the parent/guardian. Any medication not retrieved by parent/guardian within 72 hours of completion of treatment, or withdrawal of authorization, was not discarded. JW permission to administer medication form expired 6/13/2023 and CW permission to administer medication form expired 10/2/2023. 10A NCAC 09 .1720(c)(5) 1821 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of 30 days. Infant RM was laid down at 10:00a and a sleep checks were not documented until 10:30a. .1724(a)(8)&(f) 1922 Plastic bags, toys, and toy parts small enough to be swallowed, including but not limited to materials that can be easily torn apart such as foam rubber and styrofoam, were accessible to children under the age of three. Two (2) plastic wipe packaging and one (1) ziploc bag was located in a child’s cubby below five (5) feet. The owner/operator corrected this during the visit. .1719(a)(18) Technical assistance was provided as follows: Item #706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (a) The operator of a family child care home (operator) shall provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of children in care, including but not limited to the following: (7) keep all corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product that 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 area when not in use. Locked areas shall include those that 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 in this Paragraph that 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; - Scrubbing Bubble cleaning spray in an aerosol can was located on top of a cabinet in the sleep/nap room. Lysol disinfectant spray in an aerosol can was located on top of the refrigerator. The owner/operator corrected this during the visit. Item #1301 Operator did not complete the required number of on-going training hours as specified in rule. 10A NCAC 09 .1703 ON-GOING REQUIREMENTS FOR FAMILY CHILD CARE HOME OPERATORS (d) After the first year of employment, the family child care home operator, and staff who work with children shall complete on-going training activities as follows: Education and Experience Four-year degree or higher advanced degree in a child care related field of study Required Training 5 clock hours Two-year degree in a child care related field of study Required Training 8 clock hours Certificate or diploma in a child care related field of study or persons with a North Carolina Early Childhood Administration Credential Required Training 10 clock hours 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement Required Training 15 clock hours - Substitute caregiver hired 8/17/2018 did not complete the required fifteen (15) clock hours of on-going training by 8/17/2023. One (1) training certificate for one (1) hours was on file dated March 23, 2023. Item #1404 Medication remaining after the course of treatment is completed, after authorization is withdrawn, or after authorization has expired, was not returned to the parent/guardian. Any medication not retrieved by parent/guardian within 72 hours of completion of treatment, or withdrawal of authorization, was not discarded. 10A NCAC 09 .1720 MEDICATION REQUIREMENTS (b) The following provisions apply to the administration of medication in family child care homes: (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. - JW permission to administer medication form expired 6/13/2023 and CW permission to administer medication form expired 10/2/2023. Item #1821 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of 30 days. 10A NCAC 09 .1724 SAFE SLEEP PRACTICES (a) Each operator licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (8) specifies how the operator shall document compliance with visually checking on sleeping infants aged 12 months or younger; -Infant RM was laid down at 10:00a and a sleep checks were not documented until 10:30a. Item #1922 Plastic bags, toys, and toy parts small enough to be swallowed, including but not limited to materials that can be easily torn apart such as foam rubber and styrofoam, were accessible to children under the age of three. The owner/operator corrected this during the visit. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (a) The operator of a family child care home (operator) shall provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of children in care, including but not limited to the following: (18) not have plastic bags, toys, and toy parts small enough to be swallowed accessible to children under three years of age. This includes materials that can be easily torn apart such as foam rubber and Styrofoam, except that Styrofoam plates may be used for food service and larger pieces of foam rubber may be used for supervised art activities; - Two (2) plastic wipe packaging and one (1) ziploc bag was located in a child’s cubby below five (5) feet. The owner/operator corrected this during the visit. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/30/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation is provided as follows: Today, we discussed the following: - Activity plans need to be current and written down for the caregiver and substitute caregiver to reference. - Substitute providers providing care for more than ten (10) days in a calendar year must complete on-going training hours and health and safety trainings. - Over the counter mediations like diaper cream and sunscreen can only be authorized to be administered for twelve (12) months. - When completing the permission to administer medication forms, ensure that each line is completed, and the specific dosage amount is listed (ex. Dime size, pea size, quarter size) instead of as needed. - Review the safe sleep requirements with your substitute caregivers to ensure they understand that the fifteen (15) minute sleep checks must be documented. - Emergency Medical Care Plan needs to be documented an alternate person in the event of an emergency when the operator is not present. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. 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 karla.terry@dhhs.nc.gov or 828-200-9952, 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 .1719 · Violation

Name of Operation: SHEMA Facility ID: 11000877 Consultant: KARLA TERRY Operation Type: Family CC Home Case Number: Visit Date: 10/16/2023 Number Present: 5 Completed Date: 10/16/2023 Age: From 0 To 2 Total Minutes: 165 Time In: 10:00 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Mercedalia Vega, Substitute. Your program currently operates with a One (1) Star Rated License, issued 7/18/2022. The permit restrictions were in compliance including first shift (daytime care), second shift, children in care on ground level only, maximum of five preschool children at any time. This facility provides transportation and offers foreign language. Mercedalia Vega, Substitute, was available to assist with questions. Martha Quinones, Operator arrived at the facility 10:30a and was able to assist with questions. The program’s annual compliance visit was conducted on 3/24/2023. The following items were monitored today: Supervision Capacity CPR / First Aid ITS-SIDS CBC Qualification General Health Administering of Medication Storage of Hazardous Products Storage of Medication General Safety General License Requirements Program Records License Posted Fire Safety Sanitation Today there were five (5) children present and five (5) children enrolled. Three children were observed engaged in play with kitchen set, toy foods and utensils, and books. One (1) infant and one (1) one year old was sleeping in the nap room. The caregiver was supervising the children and checking on the two (2) children sleeping. Ms. Quinones arrived at 10:30a to assist Ms. Vega with the visit. When Ms. Quinones arrived, the children prepared to transition outside with Ms. Vega. Once outside the children engaged in play with trikes, balls, little tikes cottage, and climbers. The caregivers interactions were loving, nurturing and positive and children were happy and engaged in developmentally appropriate activities. Toys were ample in quantity, in good condition and developmentally appropriate for the children in care. The children in care were adjusted to the daily routine, happy and secure with their caregiver. The children bring their meals and snacks from home. Limited staff file monitoring was conducted to review trainings ITS-SIDS, First Aid and CPR, and valid qualification letters. Substitute caregiver Ms. Vegas file was reviewed today. The last fire drill was practiced on 9/18/2023. The last emergency drill, lockdown drill, was practiced on 9/18/2023. The Emergency Medical Care Plan is posted and needs to be updated to reflect the substitute as the alternate person. You stated the following: - You stated you, your husband, and daughter live in the residence. - Criminal Record Checks were found to be current. - CPR and First Aid is current and up to date. - You do not provide transportation. - You do have one (1) dog in the home that is kept inside. - You keep children from going into un-used areas of the home through the use of gates, closed and locked doors. 