Ymca Sandhill-Venable Afterschool

10A NCAC 09 .0901 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 5/21/2026 Number Present: 29 Completed Date: 5/21/2026 Age: From 5 To 10 Total Minutes: 152 Time In: 01:48 PM Time Out: 04:20 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Lily Elder, Program Director, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to Delaney Burke, Senior Operations Director. Today, Ms. Elder 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. The North Carolina Secretary of State website was viewed prior to today’s visit and non-profit corporation, The Young Men’s Christian Association of Western North Carolina, Inc., is current/active as of 5/18/26. Permit type – five-star center license issued on 8/13/24. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space. “Playground area does not meet child care playground safety requirements” and “Children prohibited from occupying kitchen space for any reason” will be removed from the restriction. Meeting reduced ratio is required for five-star level for Classroom and Instructional Quality pathway. This information was communicated with Ms. Burke via email. The last annual compliance visit was conducted on 5/29/25. The last fire drill was practiced on 4/30/26. The last lockdown drill was practiced on 3/6/26. The Emergency Medical Care plan was posted and current. The approved curriculum is Funny Daffer. Lead water testing was completed on 6/26/24 without hazards. Lead paint and asbestos testing was completed on 3/27/25. Forty-three (43) staff members were listed on the Automated Criminal Background Check Management System (ABCMS). Upon arrival, I announced my presence and the purpose of the visit. Children started arriving in cafeteria around 2:25 pm. As they arrived, children sat with staff members. When all students arrived, children in group #1 gathered around the entrance to the cafeteria. The group leader directed a few children to use the bathroom and supervised them from cafeteria. Bathrooms are located across hallway from the cafeteria. Due to thunder storm started shortly after children’s arrival, the program changed their schedule to go outside. Children in group #1 and #2 remained in cafeteria while children in group #3 transitioned to the gym. Eight (8) children in group #1 and ten (10) children in group #2 had snacks. Today, WOW butter, sunflower kernels, Jelly packet, WG tortilla, veggie blend juice and milk for served. On the menu, BBQ Jack links, sunflower kernels, WG pizza crackers, apple sauce and veggie blend juice were listed. Later, eleven (11) children had snacks in the cafeteria. For this group, BBQ Jack links, sunflower kernels, WG Pizza cracker, apple sauce veggie blend juice were served. Per Ms. Elder, snacks shipment has been delayed, and children are served with snacks that are available each day. Children in group #3 gathered in the center of the gym and engaged in discussion. Some children assisted Ms. Elder set up the centers in the gym by putting toy bins and rugs. The children played with magnetic tiles, dolls/puppets, pretend animal, pretend pizza store and KEVA structures blocks. In the cafeteria, children in group #1 and #2 transitioned to free play after snacks. Children created art by paper, writing tools and rubber bands, played games and manipulative plays, such as Jenga, Plus Plus, Brittle blocks, peg board, etc. During today’s observation, children’s unsafe behaviors, such as running, flipping, climbing were addressed by each staff member. Ms. Elder and group leaders frequently conversed with children. One (1) emergency medications were maintained in a backpack for group #3. The medication was Ventolin and the permission form and action plan were current. Storage was adequate. The medication log indicated that the medication was last administered on 5/14/26. Current license, first aid poster, menu, schedule/activity plan and current EMC were posted. Due to thunderstorms, playground was not monitored during today’s visit. Staff files: Ms. Burke met with me via TEAMS and reviewed the staff files. One (1) new staff member and one (1) existing staff member’s files were monitored in full. The following discrepancies in dates were noted: Q. Turner: Completion of Health and Safety training- 6/11/25 On-going training hours completed (6/13/25 – 6/12/26) – 15 hours J. Johnston: HQ – 4/2/26 EI – 4/2/26 OP/PP/AQ review – 4/2/26 L. Elder: CPR/First Aid expiration date - 1/22/28. Children’s files: Five (5) children’s files were monitored and were in compliance. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation during summer camp months. No buses were maintained on the premises, and I was unable to monitor them. Vehicle insurance and vehicle registration information and inspection were requested for review. The email was sent to Ms. Burke during today’s visit. The following violations were documented during today’s visit: Violation Number Comment Rule 528 Food substitution was not of comparable food value or recorded on the menu prior to the meal or snack being served. WOW butter, BBQ Jack links, sunflower kernels, WG Pizza crackers, WG tortilla, jelly packet, apple sauce and veggie blend juice and milk were served during today's visit. BBQ Jack links, sunflower kernels, WG pizza crackers, apple sauce and veggie blend juice and milk were listed on the menu. 10A NCAC 09 .0901(b) Technical assistance was provided as follows: 528: Food substitution Food substitution must be documented on the menu prior to serving children. To comply, current menu of today’s snacks must be posted. One (1) of the group leaders posted correct items on the menu during observation. Therefore, this item was corrected during visit. Various types of snacks can be served to children. However, all items served to children must be posted on the menu prior to serving children. Since no other violations were cited, compliance statement is not required. Consultation is provided as follows: New permit: You must post the current permit/license. As soon as you receive new license reflecting current restrictions, please post it on the bulletin board. 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. 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: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 5/21/2026 Number Present: 29 Completed Date: 5/21/2026 Age: From 5 To 10 Total Minutes: 152 Time In: 01:48 PM Time Out: 04:20 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Lily Elder, Program Director, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to Delaney Burke, Senior Operations Director. Today, Ms. Elder 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. The North Carolina Secretary of State website was viewed prior to today’s visit and non-profit corporation, The Young Men’s Christian Association of Western North Carolina, Inc., is current/active as of 5/18/26. Permit type – five-star center license issued on 8/13/24. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space. “Playground area does not meet child care playground safety requirements” and “Children prohibited from occupying kitchen space for any reason” will be removed from the restriction. Meeting reduced ratio is required for five-star level for Classroom and Instructional Quality pathway. This information was communicated with Ms. Burke via email. The last annual compliance visit was conducted on 5/29/25. The last fire drill was practiced on 4/30/26. The last lockdown drill was practiced on 3/6/26. The Emergency Medical Care plan was posted and current. The approved curriculum is Funny Daffer. Lead water testing was completed on 6/26/24 without hazards. Lead paint and asbestos testing was completed on 3/27/25. Forty-three (43) staff members were listed on the Automated Criminal Background Check Management System (ABCMS). Upon arrival, I announced my presence and the purpose of the visit. Children started arriving in cafeteria around 2:25 pm. As they arrived, children sat with staff members. When all students arrived, children in group #1 gathered around the entrance to the cafeteria. The group leader directed a few children to use the bathroom and supervised them from cafeteria. Bathrooms are located across hallway from the cafeteria. Due to thunder storm started shortly after children’s arrival, the program changed their schedule to go outside. Children in group #1 and #2 remained in cafeteria while children in group #3 transitioned to the gym. Eight (8) children in group #1 and ten (10) children in group #2 had snacks. Today, WOW butter, sunflower kernels, Jelly packet, WG tortilla, veggie blend juice and milk for served. On the menu, BBQ Jack links, sunflower kernels, WG pizza crackers, apple sauce and veggie blend juice were listed. Later, eleven (11) children had snacks in the cafeteria. For this group, BBQ Jack links, sunflower kernels, WG Pizza cracker, apple sauce veggie blend juice were served. Per Ms. Elder, snacks shipment has been delayed, and children are served with snacks that are available each day. Children in group #3 gathered in the center of the gym and engaged in discussion. Some children assisted Ms. Elder set up the centers in the gym by putting toy bins and rugs. The children played with magnetic tiles, dolls/puppets, pretend animal, pretend pizza store and KEVA structures blocks. In the cafeteria, children in group #1 and #2 transitioned to free play after snacks. Children created art by paper, writing tools and rubber bands, played games and manipulative plays, such as Jenga, Plus Plus, Brittle blocks, peg board, etc. During today’s observation, children’s unsafe behaviors, such as running, flipping, climbing were addressed by each staff member. Ms. Elder and group leaders frequently conversed with children. One (1) emergency medications were maintained in a backpack for group #3. The medication was Ventolin and the permission form and action plan were current. Storage was adequate. The medication log indicated that the medication was last administered on 5/14/26. Current license, first aid poster, menu, schedule/activity plan and current EMC were posted. Due to thunderstorms, playground was not monitored during today’s visit. Staff files: Ms. Burke met with me via TEAMS and reviewed the staff files. One (1) new staff member and one (1) existing staff member’s files were monitored in full. The following discrepancies in dates were noted: Q. Turner: Completion of Health and Safety training- 6/11/25 On-going training hours completed (6/13/25 – 6/12/26) – 15 hours J. Johnston: HQ – 4/2/26 EI – 4/2/26 OP/PP/AQ review – 4/2/26 L. Elder: CPR/First Aid expiration date - 1/22/28. Children’s files: Five (5) children’s files were monitored and were in compliance. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation during summer camp months. No buses were maintained on the premises, and I was unable to monitor them. Vehicle insurance and vehicle registration information and inspection were requested for review. The email was sent to Ms. Burke during today’s visit. The following violations were documented during today’s visit: Violation Number Comment Rule 528 Food substitution was not of comparable food value or recorded on the menu prior to the meal or snack being served. WOW butter, BBQ Jack links, sunflower kernels, WG Pizza crackers, WG tortilla, jelly packet, apple sauce and veggie blend juice and milk were served during today's visit. BBQ Jack links, sunflower kernels, WG pizza crackers, apple sauce and veggie blend juice and milk were listed on the menu. 10A NCAC 09 .0901(b) Technical assistance was provided as follows: 528: Food substitution Food substitution must be documented on the menu prior to serving children. To comply, current menu of today’s snacks must be posted. One (1) of the group leaders posted correct items on the menu during observation. Therefore, this item was corrected during visit. Various types of snacks can be served to children. However, all items served to children must be posted on the menu prior to serving children. Since no other violations were cited, compliance statement is not required. Consultation is provided as follows: New permit: You must post the current permit/license. As soon as you receive new license reflecting current restrictions, please post it on the bulletin board. 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. 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: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 10/31/2025 Number Present: 34 Completed Date: 10/31/2025 Age: From 5 To 10 Total Minutes: 143 Time In: 01:55 PM Time Out: 04:18 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a routine unannounced visit A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaoru Eddins Child Care Consultant and also signed by Lily Elder, Program Director, during the visit. A signed copy of the visit summary was electronically emailed to you and Delaney Burke, Senior Director of Operations. Today, Ms. Elder was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-three (93) percent as of today prior to this visit. Permit type – Five-star center license issued on 8/13/24. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space. Additional restrictions regarding kitchen space and playground are in the process to being removed. The last annual compliance visit was conducted on 5/29/25. The last fire drill was practiced on 10/24/25. The last lockdown drill was practiced on 9/9/25. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. Due to Buncombe County School being dismissed earlier, the program started earlier in the afternoon. Twelve (12) children from group #2 and nine (9) children from group #1 were combined in cafeteria and engaged in free play. Children played chess, created crafts and built structures with manipulatives. Thirteen (13) children in group #1 played on the playground, then transitioned to the cafeteria. The children played with manipulative toys, such as connectors, Legos, etc. Medications were monitored for this group. Two (2) inhalers were maintained. Amy Deter, Executive Director, met with me on-site to review the staff files. Two (2) new staff files and two (2) existing staff files were monitored. Interaction and supervision were adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ YMCA transportation was monitored in June 2025. The following violations were documented during today’s visit: Violation Number Comment Rule 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A Group Leader who was hired on 9/24/25 did not have medical statement on file. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. A Group Leader who was hired on 9/24/25 did not have TB screening document on file. .0701(a) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). A. Deter's qualification letter expired on 10/26/25. The application for renewal was submitted during the visit. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. M. Weeks' and A. Deter's qualification letters were not maintained their staff files. G.S. 110-90.2(b) & (d) & .2703(e) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. One (1) child's authorization form for his/her inhaler was not signed but typed by his/her parent. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: 1032: medical statement Medical statement must be on file for new staff members on or prior to the first day of employment. If a staff member leaves employment for more than 90 days, he/she is considered new employee. Medical statement is only valid if it was completed within twelve (12) months prior to the new employment date. To comply, M. Weeks needs to complete his/her medical exam. The document shall be maintained in the file. You may access medical statement template at our Division’s website at https://ncchildcare.ncdhhs.gov/Provider/Provider-Documents-and-Forms 1033: TB records All staff members must provide documentation indicating they are free of active TB or TB tests on or prior to first day of work. You may use the form provided by the Division. If you answer yes to any of the questionnaires, a follow-up skin test is required. https://ncchildcare.ncdhhs.gov/Provider/Provider-Documents-and-Forms To comply, M. Week shall complete TB screening and verify that he/she is free of active TB. To comply, he/she must submit the screening result completed by a medical professional, such as physician’s office or a health department. 1044: Criminal background letter renewal Criminal background check must be completed prior to first day of employment. Additionally, the qualification letter must be renewed prior to its expiration date. A. Deter must renew the criminal background check immediately. You have up to fifteen (15) days to apply for the criminal background check, complete fingerprinting, receiving the letter and maintaining a copy on file. If you do not complete this process by November 15, 2025, you may not be on-site at any of your licensed child care facilities. 1757: maintaining CBC letters Criminal background qualification letter must be maintained in each staff file and available for review. M. Week must submit a copy of his/her qualification letter to employer and maintain the copy in his/her personal file. A. Deter must renew the qualification letter and submit a copy to the employer on or prior to November 15, 2025. 1882: Medication authorization form The following information is required for parental authorization for medications: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. The medication is an inhaler for M.D. A typed name is not considered a signature. To comply, please have the child’s parent sign the document. The medication shall not be administered until the signature is obtained. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 11/14/25. 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: I have a virtual technical assistant meeting via TEAMS to discuss the Rated License Assessment with Ms. Burke on November 14, 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. 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 .0701 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 10/31/2025 Number Present: 34 Completed Date: 10/31/2025 Age: From 5 To 10 Total Minutes: 143 Time In: 01:55 PM Time Out: 04:18 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a routine unannounced visit A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaoru Eddins Child Care Consultant and also signed by Lily Elder, Program Director, during the visit. A signed copy of the visit summary was electronically emailed to you and Delaney Burke, Senior Director of Operations. Today, Ms. Elder was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-three (93) percent as of today prior to this visit. Permit type – Five-star center license issued on 8/13/24. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space. Additional restrictions regarding kitchen space and playground are in the process to being removed. The last annual compliance visit was conducted on 5/29/25. The last fire drill was practiced on 10/24/25. The last lockdown drill was practiced on 9/9/25. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. Due to Buncombe County School being dismissed earlier, the program started earlier in the afternoon. Twelve (12) children from group #2 and nine (9) children from group #1 were combined in cafeteria and engaged in free play. Children played chess, created crafts and built structures with manipulatives. Thirteen (13) children in group #1 played on the playground, then transitioned to the cafeteria. The children played with manipulative toys, such as connectors, Legos, etc. Medications were monitored for this group. Two (2) inhalers were maintained. Amy Deter, Executive Director, met with me on-site to review the staff files. Two (2) new staff files and two (2) existing staff files were monitored. Interaction and supervision were adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ YMCA transportation was monitored in June 2025. The following violations were documented during today’s visit: Violation Number Comment Rule 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A Group Leader who was hired on 9/24/25 did not have medical statement on file. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. A Group Leader who was hired on 9/24/25 did not have TB screening document on file. .0701(a) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). A. Deter's qualification letter expired on 10/26/25. The application for renewal was submitted during the visit. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. M. Weeks' and A. Deter's qualification letters were not maintained their staff files. G.S. 110-90.2(b) & (d) & .2703(e) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. One (1) child's authorization form for his/her inhaler was not signed but typed by his/her parent. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: 1032: medical statement Medical statement must be on file for new staff members on or prior to the first day of employment. If a staff member leaves employment for more than 90 days, he/she is considered new employee. Medical statement is only valid if it was completed within twelve (12) months prior to the new employment date. To comply, M. Weeks needs to complete his/her medical exam. The document shall be maintained in the file. You may access medical statement template at our Division’s website at https://ncchildcare.ncdhhs.gov/Provider/Provider-Documents-and-Forms 1033: TB records All staff members must provide documentation indicating they are free of active TB or TB tests on or prior to first day of work. You may use the form provided by the Division. If you answer yes to any of the questionnaires, a follow-up skin test is required. https://ncchildcare.ncdhhs.gov/Provider/Provider-Documents-and-Forms To comply, M. Week shall complete TB screening and verify that he/she is free of active TB. To comply, he/she must submit the screening result completed by a medical professional, such as physician’s office or a health department. 1044: Criminal background letter renewal Criminal background check must be completed prior to first day of employment. Additionally, the qualification letter must be renewed prior to its expiration date. A. Deter must renew the criminal background check immediately. You have up to fifteen (15) days to apply for the criminal background check, complete fingerprinting, receiving the letter and maintaining a copy on file. If you do not complete this process by November 15, 2025, you may not be on-site at any of your licensed child care facilities. 1757: maintaining CBC letters Criminal background qualification letter must be maintained in each staff file and available for review. M. Week must submit a copy of his/her qualification letter to employer and maintain the copy in his/her personal file. A. Deter must renew the qualification letter and submit a copy to the employer on or prior to November 15, 2025. 1882: Medication authorization form The following information is required for parental authorization for medications: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. The medication is an inhaler for M.D. A typed name is not considered a signature. To comply, please have the child’s parent sign the document. The medication shall not be administered until the signature is obtained. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 11/14/25. 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: I have a virtual technical assistant meeting via TEAMS to discuss the Rated License Assessment with Ms. Burke on November 14, 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. 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: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 10/31/2025 Number Present: 34 Completed Date: 10/31/2025 Age: From 5 To 10 Total Minutes: 143 Time In: 01:55 PM Time Out: 04:18 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a routine unannounced visit A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaoru Eddins Child Care Consultant and also signed by Lily Elder, Program Director, during the visit. A signed copy of the visit summary was electronically emailed to you and Delaney Burke, Senior Director of Operations. Today, Ms. Elder was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-three (93) percent as of today prior to this visit. Permit type – Five-star center license issued on 8/13/24. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space. Additional restrictions regarding kitchen space and playground are in the process to being removed. The last annual compliance visit was conducted on 5/29/25. The last fire drill was practiced on 10/24/25. The last lockdown drill was practiced on 9/9/25. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. Due to Buncombe County School being dismissed earlier, the program started earlier in the afternoon. Twelve (12) children from group #2 and nine (9) children from group #1 were combined in cafeteria and engaged in free play. Children played chess, created crafts and built structures with manipulatives. Thirteen (13) children in group #1 played on the playground, then transitioned to the cafeteria. The children played with manipulative toys, such as connectors, Legos, etc. Medications were monitored for this group. Two (2) inhalers were maintained. Amy Deter, Executive Director, met with me on-site to review the staff files. Two (2) new staff files and two (2) existing staff files were monitored. Interaction and supervision were adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ YMCA transportation was monitored in June 2025. The following violations were documented during today’s visit: Violation Number Comment Rule 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A Group Leader who was hired on 9/24/25 did not have medical statement on file. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. A Group Leader who was hired on 9/24/25 did not have TB screening document on file. .0701(a) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). A. Deter's qualification letter expired on 10/26/25. The application for renewal was submitted during the visit. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. M. Weeks' and A. Deter's qualification letters were not maintained their staff files. G.S. 110-90.2(b) & (d) & .2703(e) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. One (1) child's authorization form for his/her inhaler was not signed but typed by his/her parent. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: 1032: medical statement Medical statement must be on file for new staff members on or prior to the first day of employment. If a staff member leaves employment for more than 90 days, he/she is considered new employee. Medical statement is only valid if it was completed within twelve (12) months prior to the new employment date. To comply, M. Weeks needs to complete his/her medical exam. The document shall be maintained in the file. You may access medical statement template at our Division’s website at https://ncchildcare.ncdhhs.gov/Provider/Provider-Documents-and-Forms 1033: TB records All staff members must provide documentation indicating they are free of active TB or TB tests on or prior to first day of work. You may use the form provided by the Division. If you answer yes to any of the questionnaires, a follow-up skin test is required. https://ncchildcare.ncdhhs.gov/Provider/Provider-Documents-and-Forms To comply, M. Week shall complete TB screening and verify that he/she is free of active TB. To comply, he/she must submit the screening result completed by a medical professional, such as physician’s office or a health department. 1044: Criminal background letter renewal Criminal background check must be completed prior to first day of employment. Additionally, the qualification letter must be renewed prior to its expiration date. A. Deter must renew the criminal background check immediately. You have up to fifteen (15) days to apply for the criminal background check, complete fingerprinting, receiving the letter and maintaining a copy on file. If you do not complete this process by November 15, 2025, you may not be on-site at any of your licensed child care facilities. 1757: maintaining CBC letters Criminal background qualification letter must be maintained in each staff file and available for review. M. Week must submit a copy of his/her qualification letter to employer and maintain the copy in his/her personal file. A. Deter must renew the qualification letter and submit a copy to the employer on or prior to November 15, 2025. 1882: Medication authorization form The following information is required for parental authorization for medications: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. The medication is an inhaler for M.D. A typed name is not considered a signature. To comply, please have the child’s parent sign the document. The medication shall not be administered until the signature is obtained. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 11/14/25. 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: I have a virtual technical assistant meeting via TEAMS to discuss the Rated License Assessment with Ms. Burke on November 14, 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. 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: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 10/31/2025 Number Present: 34 Completed Date: 10/31/2025 Age: From 5 To 10 Total Minutes: 143 Time In: 01:55 PM Time Out: 04:18 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a routine unannounced visit A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaoru Eddins Child Care Consultant and also signed by Lily Elder, Program Director, during the visit. A signed copy of the visit summary was electronically emailed to you and Delaney Burke, Senior Director of Operations. Today, Ms. Elder was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-three (93) percent as of today prior to this visit. Permit type – Five-star center license issued on 8/13/24. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space. Additional restrictions regarding kitchen space and playground are in the process to being removed. The last annual compliance visit was conducted on 5/29/25. The last fire drill was practiced on 10/24/25. The last lockdown drill was practiced on 9/9/25. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. Due to Buncombe County School being dismissed earlier, the program started earlier in the afternoon. Twelve (12) children from group #2 and nine (9) children from group #1 were combined in cafeteria and engaged in free play. Children played chess, created crafts and built structures with manipulatives. Thirteen (13) children in group #1 played on the playground, then transitioned to the cafeteria. The children played with manipulative toys, such as connectors, Legos, etc. Medications were monitored for this group. Two (2) inhalers were maintained. Amy Deter, Executive Director, met with me on-site to review the staff files. Two (2) new staff files and two (2) existing staff files were monitored. Interaction and supervision were adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ YMCA transportation was monitored in June 2025. The following violations were documented during today’s visit: Violation Number Comment Rule 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A Group Leader who was hired on 9/24/25 did not have medical statement on file. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. A Group Leader who was hired on 9/24/25 did not have TB screening document on file. .0701(a) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). A. Deter's qualification letter expired on 10/26/25. The application for renewal was submitted during the visit. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. M. Weeks' and A. Deter's qualification letters were not maintained their staff files. G.S. 110-90.2(b) & (d) & .2703(e) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. One (1) child's authorization form for his/her inhaler was not signed but typed by his/her parent. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: 1032: medical statement Medical statement must be on file for new staff members on or prior to the first day of employment. If a staff member leaves employment for more than 90 days, he/she is considered new employee. Medical statement is only valid if it was completed within twelve (12) months prior to the new employment date. To comply, M. Weeks needs to complete his/her medical exam. The document shall be maintained in the file. You may access medical statement template at our Division’s website at https://ncchildcare.ncdhhs.gov/Provider/Provider-Documents-and-Forms 1033: TB records All staff members must provide documentation indicating they are free of active TB or TB tests on or prior to first day of work. You may use the form provided by the Division. If you answer yes to any of the questionnaires, a follow-up skin test is required. https://ncchildcare.ncdhhs.gov/Provider/Provider-Documents-and-Forms To comply, M. Week shall complete TB screening and verify that he/she is free of active TB. To comply, he/she must submit the screening result completed by a medical professional, such as physician’s office or a health department. 1044: Criminal background letter renewal Criminal background check must be completed prior to first day of employment. Additionally, the qualification letter must be renewed prior to its expiration date. A. Deter must renew the criminal background check immediately. You have up to fifteen (15) days to apply for the criminal background check, complete fingerprinting, receiving the letter and maintaining a copy on file. If you do not complete this process by November 15, 2025, you may not be on-site at any of your licensed child care facilities. 1757: maintaining CBC letters Criminal background qualification letter must be maintained in each staff file and available for review. M. Week must submit a copy of his/her qualification letter to employer and maintain the copy in his/her personal file. A. Deter must renew the qualification letter and submit a copy to the employer on or prior to November 15, 2025. 1882: Medication authorization form The following information is required for parental authorization for medications: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. The medication is an inhaler for M.D. A typed name is not considered a signature. To comply, please have the child’s parent sign the document. The medication shall not be administered until the signature is obtained. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 11/14/25. 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: I have a virtual technical assistant meeting via TEAMS to discuss the Rated License Assessment with Ms. Burke on November 14, 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. 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: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 10/31/2025 Number Present: 34 Completed Date: 10/31/2025 Age: From 5 To 10 Total Minutes: 143 Time In: 01:55 PM Time Out: 04:18 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a routine unannounced visit A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaoru Eddins Child Care Consultant and also signed by Lily Elder, Program Director, during the visit. A signed copy of the visit summary was electronically emailed to you and Delaney Burke, Senior Director of Operations. Today, Ms. Elder was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-three (93) percent as of today prior to this visit. Permit type – Five-star center license issued on 8/13/24. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space. Additional restrictions regarding kitchen space and playground are in the process to being removed. The last annual compliance visit was conducted on 5/29/25. The last fire drill was practiced on 10/24/25. The last lockdown drill was practiced on 9/9/25. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. Due to Buncombe County School being dismissed earlier, the program started earlier in the afternoon. Twelve (12) children from group #2 and nine (9) children from group #1 were combined in cafeteria and engaged in free play. Children played chess, created crafts and built structures with manipulatives. Thirteen (13) children in group #1 played on the playground, then transitioned to the cafeteria. The children played with manipulative toys, such as connectors, Legos, etc. Medications were monitored for this group. Two (2) inhalers were maintained. Amy Deter, Executive Director, met with me on-site to review the staff files. Two (2) new staff files and two (2) existing staff files were monitored. Interaction and supervision were adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ YMCA transportation was monitored in June 2025. The following violations were documented during today’s visit: Violation Number Comment Rule 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A Group Leader who was hired on 9/24/25 did not have medical statement on file. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. A Group Leader who was hired on 9/24/25 did not have TB screening document on file. .0701(a) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). A. Deter's qualification letter expired on 10/26/25. The application for renewal was submitted during the visit. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. M. Weeks' and A. Deter's qualification letters were not maintained their staff files. G.S. 110-90.2(b) & (d) & .2703(e) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. One (1) child's authorization form for his/her inhaler was not signed but typed by his/her parent. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: 1032: medical statement Medical statement must be on file for new staff members on or prior to the first day of employment. If a staff member leaves employment for more than 90 days, he/she is considered new employee. Medical statement is only valid if it was completed within twelve (12) months prior to the new employment date. To comply, M. Weeks needs to complete his/her medical exam. The document shall be maintained in the file. You may access medical statement template at our Division’s website at https://ncchildcare.ncdhhs.gov/Provider/Provider-Documents-and-Forms 1033: TB records All staff members must provide documentation indicating they are free of active TB or TB tests on or prior to first day of work. You may use the form provided by the Division. If you answer yes to any of the questionnaires, a follow-up skin test is required. https://ncchildcare.ncdhhs.gov/Provider/Provider-Documents-and-Forms To comply, M. Week shall complete TB screening and verify that he/she is free of active TB. To comply, he/she must submit the screening result completed by a medical professional, such as physician’s office or a health department. 1044: Criminal background letter renewal Criminal background check must be completed prior to first day of employment. Additionally, the qualification letter must be renewed prior to its expiration date. A. Deter must renew the criminal background check immediately. You have up to fifteen (15) days to apply for the criminal background check, complete fingerprinting, receiving the letter and maintaining a copy on file. If you do not complete this process by November 15, 2025, you may not be on-site at any of your licensed child care facilities. 1757: maintaining CBC letters Criminal background qualification letter must be maintained in each staff file and available for review. M. Week must submit a copy of his/her qualification letter to employer and maintain the copy in his/her personal file. A. Deter must renew the qualification letter and submit a copy to the employer on or prior to November 15, 2025. 1882: Medication authorization form The following information is required for parental authorization for medications: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. The medication is an inhaler for M.D. A typed name is not considered a signature. To comply, please have the child’s parent sign the document. The medication shall not be administered until the signature is obtained. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 11/14/25. 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: I have a virtual technical assistant meeting via TEAMS to discuss the Rated License Assessment with Ms. Burke on November 14, 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. 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

G.S. 110-90 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 10/31/2025 Number Present: 34 Completed Date: 10/31/2025 Age: From 5 To 10 Total Minutes: 143 Time In: 01:55 PM Time Out: 04:18 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a routine unannounced visit A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaoru Eddins Child Care Consultant and also signed by Lily Elder, Program Director, during the visit. A signed copy of the visit summary was electronically emailed to you and Delaney Burke, Senior Director of Operations. Today, Ms. Elder was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-three (93) percent as of today prior to this visit. Permit type – Five-star center license issued on 8/13/24. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space. Additional restrictions regarding kitchen space and playground are in the process to being removed. The last annual compliance visit was conducted on 5/29/25. The last fire drill was practiced on 10/24/25. The last lockdown drill was practiced on 9/9/25. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. Due to Buncombe County School being dismissed earlier, the program started earlier in the afternoon. Twelve (12) children from group #2 and nine (9) children from group #1 were combined in cafeteria and engaged in free play. Children played chess, created crafts and built structures with manipulatives. Thirteen (13) children in group #1 played on the playground, then transitioned to the cafeteria. The children played with manipulative toys, such as connectors, Legos, etc. Medications were monitored for this group. Two (2) inhalers were maintained. Amy Deter, Executive Director, met with me on-site to review the staff files. Two (2) new staff files and two (2) existing staff files were monitored. Interaction and supervision were adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ YMCA transportation was monitored in June 2025. The following violations were documented during today’s visit: Violation Number Comment Rule 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A Group Leader who was hired on 9/24/25 did not have medical statement on file. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. A Group Leader who was hired on 9/24/25 did not have TB screening document on file. .0701(a) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). A. Deter's qualification letter expired on 10/26/25. The application for renewal was submitted during the visit. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. M. Weeks' and A. Deter's qualification letters were not maintained their staff files. G.S. 110-90.2(b) & (d) & .2703(e) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. One (1) child's authorization form for his/her inhaler was not signed but typed by his/her parent. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: 1032: medical statement Medical statement must be on file for new staff members on or prior to the first day of employment. If a staff member leaves employment for more than 90 days, he/she is considered new employee. Medical statement is only valid if it was completed within twelve (12) months prior to the new employment date. To comply, M. Weeks needs to complete his/her medical exam. The document shall be maintained in the file. You may access medical statement template at our Division’s website at https://ncchildcare.ncdhhs.gov/Provider/Provider-Documents-and-Forms 1033: TB records All staff members must provide documentation indicating they are free of active TB or TB tests on or prior to first day of work. You may use the form provided by the Division. If you answer yes to any of the questionnaires, a follow-up skin test is required. https://ncchildcare.ncdhhs.gov/Provider/Provider-Documents-and-Forms To comply, M. Week shall complete TB screening and verify that he/she is free of active TB. To comply, he/she must submit the screening result completed by a medical professional, such as physician’s office or a health department. 1044: Criminal background letter renewal Criminal background check must be completed prior to first day of employment. Additionally, the qualification letter must be renewed prior to its expiration date. A. Deter must renew the criminal background check immediately. You have up to fifteen (15) days to apply for the criminal background check, complete fingerprinting, receiving the letter and maintaining a copy on file. If you do not complete this process by November 15, 2025, you may not be on-site at any of your licensed child care facilities. 1757: maintaining CBC letters Criminal background qualification letter must be maintained in each staff file and available for review. M. Week must submit a copy of his/her qualification letter to employer and maintain the copy in his/her personal file. A. Deter must renew the qualification letter and submit a copy to the employer on or prior to November 15, 2025. 1882: Medication authorization form The following information is required for parental authorization for medications: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. The medication is an inhaler for M.D. A typed name is not considered a signature. To comply, please have the child’s parent sign the document. The medication shall not be administered until the signature is obtained. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 11/14/25. 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: I have a virtual technical assistant meeting via TEAMS to discuss the Rated License Assessment with Ms. Burke on November 14, 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. 