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 following violations of child care requirements were observed today: Violation Number Comment Rule 706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. Scrubbing Bubble cleaning spray in an aerosol can was located on top of a cabinet in the sleep/nap room. Lysol disinfectant spray in an aerosol can was located on top of the refrigerator. .1719 (a)(7) 1301 Operator did not complete the required number of on-going training hours as specified in rule. Substitute caregiver hired 8/17/2018 did not complete the required fifteen (15) clock hours of on-going training by 8/17/2023. One (1) training certificate for one (1) hours was on file dated March 23, 2023. GS 110-91(11); 10A NCAC 09 .1705(b)(5) 1404 Medication remaining after the course of treatment is completed, after authorization is withdrawn. or after authorization has expired, was not returned to the parent/guardian. Any medication not retrieved by parent/guardian within 72 hours of completion of treatment, or withdrawal of authorization, was not discarded. JW permission to administer medication form expired 6/13/2023 and CW permission to administer medication form expired 10/2/2023. 10A NCAC 09 .1720(c)(5) 1821 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of 30 days. Infant RM was laid down at 10:00a and a sleep checks were not documented until 10:30a. .1724(a)(8)&(f) 1922 Plastic bags, toys, and toy parts small enough to be swallowed, including but not limited to materials that can be easily torn apart such as foam rubber and styrofoam, were accessible to children under the age of three. Two (2) plastic wipe packaging and one (1) ziploc bag was located in a child’s cubby below five (5) feet. The owner/operator corrected this during the visit. .1719(a)(18) Technical assistance was provided as follows: Item #706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (a) The operator of a family child care home (operator) shall provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of children in care, including but not limited to the following: (7) keep all corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product that 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 area when not in use. Locked areas shall include those that 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 in this Paragraph that 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; - Scrubbing Bubble cleaning spray in an aerosol can was located on top of a cabinet in the sleep/nap room. Lysol disinfectant spray in an aerosol can was located on top of the refrigerator. The owner/operator corrected this during the visit. Item #1301 Operator did not complete the required number of on-going training hours as specified in rule. 10A NCAC 09 .1703 ON-GOING REQUIREMENTS FOR FAMILY CHILD CARE HOME OPERATORS (d) After the first year of employment, the family child care home operator, and staff who work with children shall complete on-going training activities as follows: Education and Experience Four-year degree or higher advanced degree in a child care related field of study Required Training 5 clock hours Two-year degree in a child care related field of study Required Training 8 clock hours Certificate or diploma in a child care related field of study or persons with a North Carolina Early Childhood Administration Credential Required Training 10 clock hours 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement Required Training 15 clock hours - Substitute caregiver hired 8/17/2018 did not complete the required fifteen (15) clock hours of on-going training by 8/17/2023. One (1) training certificate for one (1) hours was on file dated March 23, 2023. Item #1404 Medication remaining after the course of treatment is completed, after authorization is withdrawn, or after authorization has expired, was not returned to the parent/guardian. Any medication not retrieved by parent/guardian within 72 hours of completion of treatment, or withdrawal of authorization, was not discarded. 10A NCAC 09 .1720 MEDICATION REQUIREMENTS (b) The following provisions apply to the administration of medication in family child care homes: (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. - JW permission to administer medication form expired 6/13/2023 and CW permission to administer medication form expired 10/2/2023. Item #1821 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of 30 days. 10A NCAC 09 .1724 SAFE SLEEP PRACTICES (a) Each operator licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (8) specifies how the operator shall document compliance with visually checking on sleeping infants aged 12 months or younger; -Infant RM was laid down at 10:00a and a sleep checks were not documented until 10:30a. Item #1922 Plastic bags, toys, and toy parts small enough to be swallowed, including but not limited to materials that can be easily torn apart such as foam rubber and styrofoam, were accessible to children under the age of three. The owner/operator corrected this during the visit. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (a) The operator of a family child care home (operator) shall provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of children in care, including but not limited to the following: (18) not have plastic bags, toys, and toy parts small enough to be swallowed accessible to children under three years of age. This includes materials that can be easily torn apart such as foam rubber and Styrofoam, except that Styrofoam plates may be used for food service and larger pieces of foam rubber may be used for supervised art activities; - Two (2) plastic wipe packaging and one (1) ziploc bag was located in a child’s cubby below five (5) feet. The owner/operator corrected this during the visit. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/30/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation is provided as follows: Today, we discussed the following: - Activity plans need to be current and written down for the caregiver and substitute caregiver to reference. - Substitute providers providing care for more than ten (10) days in a calendar year must complete on-going training hours and health and safety trainings. - Over the counter mediations like diaper cream and sunscreen can only be authorized to be administered for twelve (12) months. - When completing the permission to administer medication forms, ensure that each line is completed, and the specific dosage amount is listed (ex. Dime size, pea size, quarter size) instead of as needed. - Review the safe sleep requirements with your substitute caregivers to ensure they understand that the fifteen (15) minute sleep checks must be documented. - Emergency Medical Care Plan needs to be documented an alternate person in the event of an emergency when the operator is not present. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. 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 karla.terry@dhhs.nc.gov or 828-200-9952, 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 .1720 · Violation

Name of Operation: SHEMA Facility ID: 11000877 Consultant: KARLA TERRY Operation Type: Family CC Home Case Number: Visit Date: 10/16/2023 Number Present: 5 Completed Date: 10/16/2023 Age: From 0 To 2 Total Minutes: 165 Time In: 10:00 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Mercedalia Vega, Substitute. Your program currently operates with a One (1) Star Rated License, issued 7/18/2022. The permit restrictions were in compliance including first shift (daytime care), second shift, children in care on ground level only, maximum of five preschool children at any time. This facility provides transportation and offers foreign language. Mercedalia Vega, Substitute, was available to assist with questions. Martha Quinones, Operator arrived at the facility 10:30a and was able to assist with questions. The program’s annual compliance visit was conducted on 3/24/2023. The following items were monitored today: Supervision Capacity CPR / First Aid ITS-SIDS CBC Qualification General Health Administering of Medication Storage of Hazardous Products Storage of Medication General Safety General License Requirements Program Records License Posted Fire Safety Sanitation Today there were five (5) children present and five (5) children enrolled. Three children were observed engaged in play with kitchen set, toy foods and utensils, and books. One (1) infant and one (1) one year old was sleeping in the nap room. The caregiver was supervising the children and checking on the two (2) children sleeping. Ms. Quinones arrived at 10:30a to assist Ms. Vega with the visit. When Ms. Quinones arrived, the children prepared to transition outside with Ms. Vega. Once outside the children engaged in play with trikes, balls, little tikes cottage, and climbers. The caregivers interactions were loving, nurturing and positive and children were happy and engaged in developmentally appropriate activities. Toys were ample in quantity, in good condition and developmentally appropriate for the children in care. The children in care were adjusted to the daily routine, happy and secure with their caregiver. The children bring their meals and snacks from home. Limited staff file monitoring was conducted to review trainings ITS-SIDS, First Aid and CPR, and valid qualification letters. Substitute caregiver Ms. Vegas file was reviewed today. The last fire drill was practiced on 9/18/2023. The last emergency drill, lockdown drill, was practiced on 9/18/2023. The Emergency Medical Care Plan is posted and needs to be updated to reflect the substitute as the alternate person. You stated the following: - You stated you, your husband, and daughter live in the residence. - Criminal Record Checks were found to be current. - CPR and First Aid is current and up to date. - You do not provide transportation. - You do have one (1) dog in the home that is kept inside. - You keep children from going into un-used areas of the home through the use of gates, closed and locked doors. 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 following violations of child care requirements were observed today: Violation Number Comment Rule 706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. Scrubbing Bubble cleaning spray in an aerosol can was located on top of a cabinet in the sleep/nap room. Lysol disinfectant spray in an aerosol can was located on top of the refrigerator. .1719 (a)(7) 1301 Operator did not complete the required number of on-going training hours as specified in rule. Substitute caregiver hired 8/17/2018 did not complete the required fifteen (15) clock hours of on-going training by 8/17/2023. One (1) training certificate for one (1) hours was on file dated March 23, 2023. GS 110-91(11); 10A NCAC 09 .1705(b)(5) 1404 Medication remaining after the course of treatment is completed, after authorization is withdrawn. or after authorization has expired, was not returned to the parent/guardian. Any medication not retrieved by parent/guardian within 72 hours of completion of treatment, or withdrawal of authorization, was not discarded. JW permission to administer medication form expired 6/13/2023 and CW permission to administer medication form expired 10/2/2023. 10A NCAC 09 .1720(c)(5) 1821 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of 30 days. Infant RM was laid down at 10:00a and a sleep checks were not documented until 10:30a. .1724(a)(8)&(f) 1922 Plastic bags, toys, and toy parts small enough to be swallowed, including but not limited to materials that can be easily torn apart such as foam rubber and styrofoam, were accessible to children under the age of three. Two (2) plastic wipe packaging and one (1) ziploc bag was located in a child’s cubby below five (5) feet. The owner/operator corrected this during the visit. .1719(a)(18) Technical assistance was provided as follows: Item #706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (a) The operator of a family child care home (operator) shall provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of children in care, including but not limited to the following: (7) keep all corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product that 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 area when not in use. Locked areas shall include those that 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 in this Paragraph that 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; - Scrubbing Bubble cleaning spray in an aerosol can was located on top of a cabinet in the sleep/nap room. Lysol disinfectant spray in an aerosol can was located on top of the refrigerator. The owner/operator corrected this during the visit. Item #1301 Operator did not complete the required number of on-going training hours as specified in rule. 10A NCAC 09 .1703 ON-GOING REQUIREMENTS FOR FAMILY CHILD CARE HOME OPERATORS (d) After the first year of employment, the family child care home operator, and staff who work with children shall complete on-going training activities as follows: Education and Experience Four-year degree or higher advanced degree in a child care related field of study Required Training 5 clock hours Two-year degree in a child care related field of study Required Training 8 clock hours Certificate or diploma in a child care related field of study or persons with a North Carolina Early Childhood Administration Credential Required Training 10 clock hours 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement Required Training 15 clock hours - Substitute caregiver hired 8/17/2018 did not complete the required fifteen (15) clock hours of on-going training by 8/17/2023. One (1) training certificate for one (1) hours was on file dated March 23, 2023. Item #1404 Medication remaining after the course of treatment is completed, after authorization is withdrawn, or after authorization has expired, was not returned to the parent/guardian. Any medication not retrieved by parent/guardian within 72 hours of completion of treatment, or withdrawal of authorization, was not discarded. 10A NCAC 09 .1720 MEDICATION REQUIREMENTS (b) The following provisions apply to the administration of medication in family child care homes: (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. - JW permission to administer medication form expired 6/13/2023 and CW permission to administer medication form expired 10/2/2023. Item #1821 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of 30 days. 10A NCAC 09 .1724 SAFE SLEEP PRACTICES (a) Each operator licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (8) specifies how the operator shall document compliance with visually checking on sleeping infants aged 12 months or younger; -Infant RM was laid down at 10:00a and a sleep checks were not documented until 10:30a. Item #1922 Plastic bags, toys, and toy parts small enough to be swallowed, including but not limited to materials that can be easily torn apart such as foam rubber and styrofoam, were accessible to children under the age of three. The owner/operator corrected this during the visit. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (a) The operator of a family child care home (operator) shall provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of children in care, including but not limited to the following: (18) not have plastic bags, toys, and toy parts small enough to be swallowed accessible to children under three years of age. This includes materials that can be easily torn apart such as foam rubber and Styrofoam, except that Styrofoam plates may be used for food service and larger pieces of foam rubber may be used for supervised art activities; - Two (2) plastic wipe packaging and one (1) ziploc bag was located in a child’s cubby below five (5) feet. The owner/operator corrected this during the visit. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/30/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation is provided as follows: Today, we discussed the following: - Activity plans need to be current and written down for the caregiver and substitute caregiver to reference. - Substitute providers providing care for more than ten (10) days in a calendar year must complete on-going training hours and health and safety trainings. - Over the counter mediations like diaper cream and sunscreen can only be authorized to be administered for twelve (12) months. - When completing the permission to administer medication forms, ensure that each line is completed, and the specific dosage amount is listed (ex. Dime size, pea size, quarter size) instead of as needed. - Review the safe sleep requirements with your substitute caregivers to ensure they understand that the fifteen (15) minute sleep checks must be documented. - Emergency Medical Care Plan needs to be documented an alternate person in the event of an emergency when the operator is not present. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. 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 karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1724 · Violation

Name of Operation: SHEMA Facility ID: 11000877 Consultant: KARLA TERRY Operation Type: Family CC Home Case Number: Visit Date: 10/16/2023 Number Present: 5 Completed Date: 10/16/2023 Age: From 0 To 2 Total Minutes: 165 Time In: 10:00 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Mercedalia Vega, Substitute. Your program currently operates with a One (1) Star Rated License, issued 7/18/2022. The permit restrictions were in compliance including first shift (daytime care), second shift, children in care on ground level only, maximum of five preschool children at any time. This facility provides transportation and offers foreign language. Mercedalia Vega, Substitute, was available to assist with questions. Martha Quinones, Operator arrived at the facility 10:30a and was able to assist with questions. The program’s annual compliance visit was conducted on 3/24/2023. The following items were monitored today: Supervision Capacity CPR / First Aid ITS-SIDS CBC Qualification General Health Administering of Medication Storage of Hazardous Products Storage of Medication General Safety General License Requirements Program Records License Posted Fire Safety Sanitation Today there were five (5) children present and five (5) children enrolled. Three children were observed engaged in play with kitchen set, toy foods and utensils, and books. One (1) infant and one (1) one year old was sleeping in the nap room. The caregiver was supervising the children and checking on the two (2) children sleeping. Ms. Quinones arrived at 10:30a to assist Ms. Vega with the visit. When Ms. Quinones arrived, the children prepared to transition outside with Ms. Vega. Once outside the children engaged in play with trikes, balls, little tikes cottage, and climbers. The caregivers interactions were loving, nurturing and positive and children were happy and engaged in developmentally appropriate activities. Toys were ample in quantity, in good condition and developmentally appropriate for the children in care. The children in care were adjusted to the daily routine, happy and secure with their caregiver. The children bring their meals and snacks from home. Limited staff file monitoring was conducted to review trainings ITS-SIDS, First Aid and CPR, and valid qualification letters. Substitute caregiver Ms. Vegas file was reviewed today. The last fire drill was practiced on 9/18/2023. The last emergency drill, lockdown drill, was practiced on 9/18/2023. The Emergency Medical Care Plan is posted and needs to be updated to reflect the substitute as the alternate person. You stated the following: - You stated you, your husband, and daughter live in the residence. - Criminal Record Checks were found to be current. - CPR and First Aid is current and up to date. - You do not provide transportation. - You do have one (1) dog in the home that is kept inside. - You keep children from going into un-used areas of the home through the use of gates, closed and locked doors. 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 following violations of child care requirements were observed today: Violation Number Comment Rule 706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. Scrubbing Bubble cleaning spray in an aerosol can was located on top of a cabinet in the sleep/nap room. Lysol disinfectant spray in an aerosol can was located on top of the refrigerator. .1719 (a)(7) 1301 Operator did not complete the required number of on-going training hours as specified in rule. Substitute caregiver hired 8/17/2018 did not complete the required fifteen (15) clock hours of on-going training by 8/17/2023. One (1) training certificate for one (1) hours was on file dated March 23, 2023. GS 110-91(11); 10A NCAC 09 .1705(b)(5) 1404 Medication remaining after the course of treatment is completed, after authorization is withdrawn. or after authorization has expired, was not returned to the parent/guardian. Any medication not retrieved by parent/guardian within 72 hours of completion of treatment, or withdrawal of authorization, was not discarded. JW permission to administer medication form expired 6/13/2023 and CW permission to administer medication form expired 10/2/2023. 10A NCAC 09 .1720(c)(5) 1821 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of 30 days. Infant RM was laid down at 10:00a and a sleep checks were not documented until 10:30a. .1724(a)(8)&(f) 1922 Plastic bags, toys, and toy parts small enough to be swallowed, including but not limited to materials that can be easily torn apart such as foam rubber and styrofoam, were accessible to children under the age of three. Two (2) plastic wipe packaging and one (1) ziploc bag was located in a child’s cubby below five (5) feet. The owner/operator corrected this during the visit. .1719(a)(18) Technical assistance was provided as follows: Item #706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (a) The operator of a family child care home (operator) shall provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of children in care, including but not limited to the following: (7) keep all corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product that 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 area when not in use. Locked areas shall include those that 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 in this Paragraph that 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; - Scrubbing Bubble cleaning spray in an aerosol can was located on top of a cabinet in the sleep/nap room. Lysol disinfectant spray in an aerosol can was located on top of the refrigerator. The owner/operator corrected this during the visit. Item #1301 Operator did not complete the required number of on-going training hours as specified in rule. 10A NCAC 09 .1703 ON-GOING REQUIREMENTS FOR FAMILY CHILD CARE HOME OPERATORS (d) After the first year of employment, the family child care home operator, and staff who work with children shall complete on-going training activities as follows: Education and Experience Four-year degree or higher advanced degree in a child care related field of study Required Training 5 clock hours Two-year degree in a child care related field of study Required Training 8 clock hours Certificate or diploma in a child care related field of study or persons with a North Carolina Early Childhood Administration Credential Required Training 10 clock hours 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement Required Training 15 clock hours - Substitute caregiver hired 8/17/2018 did not complete the required fifteen (15) clock hours of on-going training by 8/17/2023. One (1) training certificate for one (1) hours was on file dated March 23, 2023. Item #1404 Medication remaining after the course of treatment is completed, after authorization is withdrawn, or after authorization has expired, was not returned to the parent/guardian. Any medication not retrieved by parent/guardian within 72 hours of completion of treatment, or withdrawal of authorization, was not discarded. 