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: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 10/31/2025 Number Present: 34 Completed Date: 10/31/2025 Age: From 5 To 10 Total Minutes: 143 Time In: 01:55 PM Time Out: 04:18 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a routine unannounced visit A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaoru Eddins Child Care Consultant and also signed by Lily Elder, Program Director, during the visit. A signed copy of the visit summary was electronically emailed to you and Delaney Burke, Senior Director of Operations. Today, Ms. Elder was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-three (93) percent as of today prior to this visit. Permit type – Five-star center license issued on 8/13/24. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space. Additional restrictions regarding kitchen space and playground are in the process to being removed. The last annual compliance visit was conducted on 5/29/25. The last fire drill was practiced on 10/24/25. The last lockdown drill was practiced on 9/9/25. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. Due to Buncombe County School being dismissed earlier, the program started earlier in the afternoon. Twelve (12) children from group #2 and nine (9) children from group #1 were combined in cafeteria and engaged in free play. Children played chess, created crafts and built structures with manipulatives. Thirteen (13) children in group #1 played on the playground, then transitioned to the cafeteria. The children played with manipulative toys, such as connectors, Legos, etc. Medications were monitored for this group. Two (2) inhalers were maintained. Amy Deter, Executive Director, met with me on-site to review the staff files. Two (2) new staff files and two (2) existing staff files were monitored. Interaction and supervision were adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ YMCA transportation was monitored in June 2025. The following violations were documented during today’s visit: Violation Number Comment Rule 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A Group Leader who was hired on 9/24/25 did not have medical statement on file. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. A Group Leader who was hired on 9/24/25 did not have TB screening document on file. .0701(a) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). A. Deter's qualification letter expired on 10/26/25. The application for renewal was submitted during the visit. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. M. Weeks' and A. Deter's qualification letters were not maintained their staff files. G.S. 110-90.2(b) & (d) & .2703(e) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. One (1) child's authorization form for his/her inhaler was not signed but typed by his/her parent. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: 1032: medical statement Medical statement must be on file for new staff members on or prior to the first day of employment. If a staff member leaves employment for more than 90 days, he/she is considered new employee. Medical statement is only valid if it was completed within twelve (12) months prior to the new employment date. To comply, M. Weeks needs to complete his/her medical exam. The document shall be maintained in the file. You may access medical statement template at our Division’s website at https://ncchildcare.ncdhhs.gov/Provider/Provider-Documents-and-Forms 1033: TB records All staff members must provide documentation indicating they are free of active TB or TB tests on or prior to first day of work. You may use the form provided by the Division. If you answer yes to any of the questionnaires, a follow-up skin test is required. https://ncchildcare.ncdhhs.gov/Provider/Provider-Documents-and-Forms To comply, M. Week shall complete TB screening and verify that he/she is free of active TB. To comply, he/she must submit the screening result completed by a medical professional, such as physician’s office or a health department. 1044: Criminal background letter renewal Criminal background check must be completed prior to first day of employment. Additionally, the qualification letter must be renewed prior to its expiration date. A. Deter must renew the criminal background check immediately. You have up to fifteen (15) days to apply for the criminal background check, complete fingerprinting, receiving the letter and maintaining a copy on file. If you do not complete this process by November 15, 2025, you may not be on-site at any of your licensed child care facilities. 1757: maintaining CBC letters Criminal background qualification letter must be maintained in each staff file and available for review. M. Week must submit a copy of his/her qualification letter to employer and maintain the copy in his/her personal file. A. Deter must renew the qualification letter and submit a copy to the employer on or prior to November 15, 2025. 1882: Medication authorization form The following information is required for parental authorization for medications: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. The medication is an inhaler for M.D. A typed name is not considered a signature. To comply, please have the child’s parent sign the document. The medication shall not be administered until the signature is obtained. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 11/14/25. 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: I have a virtual technical assistant meeting via TEAMS to discuss the Rated License Assessment with Ms. Burke on November 14, 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. 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: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 5/29/2025 Number Present: 47 Completed Date: 5/29/2025 Age: From 5 To 10 Total Minutes: 175 Time In: 02:05 PM Time Out: 05:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Lily Elder, Program Director, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to Delaney Burke, Senior Director of Operations. Ms. Elder assisted me today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-five (95) percent today prior to this visit. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, The Young Men’s Christian Association of Western North Carolina, is current/active as of 5/27/25. Permit type – five-star center license issued on 8/13/25. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space, playground area does not meet child care playground safety requirements, children prohibited from occupying kitchen space for any reason. The last annual compliance visit was conducted on 8/14/25. The last fire drill was practiced on 4/29/25. The last lockdown drill was logged on the emergency drill log on 1/30/25. However, the program also has an electronic log. According to the electronic log, a lockdown drill was conducted on 4/22/25. The last fire inspection was approved on 2/11/25. In regard to the last sanitation inspection, there is some confusing information. A poster upon completion of sanitation inspection was posted on the bulletin board on-site. Per poster, the date of the last inspection was completed on 3/19/2025. The sanitation inspection form was also posted on the bulletin board. However, the date of the inspection was created on 10/24/24 with zero (0) demerits though no classification was checked for this visit. On the Accela website for Buncombe County Sanitation records, the most recent inspection posted was 9/12/24 with six (6) demerits with a superior classification. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 6/26/24 without hazards. Lead paint and asbestos testing was completed on 3/27/25 and exempt. Upon arrival, I announced my presence and the purpose of the visit. All the children arrived in the lobby between the cafeteria and the gym, took turns and washed their hands in the bathroom. The children in group #1 had snacks in the cafeteria, followed by the children in group #3. Today, the children had BBQ Jack links, WG Chilli Lime crackers, sunflower kernels, apple sauce, veggie blend juice and milk. The items were accurately listed on the menu. There were various crafts, games and manipulatives set up in the cafeteria. The children in group #1 transitioned to free play in cafeteria after snack. The children in group #2 transitioned to the gym after they snacked and played gross motor games as well as engaged in free play with manipulatives, pretend housekeeping materials. The children in group #3 transitioned to the theater and engaged in Karaoke as well as playing with blocks and cups. Supervision and interactions were adequate. The playground was not monitored due to inclement weather. A total of five (5) medications were maintained including four (4) inhalers and one (1) epi-pen. Storage requirements, expiration dates of medications, authorization forms and action plans were in compliance. Two (2) staff members’ files were monitored in full, one (1) existing staff file was monitored partially, and six (6) children’s files were monitored. Additional documentation is attached for review of the staff and training worksheet. The review of the staff and children’s files were conducted via TEAMS meeting with Ms. Burke. The ABCMS system was reviewed during the visit and all staff members have valid criminal background checks. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. YMCA buses are scheduled to be monitored on 6/4/25. The following violations were documented during today’s visit: Violation Number Comment Rule 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff member's first aid certificate expired on 5/3/25. The staff member completed in-person portion of hybrid training on 5/1/25 but has not completed the on-line portion yet. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff member's CPR certificate expired on 5/3/25. The staff member completed in-person portion of hybrid training on 5/1/25 but has not completed the on-line portion yet. .1102(d) The technical assistance were provided as follows: 1048 & 1049: First Aid & CPR First aid and CPR training must be completed annually without lapse. J. Harris needs to complete had completed in-person portion of the hybrid training on 5/1/25. He/she needs to complete the online portion to receive the training certificate. Please contact the trainer and seek guidance. Upon completion of the training, request the training and file it in the staff file. Refer to 10A NCAC 09 .1102(c)(d). Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 6/12/25. 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: Sanitation inspection: Upon receiving sanitation inspection, please kindly forward them to me. Staff and Training Worksheet: Please list each staff members’ date of birth and last four digits of social security number and/or a legal name. We must review the ABCMS system for the criminal background check. Without all the information, the staff members may not be found on the system. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013 or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 5/29/2025 Number Present: 47 Completed Date: 5/29/2025 Age: From 5 To 10 Total Minutes: 175 Time In: 02:05 PM Time Out: 05:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Lily Elder, Program Director, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to Delaney Burke, Senior Director of Operations. Ms. Elder assisted me today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-five (95) percent today prior to this visit. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, The Young Men’s Christian Association of Western North Carolina, is current/active as of 5/27/25. Permit type – five-star center license issued on 8/13/25. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space, playground area does not meet child care playground safety requirements, children prohibited from occupying kitchen space for any reason. The last annual compliance visit was conducted on 8/14/25. The last fire drill was practiced on 4/29/25. The last lockdown drill was logged on the emergency drill log on 1/30/25. However, the program also has an electronic log. According to the electronic log, a lockdown drill was conducted on 4/22/25. The last fire inspection was approved on 2/11/25. In regard to the last sanitation inspection, there is some confusing information. A poster upon completion of sanitation inspection was posted on the bulletin board on-site. Per poster, the date of the last inspection was completed on 3/19/2025. The sanitation inspection form was also posted on the bulletin board. However, the date of the inspection was created on 10/24/24 with zero (0) demerits though no classification was checked for this visit. On the Accela website for Buncombe County Sanitation records, the most recent inspection posted was 9/12/24 with six (6) demerits with a superior classification. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 6/26/24 without hazards. Lead paint and asbestos testing was completed on 3/27/25 and exempt. Upon arrival, I announced my presence and the purpose of the visit. All the children arrived in the lobby between the cafeteria and the gym, took turns and washed their hands in the bathroom. The children in group #1 had snacks in the cafeteria, followed by the children in group #3. Today, the children had BBQ Jack links, WG Chilli Lime crackers, sunflower kernels, apple sauce, veggie blend juice and milk. The items were accurately listed on the menu. There were various crafts, games and manipulatives set up in the cafeteria. The children in group #1 transitioned to free play in cafeteria after snack. The children in group #2 transitioned to the gym after they snacked and played gross motor games as well as engaged in free play with manipulatives, pretend housekeeping materials. The children in group #3 transitioned to the theater and engaged in Karaoke as well as playing with blocks and cups. Supervision and interactions were adequate. The playground was not monitored due to inclement weather. A total of five (5) medications were maintained including four (4) inhalers and one (1) epi-pen. Storage requirements, expiration dates of medications, authorization forms and action plans were in compliance. Two (2) staff members’ files were monitored in full, one (1) existing staff file was monitored partially, and six (6) children’s files were monitored. Additional documentation is attached for review of the staff and training worksheet. The review of the staff and children’s files were conducted via TEAMS meeting with Ms. Burke. The ABCMS system was reviewed during the visit and all staff members have valid criminal background checks. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. YMCA buses are scheduled to be monitored on 6/4/25. The following violations were documented during today’s visit: Violation Number Comment Rule 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff member's first aid certificate expired on 5/3/25. The staff member completed in-person portion of hybrid training on 5/1/25 but has not completed the on-line portion yet. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff member's CPR certificate expired on 5/3/25. The staff member completed in-person portion of hybrid training on 5/1/25 but has not completed the on-line portion yet. .1102(d) The technical assistance were provided as follows: 1048 & 1049: First Aid & CPR First aid and CPR training must be completed annually without lapse. J. Harris needs to complete had completed in-person portion of the hybrid training on 5/1/25. He/she needs to complete the online portion to receive the training certificate. Please contact the trainer and seek guidance. Upon completion of the training, request the training and file it in the staff file. Refer to 10A NCAC 09 .1102(c)(d). Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 6/12/25. 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: Sanitation inspection: Upon receiving sanitation inspection, please kindly forward them to me. Staff and Training Worksheet: Please list each staff members’ date of birth and last four digits of social security number and/or a legal name. We must review the ABCMS system for the criminal background check. Without all the information, the staff members may not be found on the system. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013 or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 5/29/2025 Number Present: 47 Completed Date: 5/29/2025 Age: From 5 To 10 Total Minutes: 175 Time In: 02:05 PM Time Out: 05:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Lily Elder, Program Director, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to Delaney Burke, Senior Director of Operations. Ms. Elder assisted me today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-five (95) percent today prior to this visit. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, The Young Men’s Christian Association of Western North Carolina, is current/active as of 5/27/25. Permit type – five-star center license issued on 8/13/25. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space, playground area does not meet child care playground safety requirements, children prohibited from occupying kitchen space for any reason. The last annual compliance visit was conducted on 8/14/25. The last fire drill was practiced on 4/29/25. The last lockdown drill was logged on the emergency drill log on 1/30/25. However, the program also has an electronic log. According to the electronic log, a lockdown drill was conducted on 4/22/25. The last fire inspection was approved on 2/11/25. In regard to the last sanitation inspection, there is some confusing information. A poster upon completion of sanitation inspection was posted on the bulletin board on-site. Per poster, the date of the last inspection was completed on 3/19/2025. The sanitation inspection form was also posted on the bulletin board. However, the date of the inspection was created on 10/24/24 with zero (0) demerits though no classification was checked for this visit. On the Accela website for Buncombe County Sanitation records, the most recent inspection posted was 9/12/24 with six (6) demerits with a superior classification. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 6/26/24 without hazards. Lead paint and asbestos testing was completed on 3/27/25 and exempt. Upon arrival, I announced my presence and the purpose of the visit. All the children arrived in the lobby between the cafeteria and the gym, took turns and washed their hands in the bathroom. The children in group #1 had snacks in the cafeteria, followed by the children in group #3. Today, the children had BBQ Jack links, WG Chilli Lime crackers, sunflower kernels, apple sauce, veggie blend juice and milk. The items were accurately listed on the menu. There were various crafts, games and manipulatives set up in the cafeteria. The children in group #1 transitioned to free play in cafeteria after snack. The children in group #2 transitioned to the gym after they snacked and played gross motor games as well as engaged in free play with manipulatives, pretend housekeeping materials. The children in group #3 transitioned to the theater and engaged in Karaoke as well as playing with blocks and cups. Supervision and interactions were adequate. The playground was not monitored due to inclement weather. A total of five (5) medications were maintained including four (4) inhalers and one (1) epi-pen. Storage requirements, expiration dates of medications, authorization forms and action plans were in compliance. Two (2) staff members’ files were monitored in full, one (1) existing staff file was monitored partially, and six (6) children’s files were monitored. Additional documentation is attached for review of the staff and training worksheet. The review of the staff and children’s files were conducted via TEAMS meeting with Ms. Burke. The ABCMS system was reviewed during the visit and all staff members have valid criminal background checks. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. YMCA buses are scheduled to be monitored on 6/4/25. The following violations were documented during today’s visit: Violation Number Comment Rule 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff member's first aid certificate expired on 5/3/25. The staff member completed in-person portion of hybrid training on 5/1/25 but has not completed the on-line portion yet. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff member's CPR certificate expired on 5/3/25. The staff member completed in-person portion of hybrid training on 5/1/25 but has not completed the on-line portion yet. .1102(d) The technical assistance were provided as follows: 1048 & 1049: First Aid & CPR First aid and CPR training must be completed annually without lapse. J. Harris needs to complete had completed in-person portion of the hybrid training on 5/1/25. He/she needs to complete the online portion to receive the training certificate. Please contact the trainer and seek guidance. Upon completion of the training, request the training and file it in the staff file. Refer to 10A NCAC 09 .1102(c)(d). Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 6/12/25. 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: Sanitation inspection: Upon receiving sanitation inspection, please kindly forward them to me. Staff and Training Worksheet: Please list each staff members’ date of birth and last four digits of social security number and/or a legal name. We must review the ABCMS system for the criminal background check. Without all the information, the staff members may not be found on the system. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013 or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 5/29/2025 Number Present: 47 Completed Date: 5/29/2025 Age: From 5 To 10 Total Minutes: 175 Time In: 02:05 PM Time Out: 05:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Lily Elder, Program Director, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to Delaney Burke, Senior Director of Operations. Ms. Elder assisted me today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-five (95) percent today prior to this visit. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, The Young Men’s Christian Association of Western North Carolina, is current/active as of 5/27/25. Permit type – five-star center license issued on 8/13/25. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space, playground area does not meet child care playground safety requirements, children prohibited from occupying kitchen space for any reason. The last annual compliance visit was conducted on 8/14/25. The last fire drill was practiced on 4/29/25. The last lockdown drill was logged on the emergency drill log on 1/30/25. However, the program also has an electronic log. According to the electronic log, a lockdown drill was conducted on 4/22/25. The last fire inspection was approved on 2/11/25. In regard to the last sanitation inspection, there is some confusing information. A poster upon completion of sanitation inspection was posted on the bulletin board on-site. Per poster, the date of the last inspection was completed on 3/19/2025. The sanitation inspection form was also posted on the bulletin board. However, the date of the inspection was created on 10/24/24 with zero (0) demerits though no classification was checked for this visit. On the Accela website for Buncombe County Sanitation records, the most recent inspection posted was 9/12/24 with six (6) demerits with a superior classification. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 6/26/24 without hazards. Lead paint and asbestos testing was completed on 3/27/25 and exempt. Upon arrival, I announced my presence and the purpose of the visit. All the children arrived in the lobby between the cafeteria and the gym, took turns and washed their hands in the bathroom. The children in group #1 had snacks in the cafeteria, followed by the children in group #3. Today, the children had BBQ Jack links, WG Chilli Lime crackers, sunflower kernels, apple sauce, veggie blend juice and milk. The items were accurately listed on the menu. There were various crafts, games and manipulatives set up in the cafeteria. The children in group #1 transitioned to free play in cafeteria after snack. The children in group #2 transitioned to the gym after they snacked and played gross motor games as well as engaged in free play with manipulatives, pretend housekeeping materials. The children in group #3 transitioned to the theater and engaged in Karaoke as well as playing with blocks and cups. Supervision and interactions were adequate. The playground was not monitored due to inclement weather. A total of five (5) medications were maintained including four (4) inhalers and one (1) epi-pen. Storage requirements, expiration dates of medications, authorization forms and action plans were in compliance. Two (2) staff members’ files were monitored in full, one (1) existing staff file was monitored partially, and six (6) children’s files were monitored. Additional documentation is attached for review of the staff and training worksheet. The review of the staff and children’s files were conducted via TEAMS meeting with Ms. Burke. The ABCMS system was reviewed during the visit and all staff members have valid criminal background checks. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. YMCA buses are scheduled to be monitored on 6/4/25. The following violations were documented during today’s visit: Violation Number Comment Rule 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff member's first aid certificate expired on 5/3/25. The staff member completed in-person portion of hybrid training on 5/1/25 but has not completed the on-line portion yet. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff member's CPR certificate expired on 5/3/25. The staff member completed in-person portion of hybrid training on 5/1/25 but has not completed the on-line portion yet. .1102(d) The technical assistance were provided as follows: 1048 & 1049: First Aid & CPR First aid and CPR training must be completed annually without lapse. J. Harris needs to complete had completed in-person portion of the hybrid training on 5/1/25. He/she needs to complete the online portion to receive the training certificate. Please contact the trainer and seek guidance. Upon completion of the training, request the training and file it in the staff file. Refer to 10A NCAC 09 .1102(c)(d). Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 6/12/25. 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: Sanitation inspection: Upon receiving sanitation inspection, please kindly forward them to me. Staff and Training Worksheet: Please list each staff members’ date of birth and last four digits of social security number and/or a legal name. We must review the ABCMS system for the criminal background check. Without all the information, the staff members may not be found on the system. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013 or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 5/29/2025 Number Present: 47 Completed Date: 5/29/2025 Age: From 5 To 10 Total Minutes: 175 Time In: 02:05 PM Time Out: 05:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Lily Elder, Program Director, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to Delaney Burke, Senior Director of Operations. Ms. Elder assisted me today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-five (95) percent today prior to this visit. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, The Young Men’s Christian Association of Western North Carolina, is current/active as of 5/27/25. Permit type – five-star center license issued on 8/13/25. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space, playground area does not meet child care playground safety requirements, children prohibited from occupying kitchen space for any reason. The last annual compliance visit was conducted on 8/14/25. The last fire drill was practiced on 4/29/25. The last lockdown drill was logged on the emergency drill log on 1/30/25. However, the program also has an electronic log. According to the electronic log, a lockdown drill was conducted on 4/22/25. The last fire inspection was approved on 2/11/25. In regard to the last sanitation inspection, there is some confusing information. A poster upon completion of sanitation inspection was posted on the bulletin board on-site. Per poster, the date of the last inspection was completed on 3/19/2025. The sanitation inspection form was also posted on the bulletin board. However, the date of the inspection was created on 10/24/24 with zero (0) demerits though no classification was checked for this visit. On the Accela website for Buncombe County Sanitation records, the most recent inspection posted was 9/12/24 with six (6) demerits with a superior classification. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 6/26/24 without hazards. Lead paint and asbestos testing was completed on 3/27/25 and exempt. Upon arrival, I announced my presence and the purpose of the visit. All the children arrived in the lobby between the cafeteria and the gym, took turns and washed their hands in the bathroom. The children in group #1 had snacks in the cafeteria, followed by the children in group #3. Today, the children had BBQ Jack links, WG Chilli Lime crackers, sunflower kernels, apple sauce, veggie blend juice and milk. The items were accurately listed on the menu. There were various crafts, games and manipulatives set up in the cafeteria. The children in group #1 transitioned to free play in cafeteria after snack. The children in group #2 transitioned to the gym after they snacked and played gross motor games as well as engaged in free play with manipulatives, pretend housekeeping materials. The children in group #3 transitioned to the theater and engaged in Karaoke as well as playing with blocks and cups. Supervision and interactions were adequate. The playground was not monitored due to inclement weather. A total of five (5) medications were maintained including four (4) inhalers and one (1) epi-pen. Storage requirements, expiration dates of medications, authorization forms and action plans were in compliance. Two (2) staff members’ files were monitored in full, one (1) existing staff file was monitored partially, and six (6) children’s files were monitored. Additional documentation is attached for review of the staff and training worksheet. The review of the staff and children’s files were conducted via TEAMS meeting with Ms. Burke. The ABCMS system was reviewed during the visit and all staff members have valid criminal background checks. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. YMCA buses are scheduled to be monitored on 6/4/25. The following violations were documented during today’s visit: Violation Number Comment Rule 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff member's first aid certificate expired on 5/3/25. The staff member completed in-person portion of hybrid training on 5/1/25 but has not completed the on-line portion yet. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff member's CPR certificate expired on 5/3/25. The staff member completed in-person portion of hybrid training on 5/1/25 but has not completed the on-line portion yet. .1102(d) The technical assistance were provided as follows: 1048 & 1049: First Aid & CPR First aid and CPR training must be completed annually without lapse. J. Harris needs to complete had completed in-person portion of the hybrid training on 5/1/25. He/she needs to complete the online portion to receive the training certificate. Please contact the trainer and seek guidance. Upon completion of the training, request the training and file it in the staff file. Refer to 10A NCAC 09 .1102(c)(d). Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 6/12/25. 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: Sanitation inspection: Upon receiving sanitation inspection, please kindly forward them to me. Staff and Training Worksheet: Please list each staff members’ date of birth and last four digits of social security number and/or a legal name. We must review the ABCMS system for the criminal background check. Without all the information, the staff members may not be found on the system. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013 or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 5/29/2025 Number Present: 47 Completed Date: 5/29/2025 Age: From 5 To 10 Total Minutes: 175 Time In: 02:05 PM Time Out: 05:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Lily Elder, Program Director, during the visit. A signed copy of the visit summary was left on-site and electronically emailed to Delaney Burke, Senior Director of Operations. Ms. Elder assisted me today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-five (95) percent today prior to this visit. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, The Young Men’s Christian Association of Western North Carolina, is current/active as of 5/27/25. Permit type – five-star center license issued on 8/13/25. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space, playground area does not meet child care playground safety requirements, children prohibited from occupying kitchen space for any reason. The last annual compliance visit was conducted on 8/14/25. The last fire drill was practiced on 4/29/25. The last lockdown drill was logged on the emergency drill log on 1/30/25. However, the program also has an electronic log. According to the electronic log, a lockdown drill was conducted on 4/22/25. The last fire inspection was approved on 2/11/25. In regard to the last sanitation inspection, there is some confusing information. A poster upon completion of sanitation inspection was posted on the bulletin board on-site. Per poster, the date of the last inspection was completed on 3/19/2025. The sanitation inspection form was also posted on the bulletin board. However, the date of the inspection was created on 10/24/24 with zero (0) demerits though no classification was checked for this visit. On the Accela website for Buncombe County Sanitation records, the most recent inspection posted was 9/12/24 with six (6) demerits with a superior classification. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 6/26/24 without hazards. Lead paint and asbestos testing was completed on 3/27/25 and exempt. Upon arrival, I announced my presence and the purpose of the visit. All the children arrived in the lobby between the cafeteria and the gym, took turns and washed their hands in the bathroom. The children in group #1 had snacks in the cafeteria, followed by the children in group #3. Today, the children had BBQ Jack links, WG Chilli Lime crackers, sunflower kernels, apple sauce, veggie blend juice and milk. The items were accurately listed on the menu. There were various crafts, games and manipulatives set up in the cafeteria. The children in group #1 transitioned to free play in cafeteria after snack. The children in group #2 transitioned to the gym after they snacked and played gross motor games as well as engaged in free play with manipulatives, pretend housekeeping materials. The children in group #3 transitioned to the theater and engaged in Karaoke as well as playing with blocks and cups. Supervision and interactions were adequate. The playground was not monitored due to inclement weather. A total of five (5) medications were maintained including four (4) inhalers and one (1) epi-pen. Storage requirements, expiration dates of medications, authorization forms and action plans were in compliance. Two (2) staff members’ files were monitored in full, one (1) existing staff file was monitored partially, and six (6) children’s files were monitored. Additional documentation is attached for review of the staff and training worksheet. The review of the staff and children’s files were conducted via TEAMS meeting with Ms. Burke. The ABCMS system was reviewed during the visit and all staff members have valid criminal background checks. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. YMCA buses are scheduled to be monitored on 6/4/25. The following violations were documented during today’s visit: Violation Number Comment Rule 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff member's first aid certificate expired on 5/3/25. The staff member completed in-person portion of hybrid training on 5/1/25 but has not completed the on-line portion yet. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff member's CPR certificate expired on 5/3/25. The staff member completed in-person portion of hybrid training on 5/1/25 but has not completed the on-line portion yet. .1102(d) The technical assistance were provided as follows: 1048 & 1049: First Aid & CPR First aid and CPR training must be completed annually without lapse. J. Harris needs to complete had completed in-person portion of the hybrid training on 5/1/25. He/she needs to complete the online portion to receive the training certificate. Please contact the trainer and seek guidance. Upon completion of the training, request the training and file it in the staff file. Refer to 10A NCAC 09 .1102(c)(d). Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 6/12/25. 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: Sanitation inspection: Upon receiving sanitation inspection, please kindly forward them to me. Staff and Training Worksheet: Please list each staff members’ date of birth and last four digits of social security number and/or a legal name. We must review the ABCMS system for the criminal background check. Without all the information, the staff members may not be found on the system. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013 or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 1/28/2025 Number Present: 35 Completed Date: 1/28/2025 Age: From 5 To 10 Total Minutes: 175 Time In: 02:30 PM Time Out: 05:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaoru Eddins, Child Care Consultant and also signed by Liz Paul, Program Coordinator. during the visit. An electronic signed copy of the visit summary was left on-site and electronically emailed to Lily Elder, Program Director and Delaney Burke, Senior Operations Director. Today, Ms. Elder was available most of the time 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 reviewed with the operator. The program’s compliance history was ninety-two (92) percent as of today prior to this visit. Permit type – five-star center license issued on 8/13/24. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space, playground area does not meet child care playground safety requirements, children prohibited from occupying kitchen space for any reason. The last annual compliance visit was conducted on 8/9/24. The last fire drill was practiced on 12/20/24. The last shelter-in-place drill was practiced on 12/18/24. The last fire inspection was approved on 9/24/24. The last sanitation inspection was conducted on 9/12/24 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. The children arrived at the cafeteria. Shortly after arrival, the children in group #1 and #3 headed to the playground. The children in group #1 played with playground structure, swings, balls, and engaged in other gross motor activities. Upon coming back to the cafeteria, the children washed their hands in the bathrooms by the cafeteria/gym. The children in group #2 remained in the cafeteria, washed their hands in the bathroom and had snacks. The children had corn strips, apple sauce, bean dip, sunflower kernels, milk and veggie blend juice, which are listed accurately on the menu. After the snack, the children played with magnetic tiles, Legos, hot wheels, yarn, pipe cleaners and games. Interaction and supervision were adequate. Two (2) existing staff files were monitored partially for criminal background letters, BSAC and first aid/CPR certification. One (1) existing staff file was monitored in full on 8/9/24, and the documents mentioned in the previous sentence were still valid. Both staff members monitored today have valid certification and letters. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. YMCA transportation was inspected on 6/24/24. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Aero Vomit Control was stored on the bottom rack of stackable racks by the door to the kitchen located on far-right section of the cafeteria. Also, a bottle of Spraybuff PTU Handi Spray with multiple warning was stored at approximately ten (10) inches from the floor on top the box of bottled water on one corner of the cafeteria. Both products shall be stored in a locked storage. If those products do not belong to the program, please discuss the storage with the elementary school. .2820(b) Technical assistance was provided as follows: 840: hazardous products All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be stored in a locked room or cabinet. Aero Vomit Control was stored on the bottom rack of stackable racks by the door to the kitchen located on far-right section of the cafeteria. Also, a bottle of Spraybuff PTU Handi Spray with multiple warning was stored at approximately ten (10) inches from the floor on top the box of bottled water on one corner of the cafeteria. Both products shall be stored in a locked storage. If those products do not belong to the program, please discuss the storage with the elementary school. Refer to 15A NCAC 18A .2820(b). This violation was corrected during the visit. Achieving Compliance: All violations (item 840) was corrected during the visit. Consultation is provided as follows: Medication: Staff members shall consider how to store and dispose of the used needle when you use Solu-Cortef. Unused or used needles must be inaccessible to children, and the used needle must be safely disposed of, as a biohazard. Please discuss plans to safely handle the needle. Additionally, a trained staff member will be on-site when the child who is on Solu-Cortef is attending. Seven (7) medications are maintained in the program. Two (2) of the medications, Hydrocortisone E10mg tablet and Solu-Cortef Inj. 100 mg are not considered emergency medications. Hydrocortisone E10mg is used for stress, and the Solu-Cortef is used for various conditions including excessive pain, vomiting, diarrhea, fever according to the medication’s Action Plan and the medication authorization forms. Per staff member, three (3) staff members were trained in how to administer Solu-Cortef by the child’s parent and the trainer provided by the parent. If medical conditions do not cause immediate danger to life, such as anaphylaxis, seizure or other breathing issues, it is not considered emergency conditions. Per Ms. Elder, the program is not comfortable with the identification of those two (2) medications as non-emergency medications. Per parent, the Hydrocortisone and Solu-Cortef is supposed to be administered immediately after the child is showing the symptoms listed on the paperwork, otherwise, the child will not enough produce enough Cortisone and lead the child to a shock. This requires additional discussion and guidance. I will follow up on the appropriate storage of the medications (hydrocortisone and Solu-Cortef) via email. It is strongly recommended that all possible conditions that require both Hydrocortisone and Solu-Cortef are listed on the paperwork and signed by the parent and/or a physician. Any action plan/instructions on when and how to administer medication that the parents approve shall be signed and dated by the parent. Per Ms. Elder, the plan is to place the used needle in the plastic water bottle and take it to the biohazard disposal container. For the safety of staff and children, access to a biohazard disposal container within the program’s licensed space is strongly recommended. Plastic water bottle may not be sufficient to store the needle temporarily. The program must ensure the safety of staff and children at best approaches possible. 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. 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: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 1/28/2025 Number Present: 35 Completed Date: 1/28/2025 Age: From 5 To 10 Total Minutes: 175 Time In: 02:30 PM Time Out: 05:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaoru Eddins, Child Care Consultant and also signed by Liz Paul, Program Coordinator. during the visit. An electronic signed copy of the visit summary was left on-site and electronically emailed to Lily Elder, Program Director and Delaney Burke, Senior Operations Director. Today, Ms. Elder was available most of the time 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 reviewed with the operator. The program’s compliance history was ninety-two (92) percent as of today prior to this visit. Permit type – five-star center license issued on 8/13/24. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space, playground area does not meet child care playground safety requirements, children prohibited from occupying kitchen space for any reason. The last annual compliance visit was conducted on 8/9/24. The last fire drill was practiced on 12/20/24. The last shelter-in-place drill was practiced on 12/18/24. The last fire inspection was approved on 9/24/24. The last sanitation inspection was conducted on 9/12/24 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. The children arrived at the cafeteria. Shortly after arrival, the children in group #1 and #3 headed to the playground. The children in group #1 played with playground structure, swings, balls, and engaged in other gross motor activities. Upon coming back to the cafeteria, the children washed their hands in the bathrooms by the cafeteria/gym. The children in group #2 remained in the cafeteria, washed their hands in the bathroom and had snacks. The children had corn strips, apple sauce, bean dip, sunflower kernels, milk and veggie blend juice, which are listed accurately on the menu. After the snack, the children played with magnetic tiles, Legos, hot wheels, yarn, pipe cleaners and games. Interaction and supervision were adequate. Two (2) existing staff files were monitored partially for criminal background letters, BSAC and first aid/CPR certification. One (1) existing staff file was monitored in full on 8/9/24, and the documents mentioned in the previous sentence were still valid. Both staff members monitored today have valid certification and letters. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. YMCA transportation was inspected on 6/24/24. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Aero Vomit Control was stored on the bottom rack of stackable racks by the door to the kitchen located on far-right section of the cafeteria. Also, a bottle of Spraybuff PTU Handi Spray with multiple warning was stored at approximately ten (10) inches from the floor on top the box of bottled water on one corner of the cafeteria. Both products shall be stored in a locked storage. If those products do not belong to the program, please discuss the storage with the elementary school. .2820(b) Technical assistance was provided as follows: 840: hazardous products All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be stored in a locked room or cabinet. Aero Vomit Control was stored on the bottom rack of stackable racks by the door to the kitchen located on far-right section of the cafeteria. Also, a bottle of Spraybuff PTU Handi Spray with multiple warning was stored at approximately ten (10) inches from the floor on top the box of bottled water on one corner of the cafeteria. Both products shall be stored in a locked storage. If those products do not belong to the program, please discuss the storage with the elementary school. Refer to 15A NCAC 18A .2820(b). This violation was corrected during the visit. Achieving Compliance: All violations (item 840) was corrected during the visit. Consultation is provided as follows: Medication: Staff members shall consider how to store and dispose of the used needle when you use Solu-Cortef. Unused or used needles must be inaccessible to children, and the used needle must be safely disposed of, as a biohazard. Please discuss plans to safely handle the needle. Additionally, a trained staff member will be on-site when the child who is on Solu-Cortef is attending. Seven (7) medications are maintained in the program. Two (2) of the medications, Hydrocortisone E10mg tablet and Solu-Cortef Inj. 100 mg are not considered emergency medications. Hydrocortisone E10mg is used for stress, and the Solu-Cortef is used for various conditions including excessive pain, vomiting, diarrhea, fever according to the medication’s Action Plan and the medication authorization forms. Per staff member, three (3) staff members were trained in how to administer Solu-Cortef by the child’s parent and the trainer provided by the parent. If medical conditions do not cause immediate danger to life, such as anaphylaxis, seizure or other breathing issues, it is not considered emergency conditions. Per Ms. Elder, the program is not comfortable with the identification of those two (2) medications as non-emergency medications. Per parent, the Hydrocortisone and Solu-Cortef is supposed to be administered immediately after the child is showing the symptoms listed on the paperwork, otherwise, the child will not enough produce enough Cortisone and lead the child to a shock. This requires additional discussion and guidance. I will follow up on the appropriate storage of the medications (hydrocortisone and Solu-Cortef) via email. It is strongly recommended that all possible conditions that require both Hydrocortisone and Solu-Cortef are listed on the paperwork and signed by the parent and/or a physician. Any action plan/instructions on when and how to administer medication that the parents approve shall be signed and dated by the parent. Per Ms. Elder, the plan is to place the used needle in the plastic water bottle and take it to the biohazard disposal container. For the safety of staff and children, access to a biohazard disposal container within the program’s licensed space is strongly recommended. Plastic water bottle may not be sufficient to store the needle temporarily. The program must ensure the safety of staff and children at best approaches possible. 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. 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: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 1/28/2025 Number Present: 35 Completed Date: 1/28/2025 Age: From 5 To 10 Total Minutes: 175 Time In: 02:30 PM Time Out: 05:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaoru Eddins, Child Care Consultant and also signed by Liz Paul, Program Coordinator. during the visit. An electronic signed copy of the visit summary was left on-site and electronically emailed to Lily Elder, Program Director and Delaney Burke, Senior Operations Director. Today, Ms. Elder was available most of the time 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 reviewed with the operator. The program’s compliance history was ninety-two (92) percent as of today prior to this visit. Permit type – five-star center license issued on 8/13/24. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space, playground area does not meet child care playground safety requirements, children prohibited from occupying kitchen space for any reason. The last annual compliance visit was conducted on 8/9/24. The last fire drill was practiced on 12/20/24. The last shelter-in-place drill was practiced on 12/18/24. The last fire inspection was approved on 9/24/24. The last sanitation inspection was conducted on 9/12/24 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. The children arrived at the cafeteria. Shortly after arrival, the children in group #1 and #3 headed to the playground. The children in group #1 played with playground structure, swings, balls, and engaged in other gross motor activities. Upon coming back to the cafeteria, the children washed their hands in the bathrooms by the cafeteria/gym. The children in group #2 remained in the cafeteria, washed their hands in the bathroom and had snacks. The children had corn strips, apple sauce, bean dip, sunflower kernels, milk and veggie blend juice, which are listed accurately on the menu. After the snack, the children played with magnetic tiles, Legos, hot wheels, yarn, pipe cleaners and games. Interaction and supervision were adequate. Two (2) existing staff files were monitored partially for criminal background letters, BSAC and first aid/CPR certification. One (1) existing staff file was monitored in full on 8/9/24, and the documents mentioned in the previous sentence were still valid. Both staff members monitored today have valid certification and letters. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. YMCA transportation was inspected on 6/24/24. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Aero Vomit Control was stored on the bottom rack of stackable racks by the door to the kitchen located on far-right section of the cafeteria. Also, a bottle of Spraybuff PTU Handi Spray with multiple warning was stored at approximately ten (10) inches from the floor on top the box of bottled water on one corner of the cafeteria. Both products shall be stored in a locked storage. If those products do not belong to the program, please discuss the storage with the elementary school. .2820(b) Technical assistance was provided as follows: 840: hazardous products All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be stored in a locked room or cabinet. Aero Vomit Control was stored on the bottom rack of stackable racks by the door to the kitchen located on far-right section of the cafeteria. Also, a bottle of Spraybuff PTU Handi Spray with multiple warning was stored at approximately ten (10) inches from the floor on top the box of bottled water on one corner of the cafeteria. Both products shall be stored in a locked storage. If those products do not belong to the program, please discuss the storage with the elementary school. Refer to 15A NCAC 18A .2820(b). This violation was corrected during the visit. Achieving Compliance: All violations (item 840) was corrected during the visit. Consultation is provided as follows: Medication: Staff members shall consider how to store and dispose of the used needle when you use Solu-Cortef. Unused or used needles must be inaccessible to children, and the used needle must be safely disposed of, as a biohazard. Please discuss plans to safely handle the needle. Additionally, a trained staff member will be on-site when the child who is on Solu-Cortef is attending. Seven (7) medications are maintained in the program. Two (2) of the medications, Hydrocortisone E10mg tablet and Solu-Cortef Inj. 100 mg are not considered emergency medications. Hydrocortisone E10mg is used for stress, and the Solu-Cortef is used for various conditions including excessive pain, vomiting, diarrhea, fever according to the medication’s Action Plan and the medication authorization forms. Per staff member, three (3) staff members were trained in how to administer Solu-Cortef by the child’s parent and the trainer provided by the parent. If medical conditions do not cause immediate danger to life, such as anaphylaxis, seizure or other breathing issues, it is not considered emergency conditions. Per Ms. Elder, the program is not comfortable with the identification of those two (2) medications as non-emergency medications. Per parent, the Hydrocortisone and Solu-Cortef is supposed to be administered immediately after the child is showing the symptoms listed on the paperwork, otherwise, the child will not enough produce enough Cortisone and lead the child to a shock. This requires additional discussion and guidance. I will follow up on the appropriate storage of the medications (hydrocortisone and Solu-Cortef) via email. It is strongly recommended that all possible conditions that require both Hydrocortisone and Solu-Cortef are listed on the paperwork and signed by the parent and/or a physician. Any action plan/instructions on when and how to administer medication that the parents approve shall be signed and dated by the parent. Per Ms. Elder, the plan is to place the used needle in the plastic water bottle and take it to the biohazard disposal container. For the safety of staff and children, access to a biohazard disposal container within the program’s licensed space is strongly recommended. Plastic water bottle may not be sufficient to store the needle temporarily. The program must ensure the safety of staff and children at best approaches possible. 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. 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: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 1/28/2025 Number Present: 35 Completed Date: 1/28/2025 Age: From 5 To 10 Total Minutes: 175 Time In: 02:30 PM Time Out: 05:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaoru Eddins, Child Care Consultant and also signed by Liz Paul, Program Coordinator. during the visit. An electronic signed copy of the visit summary was left on-site and electronically emailed to Lily Elder, Program Director and Delaney Burke, Senior Operations Director. Today, Ms. Elder was available most of the time 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 reviewed with the operator. The program’s compliance history was ninety-two (92) percent as of today prior to this visit. Permit type – five-star center license issued on 8/13/24. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space, playground area does not meet child care playground safety requirements, children prohibited from occupying kitchen space for any reason. The last annual compliance visit was conducted on 8/9/24. The last fire drill was practiced on 12/20/24. The last shelter-in-place drill was practiced on 12/18/24. The last fire inspection was approved on 9/24/24. The last sanitation inspection was conducted on 9/12/24 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. The children arrived at the cafeteria. Shortly after arrival, the children in group #1 and #3 headed to the playground. The children in group #1 played with playground structure, swings, balls, and engaged in other gross motor activities. Upon coming back to the cafeteria, the children washed their hands in the bathrooms by the cafeteria/gym. The children in group #2 remained in the cafeteria, washed their hands in the bathroom and had snacks. The children had corn strips, apple sauce, bean dip, sunflower kernels, milk and veggie blend juice, which are listed accurately on the menu. After the snack, the children played with magnetic tiles, Legos, hot wheels, yarn, pipe cleaners and games. Interaction and supervision were adequate. Two (2) existing staff files were monitored partially for criminal background letters, BSAC and first aid/CPR certification. One (1) existing staff file was monitored in full on 8/9/24, and the documents mentioned in the previous sentence were still valid. Both staff members monitored today have valid certification and letters. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. YMCA transportation was inspected on 6/24/24. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Aero Vomit Control was stored on the bottom rack of stackable racks by the door to the kitchen located on far-right section of the cafeteria. Also, a bottle of Spraybuff PTU Handi Spray with multiple warning was stored at approximately ten (10) inches from the floor on top the box of bottled water on one corner of the cafeteria. Both products shall be stored in a locked storage. If those products do not belong to the program, please discuss the storage with the elementary school. .2820(b) Technical assistance was provided as follows: 840: hazardous products All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be stored in a locked room or cabinet. Aero Vomit Control was stored on the bottom rack of stackable racks by the door to the kitchen located on far-right section of the cafeteria. Also, a bottle of Spraybuff PTU Handi Spray with multiple warning was stored at approximately ten (10) inches from the floor on top the box of bottled water on one corner of the cafeteria. Both products shall be stored in a locked storage. If those products do not belong to the program, please discuss the storage with the elementary school. Refer to 15A NCAC 18A .2820(b). This violation was corrected during the visit. Achieving Compliance: All violations (item 840) was corrected during the visit. Consultation is provided as follows: Medication: Staff members shall consider how to store and dispose of the used needle when you use Solu-Cortef. Unused or used needles must be inaccessible to children, and the used needle must be safely disposed of, as a biohazard. Please discuss plans to safely handle the needle. Additionally, a trained staff member will be on-site when the child who is on Solu-Cortef is attending. Seven (7) medications are maintained in the program. Two (2) of the medications, Hydrocortisone E10mg tablet and Solu-Cortef Inj. 100 mg are not considered emergency medications. Hydrocortisone E10mg is used for stress, and the Solu-Cortef is used for various conditions including excessive pain, vomiting, diarrhea, fever according to the medication’s Action Plan and the medication authorization forms. Per staff member, three (3) staff members were trained in how to administer Solu-Cortef by the child’s parent and the trainer provided by the parent. If medical conditions do not cause immediate danger to life, such as anaphylaxis, seizure or other breathing issues, it is not considered emergency conditions. Per Ms. Elder, the program is not comfortable with the identification of those two (2) medications as non-emergency medications. Per parent, the Hydrocortisone and Solu-Cortef is supposed to be administered immediately after the child is showing the symptoms listed on the paperwork, otherwise, the child will not enough produce enough Cortisone and lead the child to a shock. This requires additional discussion and guidance. I will follow up on the appropriate storage of the medications (hydrocortisone and Solu-Cortef) via email. It is strongly recommended that all possible conditions that require both Hydrocortisone and Solu-Cortef are listed on the paperwork and signed by the parent and/or a physician. Any action plan/instructions on when and how to administer medication that the parents approve shall be signed and dated by the parent. Per Ms. Elder, the plan is to place the used needle in the plastic water bottle and take it to the biohazard disposal container. For the safety of staff and children, access to a biohazard disposal container within the program’s licensed space is strongly recommended. Plastic water bottle may not be sufficient to store the needle temporarily. The program must ensure the safety of staff and children at best approaches possible. 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. 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

G.S. 110-90 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 1/28/2025 Number Present: 35 Completed Date: 1/28/2025 Age: From 5 To 10 Total Minutes: 175 Time In: 02:30 PM Time Out: 05:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaoru Eddins, Child Care Consultant and also signed by Liz Paul, Program Coordinator. during the visit. An electronic signed copy of the visit summary was left on-site and electronically emailed to Lily Elder, Program Director and Delaney Burke, Senior Operations Director. Today, Ms. Elder was available most of the time 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 reviewed with the operator. The program’s compliance history was ninety-two (92) percent as of today prior to this visit. Permit type – five-star center license issued on 8/13/24. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space, playground area does not meet child care playground safety requirements, children prohibited from occupying kitchen space for any reason. The last annual compliance visit was conducted on 8/9/24. The last fire drill was practiced on 12/20/24. The last shelter-in-place drill was practiced on 12/18/24. The last fire inspection was approved on 9/24/24. The last sanitation inspection was conducted on 9/12/24 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. The children arrived at the cafeteria. Shortly after arrival, the children in group #1 and #3 headed to the playground. The children in group #1 played with playground structure, swings, balls, and engaged in other gross motor activities. Upon coming back to the cafeteria, the children washed their hands in the bathrooms by the cafeteria/gym. The children in group #2 remained in the cafeteria, washed their hands in the bathroom and had snacks. The children had corn strips, apple sauce, bean dip, sunflower kernels, milk and veggie blend juice, which are listed accurately on the menu. After the snack, the children played with magnetic tiles, Legos, hot wheels, yarn, pipe cleaners and games. Interaction and supervision were adequate. Two (2) existing staff files were monitored partially for criminal background letters, BSAC and first aid/CPR certification. One (1) existing staff file was monitored in full on 8/9/24, and the documents mentioned in the previous sentence were still valid. Both staff members monitored today have valid certification and letters. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. YMCA transportation was inspected on 6/24/24. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Aero Vomit Control was stored on the bottom rack of stackable racks by the door to the kitchen located on far-right section of the cafeteria. Also, a bottle of Spraybuff PTU Handi Spray with multiple warning was stored at approximately ten (10) inches from the floor on top the box of bottled water on one corner of the cafeteria. Both products shall be stored in a locked storage. If those products do not belong to the program, please discuss the storage with the elementary school. .2820(b) Technical assistance was provided as follows: 840: hazardous products All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be stored in a locked room or cabinet. Aero Vomit Control was stored on the bottom rack of stackable racks by the door to the kitchen located on far-right section of the cafeteria. Also, a bottle of Spraybuff PTU Handi Spray with multiple warning was stored at approximately ten (10) inches from the floor on top the box of bottled water on one corner of the cafeteria. Both products shall be stored in a locked storage. If those products do not belong to the program, please discuss the storage with the elementary school. Refer to 15A NCAC 18A .2820(b). This violation was corrected during the visit. Achieving Compliance: All violations (item 840) was corrected during the visit. Consultation is provided as follows: Medication: Staff members shall consider how to store and dispose of the used needle when you use Solu-Cortef. Unused or used needles must be inaccessible to children, and the used needle must be safely disposed of, as a biohazard. Please discuss plans to safely handle the needle. Additionally, a trained staff member will be on-site when the child who is on Solu-Cortef is attending. Seven (7) medications are maintained in the program. Two (2) of the medications, Hydrocortisone E10mg tablet and Solu-Cortef Inj. 100 mg are not considered emergency medications. Hydrocortisone E10mg is used for stress, and the Solu-Cortef is used for various conditions including excessive pain, vomiting, diarrhea, fever according to the medication’s Action Plan and the medication authorization forms. Per staff member, three (3) staff members were trained in how to administer Solu-Cortef by the child’s parent and the trainer provided by the parent. If medical conditions do not cause immediate danger to life, such as anaphylaxis, seizure or other breathing issues, it is not considered emergency conditions. Per Ms. Elder, the program is not comfortable with the identification of those two (2) medications as non-emergency medications. Per parent, the Hydrocortisone and Solu-Cortef is supposed to be administered immediately after the child is showing the symptoms listed on the paperwork, otherwise, the child will not enough produce enough Cortisone and lead the child to a shock. This requires additional discussion and guidance. I will follow up on the appropriate storage of the medications (hydrocortisone and Solu-Cortef) via email. It is strongly recommended that all possible conditions that require both Hydrocortisone and Solu-Cortef are listed on the paperwork and signed by the parent and/or a physician. Any action plan/instructions on when and how to administer medication that the parents approve shall be signed and dated by the parent. Per Ms. Elder, the plan is to place the used needle in the plastic water bottle and take it to the biohazard disposal container. For the safety of staff and children, access to a biohazard disposal container within the program’s licensed space is strongly recommended. Plastic water bottle may not be sufficient to store the needle temporarily. The program must ensure the safety of staff and children at best approaches possible. 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. 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: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 8/9/2024 Number Present: 106 Completed Date: 8/9/2024 Age: From 6 To 12 Total Minutes: 243 Time In: 08:52 AM Time Out: 12:55 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaoru Eddins, Child Care Consultant and also signed by Brooklyn Wise, Program Coordinator, during the visit. A signed copy of the visit summary was electronically emailed to Delaney Burke, Senior Operations Director. Today, Ms. Burke accompanied me. The indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89) percent as of 8/9/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, the Young Men’s Christian Association of Western North Carolina, Inc., is current/active as of today prior to this visit. Permit type – Five-star center license issued on 2/24/23. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space, playground area does not meet child care playground safety requirements, children prohibited from occupying kitchen area for any reason. The last annual compliance visit was conducted on 9/12/23. The last fire drill was practiced on 7/21/24. The last shelter-in-place drill was practiced on 6/4/24. The last fire inspection was approved on 1/26/24. The last sanitation inspection was conducted on 9/15/23 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. I observed the children. The children from Group #1 had breakfast in the cafeteria. Today’s menu was a donut, orange/pineapple juice and milk. No medications were maintained for this group. The children from Group#2 transitioned from the gym to cafeteria for breakfast. The group used the bathroom and washed their hands prior to transitioning to the cafeteria. Epi-pen was maintained in the backpack for a child. The permission form and the action plan were current. The children from Group #3 also transitioned to cafeteria for breakfast. There were three (3) emergency medications maintained in the backpack. All the action plans and permission forms were current. The children in Group #4 transitioned from inside to morning walk. One (1) medication was maintained in the backpack. The action plan and the permission form were current. The children in Group #5 played on the blacktop. They played basketball game. No medications were maintained for this group. The children in Group #6 played on the playground #1. Some children sat on the pillows and talked, and the other children were on the swings. No medications were maintained for this group. The children from Group #7 played on the playground #2. They played with gross motor equipment, such as swings and monkey bars. Some children played a game on the grass area. No hazardous products were found in the licensed areas and the playground. Supervision and interaction were adequate. Five (5) new staff files and one (1) staff file were monitored in full. Three(3) staff files were monitored partially for missing dates and expired documents. For the missing information, on-going training documents, expired emergency information form and BSAC certificate were monitored, and they were current and in compliance. There were three (3) new staff members who received the medical statements and TB screening after the hire date. YMCA programs often re-hires seasonal staff members. Per HR policy, all employees’ employment status is terminated when they leave the program in-between seasons. However, the program used the past orientation documents, medical statement, TB screening and other documents for the re-hired employees. This was discussed during a routine unannounced visit to YMCA W.W. Estes Afterschool conducted on 7/24/24. Per discussion, each employee whose employment status expires for ninety (90) days shall receive new orientation. Medical Statement and TB screening shall be reused if they were obtained less than twelve (12) months prior to the new employment date. Those three (3) employees had to renew their medical statement and TB screening based on the rule. Since this matter was recently discussed and the program corrected the matter as soon as they found out about the rules, violations on medical statement and TB screening were not cited during today’s visit. Medical statement and TB screening for the staff member hired on 9/24/21 were recently renewed. Per Ms. Burke, the documents were lost during recent file transfer. This staff member’s files were monitored during annual compliance visit conducted on 9/12/23, and the medical statement and the TB screening documents were verified then. One (1) staff member who was present today was not listed on the Staff and Training worksheet. The staff member's file was monitored by me during the routine unannounced visit conducted at YMCA W.W. Estes Afterschool on 7/26/24. Seventeen (17) children’s files were monitored and in compliance. There were a total of one hundred and six (106) children present. Per facility's license, the capacity for this program is one hundred (100). I had a conversation to submit the request to increase the program capacity with Ms. Burke. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. The transportations for YMCA programs were monitored on 6/4/24. The following violations were documented during today’s visit: Violation Number Comment Rule 103 The number of children present was not within permit capacity. There were a total of one hundred and six (106) children present during the visit, and the facility's capacity is one hundred (100). GS 110-91(7) & .1401(f) 1041 Prior to employment a Criminal Background Check was not completed. The staff member hired on 5/20/24 did not receive criminal background letter until 5/21/24. Per interview with Ms. Burke, the employee complete YMCA background check and started on the orientation process on 5/20/24. G.S. 110-90.2(b) Technical assistance was provided as follows: 103: Capacity The capacity of the facility shall be maintained at all times including during the summer camp. § 110-91. Mandatory standards for a license. (7) Staff-Child Ratio and Capacity for Child Care Facilities. – In determining the staff-child ratio in child care facilities, all children younger than 13 years old shall be counted. 1041: Criminal Background check Criminal background check shall be completed prior to employment. The qualification letter shall be in the staff files on or before the first day of employment as well. § 110-90.2. Mandatory child care providers' criminal history checks. (b) Effective January 1, 1996, the Department shall ensure that, prior to employment and every three years thereafter, the criminal history of all child care providers is checked and a determination is made of the child care provider's fitness to have responsibility for the safety and well-being of children based on the criminal history. The Department shall ensure that all child care providers are checked for county, State, and federal criminal histories. Meeting compliance: Item 103 requires a follow-up visit per § 110-91. Mandatory standards for a license. Due to the nature of this violation, you may be considered for Administrative Action. Please submit a corrective action plan for item 1041 following the guidance below: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/23/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins Address: PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: On-going training On-going training period is based on each employee’s hiring date. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: Education and experience of four-year degree or higher advanced degree in a child care related field of study from a regionally accredited college or university is required to complete 5 clock hours. Education and experience of two-year degree in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Administration Credential is required to complete 8 clock hours. Education and experience of certificate or diploma in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Credential is required to complete 10 clock hours. Education and experience of 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement is required to complete 15 clock hours. If none of the other criteria in this chart apply, 20 clock hours of on-going training is required. (d) Any staff working less than 40 hours per week may choose to complete on-going training requirements as outlined in Paragraph (a) of this Rule, or the training requirement may be prorated as follows: If working hours per week is 0-10 hours, 5 clock hours of on-going training is required. If working hours per week is 11-20 hours, 10 clock hours of on-going training is required. If working hours per week is 21-30 hours, 15 clock hours of on-going training is required. If working hours per week is 31-40 hours, 20 clock hours of on-going training is required. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 8/9/2024 Number Present: 106 Completed Date: 8/9/2024 Age: From 6 To 12 Total Minutes: 243 Time In: 08:52 AM Time Out: 12:55 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaoru Eddins, Child Care Consultant and also signed by Brooklyn Wise, Program Coordinator, during the visit. A signed copy of the visit summary was electronically emailed to Delaney Burke, Senior Operations Director. Today, Ms. Burke accompanied me. The indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89) percent as of 8/9/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, the Young Men’s Christian Association of Western North Carolina, Inc., is current/active as of today prior to this visit. Permit type – Five-star center license issued on 2/24/23. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space, playground area does not meet child care playground safety requirements, children prohibited from occupying kitchen area for any reason. The last annual compliance visit was conducted on 9/12/23. The last fire drill was practiced on 7/21/24. The last shelter-in-place drill was practiced on 6/4/24. The last fire inspection was approved on 1/26/24. The last sanitation inspection was conducted on 9/15/23 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. I observed the children. The children from Group #1 had breakfast in the cafeteria. Today’s menu was a donut, orange/pineapple juice and milk. No medications were maintained for this group. The children from Group#2 transitioned from the gym to cafeteria for breakfast. The group used the bathroom and washed their hands prior to transitioning to the cafeteria. Epi-pen was maintained in the backpack for a child. The permission form and the action plan were current. The children from Group #3 also transitioned to cafeteria for breakfast. There were three (3) emergency medications maintained in the backpack. All the action plans and permission forms were current. The children in Group #4 transitioned from inside to morning walk. One (1) medication was maintained in the backpack. The action plan and the permission form were current. The children in Group #5 played on the blacktop. They played basketball game. No medications were maintained for this group. The children in Group #6 played on the playground #1. Some children sat on the pillows and talked, and the other children were on the swings. No medications were maintained for this group. The children from Group #7 played on the playground #2. They played with gross motor equipment, such as swings and monkey bars. Some children played a game on the grass area. No hazardous products were found in the licensed areas and the playground. Supervision and interaction were adequate. Five (5) new staff files and one (1) staff file were monitored in full. Three(3) staff files were monitored partially for missing dates and expired documents. For the missing information, on-going training documents, expired emergency information form and BSAC certificate were monitored, and they were current and in compliance. There were three (3) new staff members who received the medical statements and TB screening after the hire date. YMCA programs often re-hires seasonal staff members. Per HR policy, all employees’ employment status is terminated when they leave the program in-between seasons. However, the program used the past orientation documents, medical statement, TB screening and other documents for the re-hired employees. This was discussed during a routine unannounced visit to YMCA W.W. Estes Afterschool conducted on 7/24/24. Per discussion, each employee whose employment status expires for ninety (90) days shall receive new orientation. Medical Statement and TB screening shall be reused if they were obtained less than twelve (12) months prior to the new employment date. Those three (3) employees had to renew their medical statement and TB screening based on the rule. Since this matter was recently discussed and the program corrected the matter as soon as they found out about the rules, violations on medical statement and TB screening were not cited during today’s visit. Medical statement and TB screening for the staff member hired on 9/24/21 were recently renewed. Per Ms. Burke, the documents were lost during recent file transfer. This staff member’s files were monitored during annual compliance visit conducted on 9/12/23, and the medical statement and the TB screening documents were verified then. One (1) staff member who was present today was not listed on the Staff and Training worksheet. The staff member's file was monitored by me during the routine unannounced visit conducted at YMCA W.W. Estes Afterschool on 7/26/24. Seventeen (17) children’s files were monitored and in compliance. There were a total of one hundred and six (106) children present. Per facility's license, the capacity for this program is one hundred (100). I had a conversation to submit the request to increase the program capacity with Ms. Burke. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. The transportations for YMCA programs were monitored on 6/4/24. The following violations were documented during today’s visit: Violation Number Comment Rule 103 The number of children present was not within permit capacity. There were a total of one hundred and six (106) children present during the visit, and the facility's capacity is one hundred (100). GS 110-91(7) & .1401(f) 1041 Prior to employment a Criminal Background Check was not completed. The staff member hired on 5/20/24 did not receive criminal background letter until 5/21/24. Per interview with Ms. Burke, the employee complete YMCA background check and started on the orientation process on 5/20/24. G.S. 110-90.2(b) Technical assistance was provided as follows: 103: Capacity The capacity of the facility shall be maintained at all times including during the summer camp. § 110-91. Mandatory standards for a license. (7) Staff-Child Ratio and Capacity for Child Care Facilities. – In determining the staff-child ratio in child care facilities, all children younger than 13 years old shall be counted. 1041: Criminal Background check Criminal background check shall be completed prior to employment. The qualification letter shall be in the staff files on or before the first day of employment as well. § 110-90.2. Mandatory child care providers' criminal history checks. (b) Effective January 1, 1996, the Department shall ensure that, prior to employment and every three years thereafter, the criminal history of all child care providers is checked and a determination is made of the child care provider's fitness to have responsibility for the safety and well-being of children based on the criminal history. The Department shall ensure that all child care providers are checked for county, State, and federal criminal histories. Meeting compliance: Item 103 requires a follow-up visit per § 110-91. Mandatory standards for a license. Due to the nature of this violation, you may be considered for Administrative Action. Please submit a corrective action plan for item 1041 following the guidance below: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/23/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins Address: PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: On-going training On-going training period is based on each employee’s hiring date. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: Education and experience of four-year degree or higher advanced degree in a child care related field of study from a regionally accredited college or university is required to complete 5 clock hours. Education and experience of two-year degree in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Administration Credential is required to complete 8 clock hours. Education and experience of certificate or diploma in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Credential is required to complete 10 clock hours. Education and experience of 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement is required to complete 15 clock hours. If none of the other criteria in this chart apply, 20 clock hours of on-going training is required. (d) Any staff working less than 40 hours per week may choose to complete on-going training requirements as outlined in Paragraph (a) of this Rule, or the training requirement may be prorated as follows: If working hours per week is 0-10 hours, 5 clock hours of on-going training is required. If working hours per week is 11-20 hours, 10 clock hours of on-going training is required. If working hours per week is 21-30 hours, 15 clock hours of on-going training is required. If working hours per week is 31-40 hours, 20 clock hours of on-going training is required. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1103 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 8/9/2024 Number Present: 106 Completed Date: 8/9/2024 Age: From 6 To 12 Total Minutes: 243 Time In: 08:52 AM Time Out: 12:55 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaoru Eddins, Child Care Consultant and also signed by Brooklyn Wise, Program Coordinator, during the visit. A signed copy of the visit summary was electronically emailed to Delaney Burke, Senior Operations Director. Today, Ms. Burke accompanied me. The indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89) percent as of 8/9/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, the Young Men’s Christian Association of Western North Carolina, Inc., is current/active as of today prior to this visit. Permit type – Five-star center license issued on 2/24/23. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space, playground area does not meet child care playground safety requirements, children prohibited from occupying kitchen area for any reason. The last annual compliance visit was conducted on 9/12/23. The last fire drill was practiced on 7/21/24. The last shelter-in-place drill was practiced on 6/4/24. The last fire inspection was approved on 1/26/24. The last sanitation inspection was conducted on 9/15/23 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. I observed the children. The children from Group #1 had breakfast in the cafeteria. Today’s menu was a donut, orange/pineapple juice and milk. No medications were maintained for this group. The children from Group#2 transitioned from the gym to cafeteria for breakfast. The group used the bathroom and washed their hands prior to transitioning to the cafeteria. Epi-pen was maintained in the backpack for a child. The permission form and the action plan were current. The children from Group #3 also transitioned to cafeteria for breakfast. There were three (3) emergency medications maintained in the backpack. All the action plans and permission forms were current. The children in Group #4 transitioned from inside to morning walk. One (1) medication was maintained in the backpack. The action plan and the permission form were current. The children in Group #5 played on the blacktop. They played basketball game. No medications were maintained for this group. The children in Group #6 played on the playground #1. Some children sat on the pillows and talked, and the other children were on the swings. No medications were maintained for this group. The children from Group #7 played on the playground #2. They played with gross motor equipment, such as swings and monkey bars. Some children played a game on the grass area. No hazardous products were found in the licensed areas and the playground. Supervision and interaction were adequate. Five (5) new staff files and one (1) staff file were monitored in full. Three(3) staff files were monitored partially for missing dates and expired documents. For the missing information, on-going training documents, expired emergency information form and BSAC certificate were monitored, and they were current and in compliance. There were three (3) new staff members who received the medical statements and TB screening after the hire date. YMCA programs often re-hires seasonal staff members. Per HR policy, all employees’ employment status is terminated when they leave the program in-between seasons. However, the program used the past orientation documents, medical statement, TB screening and other documents for the re-hired employees. This was discussed during a routine unannounced visit to YMCA W.W. Estes Afterschool conducted on 7/24/24. Per discussion, each employee whose employment status expires for ninety (90) days shall receive new orientation. Medical Statement and TB screening shall be reused if they were obtained less than twelve (12) months prior to the new employment date. Those three (3) employees had to renew their medical statement and TB screening based on the rule. Since this matter was recently discussed and the program corrected the matter as soon as they found out about the rules, violations on medical statement and TB screening were not cited during today’s visit. Medical statement and TB screening for the staff member hired on 9/24/21 were recently renewed. Per Ms. Burke, the documents were lost during recent file transfer. This staff member’s files were monitored during annual compliance visit conducted on 9/12/23, and the medical statement and the TB screening documents were verified then. One (1) staff member who was present today was not listed on the Staff and Training worksheet. The staff member's file was monitored by me during the routine unannounced visit conducted at YMCA W.W. Estes Afterschool on 7/26/24. Seventeen (17) children’s files were monitored and in compliance. There were a total of one hundred and six (106) children present. Per facility's license, the capacity for this program is one hundred (100). I had a conversation to submit the request to increase the program capacity with Ms. Burke. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. The transportations for YMCA programs were monitored on 6/4/24. The following violations were documented during today’s visit: Violation Number Comment Rule 103 The number of children present was not within permit capacity. There were a total of one hundred and six (106) children present during the visit, and the facility's capacity is one hundred (100). GS 110-91(7) & .1401(f) 1041 Prior to employment a Criminal Background Check was not completed. The staff member hired on 5/20/24 did not receive criminal background letter until 5/21/24. Per interview with Ms. Burke, the employee complete YMCA background check and started on the orientation process on 5/20/24. G.S. 110-90.2(b) Technical assistance was provided as follows: 103: Capacity The capacity of the facility shall be maintained at all times including during the summer camp. § 110-91. Mandatory standards for a license. (7) Staff-Child Ratio and Capacity for Child Care Facilities. – In determining the staff-child ratio in child care facilities, all children younger than 13 years old shall be counted. 