10A NCAC 09 .1720 MEDICATION REQUIREMENTS (b) The following provisions apply to the administration of medication in family child care homes: (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. - JW permission to administer medication form expired 6/13/2023 and CW permission to administer medication form expired 10/2/2023. Item #1821 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of 30 days. 10A NCAC 09 .1724 SAFE SLEEP PRACTICES (a) Each operator licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (8) specifies how the operator shall document compliance with visually checking on sleeping infants aged 12 months or younger; -Infant RM was laid down at 10:00a and a sleep checks were not documented until 10:30a. Item #1922 Plastic bags, toys, and toy parts small enough to be swallowed, including but not limited to materials that can be easily torn apart such as foam rubber and styrofoam, were accessible to children under the age of three. The owner/operator corrected this during the visit. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (a) The operator of a family child care home (operator) shall provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of children in care, including but not limited to the following: (18) not have plastic bags, toys, and toy parts small enough to be swallowed accessible to children under three years of age. This includes materials that can be easily torn apart such as foam rubber and Styrofoam, except that Styrofoam plates may be used for food service and larger pieces of foam rubber may be used for supervised art activities; - Two (2) plastic wipe packaging and one (1) ziploc bag was located in a child’s cubby below five (5) feet. The owner/operator corrected this during the visit. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/30/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation is provided as follows: Today, we discussed the following: - Activity plans need to be current and written down for the caregiver and substitute caregiver to reference. - Substitute providers providing care for more than ten (10) days in a calendar year must complete on-going training hours and health and safety trainings. - Over the counter mediations like diaper cream and sunscreen can only be authorized to be administered for twelve (12) months. - When completing the permission to administer medication forms, ensure that each line is completed, and the specific dosage amount is listed (ex. Dime size, pea size, quarter size) instead of as needed. - Review the safe sleep requirements with your substitute caregivers to ensure they understand that the fifteen (15) minute sleep checks must be documented. - Emergency Medical Care Plan needs to be documented an alternate person in the event of an emergency when the operator is not present. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. 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 karla.terry@dhhs.nc.gov or 828-200-9952, 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: SHEMA Facility ID: 11000877 Consultant: KARLA TERRY Operation Type: Family CC Home Case Number: Visit Date: 10/16/2023 Number Present: 5 Completed Date: 10/16/2023 Age: From 0 To 2 Total Minutes: 165 Time In: 10:00 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Mercedalia Vega, Substitute. Your program currently operates with a One (1) Star Rated License, issued 7/18/2022. The permit restrictions were in compliance including first shift (daytime care), second shift, children in care on ground level only, maximum of five preschool children at any time. This facility provides transportation and offers foreign language. Mercedalia Vega, Substitute, was available to assist with questions. Martha Quinones, Operator arrived at the facility 10:30a and was able to assist with questions. The program’s annual compliance visit was conducted on 3/24/2023. The following items were monitored today: Supervision Capacity CPR / First Aid ITS-SIDS CBC Qualification General Health Administering of Medication Storage of Hazardous Products Storage of Medication General Safety General License Requirements Program Records License Posted Fire Safety Sanitation Today there were five (5) children present and five (5) children enrolled. Three children were observed engaged in play with kitchen set, toy foods and utensils, and books. One (1) infant and one (1) one year old was sleeping in the nap room. The caregiver was supervising the children and checking on the two (2) children sleeping. Ms. Quinones arrived at 10:30a to assist Ms. Vega with the visit. When Ms. Quinones arrived, the children prepared to transition outside with Ms. Vega. Once outside the children engaged in play with trikes, balls, little tikes cottage, and climbers. The caregivers interactions were loving, nurturing and positive and children were happy and engaged in developmentally appropriate activities. Toys were ample in quantity, in good condition and developmentally appropriate for the children in care. The children in care were adjusted to the daily routine, happy and secure with their caregiver. The children bring their meals and snacks from home. Limited staff file monitoring was conducted to review trainings ITS-SIDS, First Aid and CPR, and valid qualification letters. Substitute caregiver Ms. Vegas file was reviewed today. The last fire drill was practiced on 9/18/2023. The last emergency drill, lockdown drill, was practiced on 9/18/2023. The Emergency Medical Care Plan is posted and needs to be updated to reflect the substitute as the alternate person. You stated the following: - You stated you, your husband, and daughter live in the residence. - Criminal Record Checks were found to be current. - CPR and First Aid is current and up to date. - You do not provide transportation. - You do have one (1) dog in the home that is kept inside. - You keep children from going into un-used areas of the home through the use of gates, closed and locked doors. 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 following violations of child care requirements were observed today: Violation Number Comment Rule 706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. Scrubbing Bubble cleaning spray in an aerosol can was located on top of a cabinet in the sleep/nap room. Lysol disinfectant spray in an aerosol can was located on top of the refrigerator. .1719 (a)(7) 1301 Operator did not complete the required number of on-going training hours as specified in rule. Substitute caregiver hired 8/17/2018 did not complete the required fifteen (15) clock hours of on-going training by 8/17/2023. One (1) training certificate for one (1) hours was on file dated March 23, 2023. GS 110-91(11); 10A NCAC 09 .1705(b)(5) 1404 Medication remaining after the course of treatment is completed, after authorization is withdrawn. or after authorization has expired, was not returned to the parent/guardian. Any medication not retrieved by parent/guardian within 72 hours of completion of treatment, or withdrawal of authorization, was not discarded. JW permission to administer medication form expired 6/13/2023 and CW permission to administer medication form expired 10/2/2023. 10A NCAC 09 .1720(c)(5) 1821 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of 30 days. Infant RM was laid down at 10:00a and a sleep checks were not documented until 10:30a. .1724(a)(8)&(f) 1922 Plastic bags, toys, and toy parts small enough to be swallowed, including but not limited to materials that can be easily torn apart such as foam rubber and styrofoam, were accessible to children under the age of three. Two (2) plastic wipe packaging and one (1) ziploc bag was located in a child’s cubby below five (5) feet. The owner/operator corrected this during the visit. .1719(a)(18) Technical assistance was provided as follows: Item #706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (a) The operator of a family child care home (operator) shall provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of children in care, including but not limited to the following: (7) keep all corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product that 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 area when not in use. Locked areas shall include those that 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 in this Paragraph that 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; - Scrubbing Bubble cleaning spray in an aerosol can was located on top of a cabinet in the sleep/nap room. Lysol disinfectant spray in an aerosol can was located on top of the refrigerator. The owner/operator corrected this during the visit. Item #1301 Operator did not complete the required number of on-going training hours as specified in rule. 10A NCAC 09 .1703 ON-GOING REQUIREMENTS FOR FAMILY CHILD CARE HOME OPERATORS (d) After the first year of employment, the family child care home operator, and staff who work with children shall complete on-going training activities as follows: Education and Experience Four-year degree or higher advanced degree in a child care related field of study Required Training 5 clock hours Two-year degree in a child care related field of study Required Training 8 clock hours Certificate or diploma in a child care related field of study or persons with a North Carolina Early Childhood Administration Credential Required Training 10 clock hours 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement Required Training 15 clock hours - Substitute caregiver hired 8/17/2018 did not complete the required fifteen (15) clock hours of on-going training by 8/17/2023. One (1) training certificate for one (1) hours was on file dated March 23, 2023. Item #1404 Medication remaining after the course of treatment is completed, after authorization is withdrawn, or after authorization has expired, was not returned to the parent/guardian. Any medication not retrieved by parent/guardian within 72 hours of completion of treatment, or withdrawal of authorization, was not discarded. 10A NCAC 09 .1720 MEDICATION REQUIREMENTS (b) The following provisions apply to the administration of medication in family child care homes: (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. - JW permission to administer medication form expired 6/13/2023 and CW permission to administer medication form expired 10/2/2023. Item #1821 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of 30 days. 10A NCAC 09 .1724 SAFE SLEEP PRACTICES (a) Each operator licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (8) specifies how the operator shall document compliance with visually checking on sleeping infants aged 12 months or younger; -Infant RM was laid down at 10:00a and a sleep checks were not documented until 10:30a. Item #1922 Plastic bags, toys, and toy parts small enough to be swallowed, including but not limited to materials that can be easily torn apart such as foam rubber and styrofoam, were accessible to children under the age of three. The owner/operator corrected this during the visit. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (a) The operator of a family child care home (operator) shall provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of children in care, including but not limited to the following: (18) not have plastic bags, toys, and toy parts small enough to be swallowed accessible to children under three years of age. This includes materials that can be easily torn apart such as foam rubber and Styrofoam, except that Styrofoam plates may be used for food service and larger pieces of foam rubber may be used for supervised art activities; - Two (2) plastic wipe packaging and one (1) ziploc bag was located in a child’s cubby below five (5) feet. The owner/operator corrected this during the visit. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/30/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation is provided as follows: Today, we discussed the following: - Activity plans need to be current and written down for the caregiver and substitute caregiver to reference. - Substitute providers providing care for more than ten (10) days in a calendar year must complete on-going training hours and health and safety trainings. - Over the counter mediations like diaper cream and sunscreen can only be authorized to be administered for twelve (12) months. - When completing the permission to administer medication forms, ensure that each line is completed, and the specific dosage amount is listed (ex. Dime size, pea size, quarter size) instead of as needed. - Review the safe sleep requirements with your substitute caregivers to ensure they understand that the fifteen (15) minute sleep checks must be documented. - Emergency Medical Care Plan needs to be documented an alternate person in the event of an emergency when the operator is not present. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. 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 karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-91 · Violation

Name of Operation: SHEMA Facility ID: 11000877 Consultant: KARLA TERRY Operation Type: Family CC Home Case Number: Visit Date: 10/16/2023 Number Present: 5 Completed Date: 10/16/2023 Age: From 0 To 2 Total Minutes: 165 Time In: 10:00 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Mercedalia Vega, Substitute. Your program currently operates with a One (1) Star Rated License, issued 7/18/2022. The permit restrictions were in compliance including first shift (daytime care), second shift, children in care on ground level only, maximum of five preschool children at any time. This facility provides transportation and offers foreign language. Mercedalia Vega, Substitute, was available to assist with questions. Martha Quinones, Operator arrived at the facility 10:30a and was able to assist with questions. The program’s annual compliance visit was conducted on 3/24/2023. The following items were monitored today: Supervision Capacity CPR / First Aid ITS-SIDS CBC Qualification General Health Administering of Medication Storage of Hazardous Products Storage of Medication General Safety General License Requirements Program Records License Posted Fire Safety Sanitation Today there were five (5) children present and five (5) children enrolled. Three children were observed engaged in play with kitchen set, toy foods and utensils, and books. One (1) infant and one (1) one year old was sleeping in the nap room. The caregiver was supervising the children and checking on the two (2) children sleeping. Ms. Quinones arrived at 10:30a to assist Ms. Vega with the visit. When Ms. Quinones arrived, the children prepared to transition outside with Ms. Vega. Once outside the children engaged in play with trikes, balls, little tikes cottage, and climbers. The caregivers interactions were loving, nurturing and positive and children were happy and engaged in developmentally appropriate activities. Toys were ample in quantity, in good condition and developmentally appropriate for the children in care. The children in care were adjusted to the daily routine, happy and secure with their caregiver. The children bring their meals and snacks from home. Limited staff file monitoring was conducted to review trainings ITS-SIDS, First Aid and CPR, and valid qualification letters. Substitute caregiver Ms. Vegas file was reviewed today. The last fire drill was practiced on 9/18/2023. The last emergency drill, lockdown drill, was practiced on 9/18/2023. The Emergency Medical Care Plan is posted and needs to be updated to reflect the substitute as the alternate person. You stated the following: - You stated you, your husband, and daughter live in the residence. - Criminal Record Checks were found to be current. - CPR and First Aid is current and up to date. - You do not provide transportation. - You do have one (1) dog in the home that is kept inside. - You keep children from going into un-used areas of the home through the use of gates, closed and locked doors. 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 following violations of child care requirements were observed today: Violation Number Comment Rule 706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. Scrubbing Bubble cleaning spray in an aerosol can was located on top of a cabinet in the sleep/nap room. Lysol disinfectant spray in an aerosol can was located on top of the refrigerator. .1719 (a)(7) 1301 Operator did not complete the required number of on-going training hours as specified in rule. Substitute caregiver hired 8/17/2018 did not complete the required fifteen (15) clock hours of on-going training by 8/17/2023. One (1) training certificate for one (1) hours was on file dated March 23, 2023. GS 110-91(11); 10A NCAC 09 .1705(b)(5) 1404 Medication remaining after the course of treatment is completed, after authorization is withdrawn. or after authorization has expired, was not returned to the parent/guardian. Any medication not retrieved by parent/guardian within 72 hours of completion of treatment, or withdrawal of authorization, was not discarded. JW permission to administer medication form expired 6/13/2023 and CW permission to administer medication form expired 10/2/2023. 10A NCAC 09 .1720(c)(5) 1821 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of 30 days. Infant RM was laid down at 10:00a and a sleep checks were not documented until 10:30a. .1724(a)(8)&(f) 1922 Plastic bags, toys, and toy parts small enough to be swallowed, including but not limited to materials that can be easily torn apart such as foam rubber and styrofoam, were accessible to children under the age of three. Two (2) plastic wipe packaging and one (1) ziploc bag was located in a child’s cubby below five (5) feet. The owner/operator corrected this during the visit. .1719(a)(18) Technical assistance was provided as follows: Item #706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (a) The operator of a family child care home (operator) shall provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of children in care, including but not limited to the following: (7) keep all corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product that 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 area when not in use. Locked areas shall include those that 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 in this Paragraph that 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; - Scrubbing Bubble cleaning spray in an aerosol can was located on top of a cabinet in the sleep/nap room. Lysol disinfectant spray in an aerosol can was located on top of the refrigerator. The owner/operator corrected this during the visit. Item #1301 Operator did not complete the required number of on-going training hours as specified in rule. 10A NCAC 09 .1703 ON-GOING REQUIREMENTS FOR FAMILY CHILD CARE HOME OPERATORS (d) After the first year of employment, the family child care home operator, and staff who work with children shall complete on-going training activities as follows: Education and Experience Four-year degree or higher advanced degree in a child care related field of study Required Training 5 clock hours Two-year degree in a child care related field of study Required Training 8 clock hours Certificate or diploma in a child care related field of study or persons with a North Carolina Early Childhood Administration Credential Required Training 10 clock hours 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement Required Training 15 clock hours - Substitute caregiver hired 8/17/2018 did not complete the required fifteen (15) clock hours of on-going training by 8/17/2023. One (1) training certificate for one (1) hours was on file dated March 23, 2023. Item #1404 Medication remaining after the course of treatment is completed, after authorization is withdrawn, or after authorization has expired, was not returned to the parent/guardian. Any medication not retrieved by parent/guardian within 72 hours of completion of treatment, or withdrawal of authorization, was not discarded. 10A NCAC 09 .1720 MEDICATION REQUIREMENTS (b) The following provisions apply to the administration of medication in family child care homes: (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. - JW permission to administer medication form expired 6/13/2023 and CW permission to administer medication form expired 10/2/2023. Item #1821 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of 30 days. 10A NCAC 09 .1724 SAFE SLEEP PRACTICES (a) Each operator licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (8) specifies how the operator shall document compliance with visually checking on sleeping infants aged 12 months or younger; -Infant RM was laid down at 10:00a and a sleep checks were not documented until 10:30a. Item #1922 Plastic bags, toys, and toy parts small enough to be swallowed, including but not limited to materials that can be easily torn apart such as foam rubber and styrofoam, were accessible to children under the age of three. The owner/operator corrected this during the visit. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (a) The operator of a family child care home (operator) shall provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of children in care, including but not limited to the following: (18) not have plastic bags, toys, and toy parts small enough to be swallowed accessible to children under three years of age. This includes materials that can be easily torn apart such as foam rubber and Styrofoam, except that Styrofoam plates may be used for food service and larger pieces of foam rubber may be used for supervised art activities; - Two (2) plastic wipe packaging and one (1) ziploc bag was located in a child’s cubby below five (5) feet. The owner/operator corrected this during the visit. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/30/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation is provided as follows: Today, we discussed the following: - Activity plans need to be current and written down for the caregiver and substitute caregiver to reference. - Substitute providers providing care for more than ten (10) days in a calendar year must complete on-going training hours and health and safety trainings. - Over the counter mediations like diaper cream and sunscreen can only be authorized to be administered for twelve (12) months. - When completing the permission to administer medication forms, ensure that each line is completed, and the specific dosage amount is listed (ex. Dime size, pea size, quarter size) instead of as needed. - Review the safe sleep requirements with your substitute caregivers to ensure they understand that the fifteen (15) minute sleep checks must be documented. - Emergency Medical Care Plan needs to be documented an alternate person in the event of an emergency when the operator is not present. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. 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 karla.terry@dhhs.nc.gov or 828-200-9952, 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: SHEMA Facility ID: 11000877 Consultant: KARLA TERRY Operation Type: Family CC Home Case Number: Visit Date: 10/16/2023 Number Present: 5 Completed Date: 10/16/2023 Age: From 0 To 2 Total Minutes: 165 Time In: 10:00 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Mercedalia Vega, Substitute. Your program currently operates with a One (1) Star Rated License, issued 7/18/2022. The permit restrictions were in compliance including first shift (daytime care), second shift, children in care on ground level only, maximum of five preschool children at any time. This facility provides transportation and offers foreign language. Mercedalia Vega, Substitute, was available to assist with questions. Martha Quinones, Operator arrived at the facility 10:30a and was able to assist with questions. The program’s annual compliance visit was conducted on 3/24/2023. The following items were monitored today: Supervision Capacity CPR / First Aid ITS-SIDS CBC Qualification General Health Administering of Medication Storage of Hazardous Products Storage of Medication General Safety General License Requirements Program Records License Posted Fire Safety Sanitation Today there were five (5) children present and five (5) children enrolled. Three children were observed engaged in play with kitchen set, toy foods and utensils, and books. One (1) infant and one (1) one year old was sleeping in the nap room. The caregiver was supervising the children and checking on the two (2) children sleeping. Ms. Quinones arrived at 10:30a to assist Ms. Vega with the visit. When Ms. Quinones arrived, the children prepared to transition outside with Ms. Vega. Once outside the children engaged in play with trikes, balls, little tikes cottage, and climbers. The caregivers interactions were loving, nurturing and positive and children were happy and engaged in developmentally appropriate activities. Toys were ample in quantity, in good condition and developmentally appropriate for the children in care. The children in care were adjusted to the daily routine, happy and secure with their caregiver. The children bring their meals and snacks from home. Limited staff file monitoring was conducted to review trainings ITS-SIDS, First Aid and CPR, and valid qualification letters. Substitute caregiver Ms. Vegas file was reviewed today. The last fire drill was practiced on 9/18/2023. The last emergency drill, lockdown drill, was practiced on 9/18/2023. The Emergency Medical Care Plan is posted and needs to be updated to reflect the substitute as the alternate person. You stated the following: - You stated you, your husband, and daughter live in the residence. - Criminal Record Checks were found to be current. - CPR and First Aid is current and up to date. - You do not provide transportation. - You do have one (1) dog in the home that is kept inside. - You keep children from going into un-used areas of the home through the use of gates, closed and locked doors. 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 following violations of child care requirements were observed today: Violation Number Comment Rule 706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. Scrubbing Bubble cleaning spray in an aerosol can was located on top of a cabinet in the sleep/nap room. Lysol disinfectant spray in an aerosol can was located on top of the refrigerator. .1719 (a)(7) 1301 Operator did not complete the required number of on-going training hours as specified in rule. Substitute caregiver hired 8/17/2018 did not complete the required fifteen (15) clock hours of on-going training by 8/17/2023. One (1) training certificate for one (1) hours was on file dated March 23, 2023. GS 110-91(11); 10A NCAC 09 .1705(b)(5) 1404 Medication remaining after the course of treatment is completed, after authorization is withdrawn. or after authorization has expired, was not returned to the parent/guardian. Any medication not retrieved by parent/guardian within 72 hours of completion of treatment, or withdrawal of authorization, was not discarded. JW permission to administer medication form expired 6/13/2023 and CW permission to administer medication form expired 10/2/2023. 10A NCAC 09 .1720(c)(5) 1821 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of 30 days. Infant RM was laid down at 10:00a and a sleep checks were not documented until 10:30a. .1724(a)(8)&(f) 1922 Plastic bags, toys, and toy parts small enough to be swallowed, including but not limited to materials that can be easily torn apart such as foam rubber and styrofoam, were accessible to children under the age of three. Two (2) plastic wipe packaging and one (1) ziploc bag was located in a child’s cubby below five (5) feet. The owner/operator corrected this during the visit. .1719(a)(18) Technical assistance was provided as follows: Item #706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (a) The operator of a family child care home (operator) shall provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of children in care, including but not limited to the following: (7) keep all corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product that 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 area when not in use. Locked areas shall include those that 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 in this Paragraph that 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; - Scrubbing Bubble cleaning spray in an aerosol can was located on top of a cabinet in the sleep/nap room. Lysol disinfectant spray in an aerosol can was located on top of the refrigerator. The owner/operator corrected this during the visit. Item #1301 Operator did not complete the required number of on-going training hours as specified in rule. 10A NCAC 09 .1703 ON-GOING REQUIREMENTS FOR FAMILY CHILD CARE HOME OPERATORS (d) After the first year of employment, the family child care home operator, and staff who work with children shall complete on-going training activities as follows: Education and Experience Four-year degree or higher advanced degree in a child care related field of study Required Training 5 clock hours Two-year degree in a child care related field of study Required Training 8 clock hours Certificate or diploma in a child care related field of study or persons with a North Carolina Early Childhood Administration Credential Required Training 10 clock hours 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement Required Training 15 clock hours - Substitute caregiver hired 8/17/2018 did not complete the required fifteen (15) clock hours of on-going training by 8/17/2023. One (1) training certificate for one (1) hours was on file dated March 23, 2023. Item #1404 Medication remaining after the course of treatment is completed, after authorization is withdrawn, or after authorization has expired, was not returned to the parent/guardian. Any medication not retrieved by parent/guardian within 72 hours of completion of treatment, or withdrawal of authorization, was not discarded. 10A NCAC 09 .1720 MEDICATION REQUIREMENTS (b) The following provisions apply to the administration of medication in family child care homes: (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. - JW permission to administer medication form expired 6/13/2023 and CW permission to administer medication form expired 10/2/2023. Item #1821 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of 30 days. 10A NCAC 09 .1724 SAFE SLEEP PRACTICES (a) Each operator licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (8) specifies how the operator shall document compliance with visually checking on sleeping infants aged 12 months or younger; -Infant RM was laid down at 10:00a and a sleep checks were not documented until 10:30a. Item #1922 Plastic bags, toys, and toy parts small enough to be swallowed, including but not limited to materials that can be easily torn apart such as foam rubber and styrofoam, were accessible to children under the age of three. The owner/operator corrected this during the visit. 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT (a) The operator of a family child care home (operator) shall provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of children in care, including but not limited to the following: (18) not have plastic bags, toys, and toy parts small enough to be swallowed accessible to children under three years of age. This includes materials that can be easily torn apart such as foam rubber and Styrofoam, except that Styrofoam plates may be used for food service and larger pieces of foam rubber may be used for supervised art activities; - Two (2) plastic wipe packaging and one (1) ziploc bag was located in a child’s cubby below five (5) feet. The owner/operator corrected this during the visit. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/30/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation is provided as follows: Today, we discussed the following: - Activity plans need to be current and written down for the caregiver and substitute caregiver to reference. - Substitute providers providing care for more than ten (10) days in a calendar year must complete on-going training hours and health and safety trainings. - Over the counter mediations like diaper cream and sunscreen can only be authorized to be administered for twelve (12) months. - When completing the permission to administer medication forms, ensure that each line is completed, and the specific dosage amount is listed (ex. Dime size, pea size, quarter size) instead of as needed. - Review the safe sleep requirements with your substitute caregivers to ensure they understand that the fifteen (15) minute sleep checks must be documented. - Emergency Medical Care Plan needs to be documented an alternate person in the event of an emergency when the operator is not present. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. 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 karla.terry@dhhs.nc.gov or 828-200-9952, 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