1041: Criminal Background check Criminal background check shall be completed prior to employment. The qualification letter shall be in the staff files on or before the first day of employment as well. § 110-90.2. Mandatory child care providers' criminal history checks. (b) Effective January 1, 1996, the Department shall ensure that, prior to employment and every three years thereafter, the criminal history of all child care providers is checked and a determination is made of the child care provider's fitness to have responsibility for the safety and well-being of children based on the criminal history. The Department shall ensure that all child care providers are checked for county, State, and federal criminal histories. Meeting compliance: Item 103 requires a follow-up visit per § 110-91. Mandatory standards for a license. Due to the nature of this violation, you may be considered for Administrative Action. Please submit a corrective action plan for item 1041 following the guidance below: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/23/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins Address: PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: On-going training On-going training period is based on each employee’s hiring date. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: Education and experience of four-year degree or higher advanced degree in a child care related field of study from a regionally accredited college or university is required to complete 5 clock hours. Education and experience of two-year degree in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Administration Credential is required to complete 8 clock hours. Education and experience of certificate or diploma in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Credential is required to complete 10 clock hours. Education and experience of 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement is required to complete 15 clock hours. If none of the other criteria in this chart apply, 20 clock hours of on-going training is required. (d) Any staff working less than 40 hours per week may choose to complete on-going training requirements as outlined in Paragraph (a) of this Rule, or the training requirement may be prorated as follows: If working hours per week is 0-10 hours, 5 clock hours of on-going training is required. If working hours per week is 11-20 hours, 10 clock hours of on-going training is required. If working hours per week is 21-30 hours, 15 clock hours of on-going training is required. If working hours per week is 31-40 hours, 20 clock hours of on-going training is required. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 8/9/2024 Number Present: 106 Completed Date: 8/9/2024 Age: From 6 To 12 Total Minutes: 243 Time In: 08:52 AM Time Out: 12:55 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaoru Eddins, Child Care Consultant and also signed by Brooklyn Wise, Program Coordinator, during the visit. A signed copy of the visit summary was electronically emailed to Delaney Burke, Senior Operations Director. Today, Ms. Burke accompanied me. The indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89) percent as of 8/9/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, the Young Men’s Christian Association of Western North Carolina, Inc., is current/active as of today prior to this visit. Permit type – Five-star center license issued on 2/24/23. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space, playground area does not meet child care playground safety requirements, children prohibited from occupying kitchen area for any reason. The last annual compliance visit was conducted on 9/12/23. The last fire drill was practiced on 7/21/24. The last shelter-in-place drill was practiced on 6/4/24. The last fire inspection was approved on 1/26/24. The last sanitation inspection was conducted on 9/15/23 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. I observed the children. The children from Group #1 had breakfast in the cafeteria. Today’s menu was a donut, orange/pineapple juice and milk. No medications were maintained for this group. The children from Group#2 transitioned from the gym to cafeteria for breakfast. The group used the bathroom and washed their hands prior to transitioning to the cafeteria. Epi-pen was maintained in the backpack for a child. The permission form and the action plan were current. The children from Group #3 also transitioned to cafeteria for breakfast. There were three (3) emergency medications maintained in the backpack. All the action plans and permission forms were current. The children in Group #4 transitioned from inside to morning walk. One (1) medication was maintained in the backpack. The action plan and the permission form were current. The children in Group #5 played on the blacktop. They played basketball game. No medications were maintained for this group. The children in Group #6 played on the playground #1. Some children sat on the pillows and talked, and the other children were on the swings. No medications were maintained for this group. The children from Group #7 played on the playground #2. They played with gross motor equipment, such as swings and monkey bars. Some children played a game on the grass area. No hazardous products were found in the licensed areas and the playground. Supervision and interaction were adequate. Five (5) new staff files and one (1) staff file were monitored in full. Three(3) staff files were monitored partially for missing dates and expired documents. For the missing information, on-going training documents, expired emergency information form and BSAC certificate were monitored, and they were current and in compliance. There were three (3) new staff members who received the medical statements and TB screening after the hire date. YMCA programs often re-hires seasonal staff members. Per HR policy, all employees’ employment status is terminated when they leave the program in-between seasons. However, the program used the past orientation documents, medical statement, TB screening and other documents for the re-hired employees. This was discussed during a routine unannounced visit to YMCA W.W. Estes Afterschool conducted on 7/24/24. Per discussion, each employee whose employment status expires for ninety (90) days shall receive new orientation. Medical Statement and TB screening shall be reused if they were obtained less than twelve (12) months prior to the new employment date. Those three (3) employees had to renew their medical statement and TB screening based on the rule. Since this matter was recently discussed and the program corrected the matter as soon as they found out about the rules, violations on medical statement and TB screening were not cited during today’s visit. Medical statement and TB screening for the staff member hired on 9/24/21 were recently renewed. Per Ms. Burke, the documents were lost during recent file transfer. This staff member’s files were monitored during annual compliance visit conducted on 9/12/23, and the medical statement and the TB screening documents were verified then. One (1) staff member who was present today was not listed on the Staff and Training worksheet. The staff member's file was monitored by me during the routine unannounced visit conducted at YMCA W.W. Estes Afterschool on 7/26/24. Seventeen (17) children’s files were monitored and in compliance. There were a total of one hundred and six (106) children present. Per facility's license, the capacity for this program is one hundred (100). I had a conversation to submit the request to increase the program capacity with Ms. Burke. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. The transportations for YMCA programs were monitored on 6/4/24. The following violations were documented during today’s visit: Violation Number Comment Rule 103 The number of children present was not within permit capacity. There were a total of one hundred and six (106) children present during the visit, and the facility's capacity is one hundred (100). GS 110-91(7) & .1401(f) 1041 Prior to employment a Criminal Background Check was not completed. The staff member hired on 5/20/24 did not receive criminal background letter until 5/21/24. Per interview with Ms. Burke, the employee complete YMCA background check and started on the orientation process on 5/20/24. G.S. 110-90.2(b) Technical assistance was provided as follows: 103: Capacity The capacity of the facility shall be maintained at all times including during the summer camp. § 110-91. Mandatory standards for a license. (7) Staff-Child Ratio and Capacity for Child Care Facilities. – In determining the staff-child ratio in child care facilities, all children younger than 13 years old shall be counted. 1041: Criminal Background check Criminal background check shall be completed prior to employment. The qualification letter shall be in the staff files on or before the first day of employment as well. § 110-90.2. Mandatory child care providers' criminal history checks. (b) Effective January 1, 1996, the Department shall ensure that, prior to employment and every three years thereafter, the criminal history of all child care providers is checked and a determination is made of the child care provider's fitness to have responsibility for the safety and well-being of children based on the criminal history. The Department shall ensure that all child care providers are checked for county, State, and federal criminal histories. Meeting compliance: Item 103 requires a follow-up visit per § 110-91. Mandatory standards for a license. Due to the nature of this violation, you may be considered for Administrative Action. Please submit a corrective action plan for item 1041 following the guidance below: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/23/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins Address: PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: On-going training On-going training period is based on each employee’s hiring date. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: Education and experience of four-year degree or higher advanced degree in a child care related field of study from a regionally accredited college or university is required to complete 5 clock hours. Education and experience of two-year degree in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Administration Credential is required to complete 8 clock hours. Education and experience of certificate or diploma in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Credential is required to complete 10 clock hours. Education and experience of 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement is required to complete 15 clock hours. If none of the other criteria in this chart apply, 20 clock hours of on-going training is required. (d) Any staff working less than 40 hours per week may choose to complete on-going training requirements as outlined in Paragraph (a) of this Rule, or the training requirement may be prorated as follows: If working hours per week is 0-10 hours, 5 clock hours of on-going training is required. If working hours per week is 11-20 hours, 10 clock hours of on-going training is required. If working hours per week is 21-30 hours, 15 clock hours of on-going training is required. If working hours per week is 31-40 hours, 20 clock hours of on-going training is required. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 8/9/2024 Number Present: 106 Completed Date: 8/9/2024 Age: From 6 To 12 Total Minutes: 243 Time In: 08:52 AM Time Out: 12:55 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaoru Eddins, Child Care Consultant and also signed by Brooklyn Wise, Program Coordinator, during the visit. A signed copy of the visit summary was electronically emailed to Delaney Burke, Senior Operations Director. Today, Ms. Burke accompanied me. The indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89) percent as of 8/9/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, the Young Men’s Christian Association of Western North Carolina, Inc., is current/active as of today prior to this visit. Permit type – Five-star center license issued on 2/24/23. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space, playground area does not meet child care playground safety requirements, children prohibited from occupying kitchen area for any reason. The last annual compliance visit was conducted on 9/12/23. The last fire drill was practiced on 7/21/24. The last shelter-in-place drill was practiced on 6/4/24. The last fire inspection was approved on 1/26/24. The last sanitation inspection was conducted on 9/15/23 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. I observed the children. The children from Group #1 had breakfast in the cafeteria. Today’s menu was a donut, orange/pineapple juice and milk. No medications were maintained for this group. The children from Group#2 transitioned from the gym to cafeteria for breakfast. The group used the bathroom and washed their hands prior to transitioning to the cafeteria. Epi-pen was maintained in the backpack for a child. The permission form and the action plan were current. The children from Group #3 also transitioned to cafeteria for breakfast. There were three (3) emergency medications maintained in the backpack. All the action plans and permission forms were current. The children in Group #4 transitioned from inside to morning walk. One (1) medication was maintained in the backpack. The action plan and the permission form were current. The children in Group #5 played on the blacktop. They played basketball game. No medications were maintained for this group. The children in Group #6 played on the playground #1. Some children sat on the pillows and talked, and the other children were on the swings. No medications were maintained for this group. The children from Group #7 played on the playground #2. They played with gross motor equipment, such as swings and monkey bars. Some children played a game on the grass area. No hazardous products were found in the licensed areas and the playground. Supervision and interaction were adequate. Five (5) new staff files and one (1) staff file were monitored in full. Three(3) staff files were monitored partially for missing dates and expired documents. For the missing information, on-going training documents, expired emergency information form and BSAC certificate were monitored, and they were current and in compliance. There were three (3) new staff members who received the medical statements and TB screening after the hire date. YMCA programs often re-hires seasonal staff members. Per HR policy, all employees’ employment status is terminated when they leave the program in-between seasons. However, the program used the past orientation documents, medical statement, TB screening and other documents for the re-hired employees. This was discussed during a routine unannounced visit to YMCA W.W. Estes Afterschool conducted on 7/24/24. Per discussion, each employee whose employment status expires for ninety (90) days shall receive new orientation. Medical Statement and TB screening shall be reused if they were obtained less than twelve (12) months prior to the new employment date. Those three (3) employees had to renew their medical statement and TB screening based on the rule. Since this matter was recently discussed and the program corrected the matter as soon as they found out about the rules, violations on medical statement and TB screening were not cited during today’s visit. Medical statement and TB screening for the staff member hired on 9/24/21 were recently renewed. Per Ms. Burke, the documents were lost during recent file transfer. This staff member’s files were monitored during annual compliance visit conducted on 9/12/23, and the medical statement and the TB screening documents were verified then. One (1) staff member who was present today was not listed on the Staff and Training worksheet. The staff member's file was monitored by me during the routine unannounced visit conducted at YMCA W.W. Estes Afterschool on 7/26/24. Seventeen (17) children’s files were monitored and in compliance. There were a total of one hundred and six (106) children present. Per facility's license, the capacity for this program is one hundred (100). I had a conversation to submit the request to increase the program capacity with Ms. Burke. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. The transportations for YMCA programs were monitored on 6/4/24. The following violations were documented during today’s visit: Violation Number Comment Rule 103 The number of children present was not within permit capacity. There were a total of one hundred and six (106) children present during the visit, and the facility's capacity is one hundred (100). GS 110-91(7) & .1401(f) 1041 Prior to employment a Criminal Background Check was not completed. The staff member hired on 5/20/24 did not receive criminal background letter until 5/21/24. Per interview with Ms. Burke, the employee complete YMCA background check and started on the orientation process on 5/20/24. G.S. 110-90.2(b) Technical assistance was provided as follows: 103: Capacity The capacity of the facility shall be maintained at all times including during the summer camp. § 110-91. Mandatory standards for a license. (7) Staff-Child Ratio and Capacity for Child Care Facilities. – In determining the staff-child ratio in child care facilities, all children younger than 13 years old shall be counted. 1041: Criminal Background check Criminal background check shall be completed prior to employment. The qualification letter shall be in the staff files on or before the first day of employment as well. § 110-90.2. Mandatory child care providers' criminal history checks. (b) Effective January 1, 1996, the Department shall ensure that, prior to employment and every three years thereafter, the criminal history of all child care providers is checked and a determination is made of the child care provider's fitness to have responsibility for the safety and well-being of children based on the criminal history. The Department shall ensure that all child care providers are checked for county, State, and federal criminal histories. Meeting compliance: Item 103 requires a follow-up visit per § 110-91. Mandatory standards for a license. Due to the nature of this violation, you may be considered for Administrative Action. Please submit a corrective action plan for item 1041 following the guidance below: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/23/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins Address: PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: On-going training On-going training period is based on each employee’s hiring date. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: Education and experience of four-year degree or higher advanced degree in a child care related field of study from a regionally accredited college or university is required to complete 5 clock hours. Education and experience of two-year degree in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Administration Credential is required to complete 8 clock hours. Education and experience of certificate or diploma in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Credential is required to complete 10 clock hours. Education and experience of 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement is required to complete 15 clock hours. If none of the other criteria in this chart apply, 20 clock hours of on-going training is required. (d) Any staff working less than 40 hours per week may choose to complete on-going training requirements as outlined in Paragraph (a) of this Rule, or the training requirement may be prorated as follows: If working hours per week is 0-10 hours, 5 clock hours of on-going training is required. If working hours per week is 11-20 hours, 10 clock hours of on-going training is required. If working hours per week is 21-30 hours, 15 clock hours of on-going training is required. If working hours per week is 31-40 hours, 20 clock hours of on-going training is required. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 8/9/2024 Number Present: 106 Completed Date: 8/9/2024 Age: From 6 To 12 Total Minutes: 243 Time In: 08:52 AM Time Out: 12:55 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaoru Eddins, Child Care Consultant and also signed by Brooklyn Wise, Program Coordinator, during the visit. A signed copy of the visit summary was electronically emailed to Delaney Burke, Senior Operations Director. Today, Ms. Burke accompanied me. The indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89) percent as of 8/9/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, the Young Men’s Christian Association of Western North Carolina, Inc., is current/active as of today prior to this visit. Permit type – Five-star center license issued on 2/24/23. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space, playground area does not meet child care playground safety requirements, children prohibited from occupying kitchen area for any reason. The last annual compliance visit was conducted on 9/12/23. The last fire drill was practiced on 7/21/24. The last shelter-in-place drill was practiced on 6/4/24. The last fire inspection was approved on 1/26/24. The last sanitation inspection was conducted on 9/15/23 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. I observed the children. The children from Group #1 had breakfast in the cafeteria. Today’s menu was a donut, orange/pineapple juice and milk. No medications were maintained for this group. The children from Group#2 transitioned from the gym to cafeteria for breakfast. The group used the bathroom and washed their hands prior to transitioning to the cafeteria. Epi-pen was maintained in the backpack for a child. The permission form and the action plan were current. The children from Group #3 also transitioned to cafeteria for breakfast. There were three (3) emergency medications maintained in the backpack. All the action plans and permission forms were current. The children in Group #4 transitioned from inside to morning walk. One (1) medication was maintained in the backpack. The action plan and the permission form were current. The children in Group #5 played on the blacktop. They played basketball game. No medications were maintained for this group. The children in Group #6 played on the playground #1. Some children sat on the pillows and talked, and the other children were on the swings. No medications were maintained for this group. The children from Group #7 played on the playground #2. They played with gross motor equipment, such as swings and monkey bars. Some children played a game on the grass area. No hazardous products were found in the licensed areas and the playground. Supervision and interaction were adequate. Five (5) new staff files and one (1) staff file were monitored in full. Three(3) staff files were monitored partially for missing dates and expired documents. For the missing information, on-going training documents, expired emergency information form and BSAC certificate were monitored, and they were current and in compliance. There were three (3) new staff members who received the medical statements and TB screening after the hire date. YMCA programs often re-hires seasonal staff members. Per HR policy, all employees’ employment status is terminated when they leave the program in-between seasons. However, the program used the past orientation documents, medical statement, TB screening and other documents for the re-hired employees. This was discussed during a routine unannounced visit to YMCA W.W. Estes Afterschool conducted on 7/24/24. Per discussion, each employee whose employment status expires for ninety (90) days shall receive new orientation. Medical Statement and TB screening shall be reused if they were obtained less than twelve (12) months prior to the new employment date. Those three (3) employees had to renew their medical statement and TB screening based on the rule. Since this matter was recently discussed and the program corrected the matter as soon as they found out about the rules, violations on medical statement and TB screening were not cited during today’s visit. Medical statement and TB screening for the staff member hired on 9/24/21 were recently renewed. Per Ms. Burke, the documents were lost during recent file transfer. This staff member’s files were monitored during annual compliance visit conducted on 9/12/23, and the medical statement and the TB screening documents were verified then. One (1) staff member who was present today was not listed on the Staff and Training worksheet. The staff member's file was monitored by me during the routine unannounced visit conducted at YMCA W.W. Estes Afterschool on 7/26/24. Seventeen (17) children’s files were monitored and in compliance. There were a total of one hundred and six (106) children present. Per facility's license, the capacity for this program is one hundred (100). I had a conversation to submit the request to increase the program capacity with Ms. Burke. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. The transportations for YMCA programs were monitored on 6/4/24. The following violations were documented during today’s visit: Violation Number Comment Rule 103 The number of children present was not within permit capacity. There were a total of one hundred and six (106) children present during the visit, and the facility's capacity is one hundred (100). GS 110-91(7) & .1401(f) 1041 Prior to employment a Criminal Background Check was not completed. The staff member hired on 5/20/24 did not receive criminal background letter until 5/21/24. Per interview with Ms. Burke, the employee complete YMCA background check and started on the orientation process on 5/20/24. G.S. 110-90.2(b) Technical assistance was provided as follows: 103: Capacity The capacity of the facility shall be maintained at all times including during the summer camp. § 110-91. Mandatory standards for a license. (7) Staff-Child Ratio and Capacity for Child Care Facilities. – In determining the staff-child ratio in child care facilities, all children younger than 13 years old shall be counted. 1041: Criminal Background check Criminal background check shall be completed prior to employment. The qualification letter shall be in the staff files on or before the first day of employment as well. § 110-90.2. Mandatory child care providers' criminal history checks. (b) Effective January 1, 1996, the Department shall ensure that, prior to employment and every three years thereafter, the criminal history of all child care providers is checked and a determination is made of the child care provider's fitness to have responsibility for the safety and well-being of children based on the criminal history. The Department shall ensure that all child care providers are checked for county, State, and federal criminal histories. Meeting compliance: Item 103 requires a follow-up visit per § 110-91. Mandatory standards for a license. Due to the nature of this violation, you may be considered for Administrative Action. Please submit a corrective action plan for item 1041 following the guidance below: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/23/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins Address: PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: On-going training On-going training period is based on each employee’s hiring date. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: Education and experience of four-year degree or higher advanced degree in a child care related field of study from a regionally accredited college or university is required to complete 5 clock hours. Education and experience of two-year degree in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Administration Credential is required to complete 8 clock hours. Education and experience of certificate or diploma in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Credential is required to complete 10 clock hours. Education and experience of 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement is required to complete 15 clock hours. If none of the other criteria in this chart apply, 20 clock hours of on-going training is required. (d) Any staff working less than 40 hours per week may choose to complete on-going training requirements as outlined in Paragraph (a) of this Rule, or the training requirement may be prorated as follows: If working hours per week is 0-10 hours, 5 clock hours of on-going training is required. If working hours per week is 11-20 hours, 10 clock hours of on-going training is required. If working hours per week is 21-30 hours, 15 clock hours of on-going training is required. If working hours per week is 31-40 hours, 20 clock hours of on-going training is required. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-91 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 8/9/2024 Number Present: 106 Completed Date: 8/9/2024 Age: From 6 To 12 Total Minutes: 243 Time In: 08:52 AM Time Out: 12:55 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaoru Eddins, Child Care Consultant and also signed by Brooklyn Wise, Program Coordinator, during the visit. A signed copy of the visit summary was electronically emailed to Delaney Burke, Senior Operations Director. Today, Ms. Burke accompanied me. The indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89) percent as of 8/9/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, the Young Men’s Christian Association of Western North Carolina, Inc., is current/active as of today prior to this visit. Permit type – Five-star center license issued on 2/24/23. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space, playground area does not meet child care playground safety requirements, children prohibited from occupying kitchen area for any reason. The last annual compliance visit was conducted on 9/12/23. The last fire drill was practiced on 7/21/24. The last shelter-in-place drill was practiced on 6/4/24. The last fire inspection was approved on 1/26/24. The last sanitation inspection was conducted on 9/15/23 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. I observed the children. The children from Group #1 had breakfast in the cafeteria. Today’s menu was a donut, orange/pineapple juice and milk. No medications were maintained for this group. The children from Group#2 transitioned from the gym to cafeteria for breakfast. The group used the bathroom and washed their hands prior to transitioning to the cafeteria. Epi-pen was maintained in the backpack for a child. The permission form and the action plan were current. The children from Group #3 also transitioned to cafeteria for breakfast. There were three (3) emergency medications maintained in the backpack. All the action plans and permission forms were current. The children in Group #4 transitioned from inside to morning walk. One (1) medication was maintained in the backpack. The action plan and the permission form were current. The children in Group #5 played on the blacktop. They played basketball game. No medications were maintained for this group. The children in Group #6 played on the playground #1. Some children sat on the pillows and talked, and the other children were on the swings. No medications were maintained for this group. The children from Group #7 played on the playground #2. They played with gross motor equipment, such as swings and monkey bars. Some children played a game on the grass area. No hazardous products were found in the licensed areas and the playground. Supervision and interaction were adequate. Five (5) new staff files and one (1) staff file were monitored in full. Three(3) staff files were monitored partially for missing dates and expired documents. For the missing information, on-going training documents, expired emergency information form and BSAC certificate were monitored, and they were current and in compliance. There were three (3) new staff members who received the medical statements and TB screening after the hire date. YMCA programs often re-hires seasonal staff members. Per HR policy, all employees’ employment status is terminated when they leave the program in-between seasons. However, the program used the past orientation documents, medical statement, TB screening and other documents for the re-hired employees. This was discussed during a routine unannounced visit to YMCA W.W. Estes Afterschool conducted on 7/24/24. Per discussion, each employee whose employment status expires for ninety (90) days shall receive new orientation. Medical Statement and TB screening shall be reused if they were obtained less than twelve (12) months prior to the new employment date. Those three (3) employees had to renew their medical statement and TB screening based on the rule. Since this matter was recently discussed and the program corrected the matter as soon as they found out about the rules, violations on medical statement and TB screening were not cited during today’s visit. Medical statement and TB screening for the staff member hired on 9/24/21 were recently renewed. Per Ms. Burke, the documents were lost during recent file transfer. This staff member’s files were monitored during annual compliance visit conducted on 9/12/23, and the medical statement and the TB screening documents were verified then. One (1) staff member who was present today was not listed on the Staff and Training worksheet. The staff member's file was monitored by me during the routine unannounced visit conducted at YMCA W.W. Estes Afterschool on 7/26/24. Seventeen (17) children’s files were monitored and in compliance. There were a total of one hundred and six (106) children present. Per facility's license, the capacity for this program is one hundred (100). I had a conversation to submit the request to increase the program capacity with Ms. Burke. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. The transportations for YMCA programs were monitored on 6/4/24. The following violations were documented during today’s visit: Violation Number Comment Rule 103 The number of children present was not within permit capacity. There were a total of one hundred and six (106) children present during the visit, and the facility's capacity is one hundred (100). GS 110-91(7) & .1401(f) 1041 Prior to employment a Criminal Background Check was not completed. The staff member hired on 5/20/24 did not receive criminal background letter until 5/21/24. Per interview with Ms. Burke, the employee complete YMCA background check and started on the orientation process on 5/20/24. G.S. 110-90.2(b) Technical assistance was provided as follows: 103: Capacity The capacity of the facility shall be maintained at all times including during the summer camp. § 110-91. Mandatory standards for a license. (7) Staff-Child Ratio and Capacity for Child Care Facilities. – In determining the staff-child ratio in child care facilities, all children younger than 13 years old shall be counted. 1041: Criminal Background check Criminal background check shall be completed prior to employment. The qualification letter shall be in the staff files on or before the first day of employment as well. § 110-90.2. Mandatory child care providers' criminal history checks. (b) Effective January 1, 1996, the Department shall ensure that, prior to employment and every three years thereafter, the criminal history of all child care providers is checked and a determination is made of the child care provider's fitness to have responsibility for the safety and well-being of children based on the criminal history. The Department shall ensure that all child care providers are checked for county, State, and federal criminal histories. Meeting compliance: Item 103 requires a follow-up visit per § 110-91. Mandatory standards for a license. Due to the nature of this violation, you may be considered for Administrative Action. Please submit a corrective action plan for item 1041 following the guidance below: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/23/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins Address: PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: On-going training On-going training period is based on each employee’s hiring date. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: Education and experience of four-year degree or higher advanced degree in a child care related field of study from a regionally accredited college or university is required to complete 5 clock hours. Education and experience of two-year degree in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Administration Credential is required to complete 8 clock hours. Education and experience of certificate or diploma in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Credential is required to complete 10 clock hours. Education and experience of 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement is required to complete 15 clock hours. If none of the other criteria in this chart apply, 20 clock hours of on-going training is required. (d) Any staff working less than 40 hours per week may choose to complete on-going training requirements as outlined in Paragraph (a) of this Rule, or the training requirement may be prorated as follows: If working hours per week is 0-10 hours, 5 clock hours of on-going training is required. If working hours per week is 11-20 hours, 10 clock hours of on-going training is required. If working hours per week is 21-30 hours, 15 clock hours of on-going training is required. If working hours per week is 31-40 hours, 20 clock hours of on-going training is required. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 8/9/2024 Number Present: 106 Completed Date: 8/9/2024 Age: From 6 To 12 Total Minutes: 243 Time In: 08:52 AM Time Out: 12:55 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaoru Eddins, Child Care Consultant and also signed by Brooklyn Wise, Program Coordinator, during the visit. A signed copy of the visit summary was electronically emailed to Delaney Burke, Senior Operations Director. Today, Ms. Burke accompanied me. The indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89) percent as of 8/9/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, the Young Men’s Christian Association of Western North Carolina, Inc., is current/active as of today prior to this visit. Permit type – Five-star center license issued on 2/24/23. Special Services/Restrictions – daytime care, school-age only, meets enhanced ratios and space, playground area does not meet child care playground safety requirements, children prohibited from occupying kitchen area for any reason. The last annual compliance visit was conducted on 9/12/23. The last fire drill was practiced on 7/21/24. The last shelter-in-place drill was practiced on 6/4/24. The last fire inspection was approved on 1/26/24. The last sanitation inspection was conducted on 9/15/23 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. I observed the children. The children from Group #1 had breakfast in the cafeteria. Today’s menu was a donut, orange/pineapple juice and milk. No medications were maintained for this group. The children from Group#2 transitioned from the gym to cafeteria for breakfast. The group used the bathroom and washed their hands prior to transitioning to the cafeteria. Epi-pen was maintained in the backpack for a child. The permission form and the action plan were current. The children from Group #3 also transitioned to cafeteria for breakfast. There were three (3) emergency medications maintained in the backpack. All the action plans and permission forms were current. The children in Group #4 transitioned from inside to morning walk. One (1) medication was maintained in the backpack. The action plan and the permission form were current. The children in Group #5 played on the blacktop. They played basketball game. No medications were maintained for this group. The children in Group #6 played on the playground #1. Some children sat on the pillows and talked, and the other children were on the swings. No medications were maintained for this group. The children from Group #7 played on the playground #2. They played with gross motor equipment, such as swings and monkey bars. Some children played a game on the grass area. No hazardous products were found in the licensed areas and the playground. Supervision and interaction were adequate. Five (5) new staff files and one (1) staff file were monitored in full. Three(3) staff files were monitored partially for missing dates and expired documents. For the missing information, on-going training documents, expired emergency information form and BSAC certificate were monitored, and they were current and in compliance. There were three (3) new staff members who received the medical statements and TB screening after the hire date. YMCA programs often re-hires seasonal staff members. Per HR policy, all employees’ employment status is terminated when they leave the program in-between seasons. However, the program used the past orientation documents, medical statement, TB screening and other documents for the re-hired employees. This was discussed during a routine unannounced visit to YMCA W.W. Estes Afterschool conducted on 7/24/24. Per discussion, each employee whose employment status expires for ninety (90) days shall receive new orientation. Medical Statement and TB screening shall be reused if they were obtained less than twelve (12) months prior to the new employment date. Those three (3) employees had to renew their medical statement and TB screening based on the rule. Since this matter was recently discussed and the program corrected the matter as soon as they found out about the rules, violations on medical statement and TB screening were not cited during today’s visit. Medical statement and TB screening for the staff member hired on 9/24/21 were recently renewed. Per Ms. Burke, the documents were lost during recent file transfer. This staff member’s files were monitored during annual compliance visit conducted on 9/12/23, and the medical statement and the TB screening documents were verified then. One (1) staff member who was present today was not listed on the Staff and Training worksheet. The staff member's file was monitored by me during the routine unannounced visit conducted at YMCA W.W. Estes Afterschool on 7/26/24. Seventeen (17) children’s files were monitored and in compliance. There were a total of one hundred and six (106) children present. Per facility's license, the capacity for this program is one hundred (100). I had a conversation to submit the request to increase the program capacity with Ms. Burke. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. The transportations for YMCA programs were monitored on 6/4/24. The following violations were documented during today’s visit: Violation Number Comment Rule 103 The number of children present was not within permit capacity. There were a total of one hundred and six (106) children present during the visit, and the facility's capacity is one hundred (100). GS 110-91(7) & .1401(f) 1041 Prior to employment a Criminal Background Check was not completed. The staff member hired on 5/20/24 did not receive criminal background letter until 5/21/24. Per interview with Ms. Burke, the employee complete YMCA background check and started on the orientation process on 5/20/24. G.S. 110-90.2(b) Technical assistance was provided as follows: 103: Capacity The capacity of the facility shall be maintained at all times including during the summer camp. § 110-91. Mandatory standards for a license. (7) Staff-Child Ratio and Capacity for Child Care Facilities. – In determining the staff-child ratio in child care facilities, all children younger than 13 years old shall be counted. 1041: Criminal Background check Criminal background check shall be completed prior to employment. The qualification letter shall be in the staff files on or before the first day of employment as well. § 110-90.2. Mandatory child care providers' criminal history checks. (b) Effective January 1, 1996, the Department shall ensure that, prior to employment and every three years thereafter, the criminal history of all child care providers is checked and a determination is made of the child care provider's fitness to have responsibility for the safety and well-being of children based on the criminal history. The Department shall ensure that all child care providers are checked for county, State, and federal criminal histories. Meeting compliance: Item 103 requires a follow-up visit per § 110-91. Mandatory standards for a license. Due to the nature of this violation, you may be considered for Administrative Action. Please submit a corrective action plan for item 1041 following the guidance below: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/23/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins Address: PO Box 795 Pisgah Forest, NC 28768 Please call me at 828-556-9013, or email kaoru.eddins@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: On-going training On-going training period is based on each employee’s hiring date. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: Education and experience of four-year degree or higher advanced degree in a child care related field of study from a regionally accredited college or university is required to complete 5 clock hours. Education and experience of two-year degree in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Administration Credential is required to complete 8 clock hours. Education and experience of certificate or diploma in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Credential is required to complete 10 clock hours. Education and experience of 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement is required to complete 15 clock hours. If none of the other criteria in this chart apply, 20 clock hours of on-going training is required. (d) Any staff working less than 40 hours per week may choose to complete on-going training requirements as outlined in Paragraph (a) of this Rule, or the training requirement may be prorated as follows: If working hours per week is 0-10 hours, 5 clock hours of on-going training is required. If working hours per week is 11-20 hours, 10 clock hours of on-going training is required. If working hours per week is 21-30 hours, 15 clock hours of on-going training is required. If working hours per week is 31-40 hours, 20 clock hours of on-going training is required. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0901 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 9/12/2023 Number Present: 44 Completed Date: 9/12/2023 Age: From 5 To 10 Total Minutes: 190 Time In: 02:20 PM Time Out: 05:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Lily Elder, Program Coordinator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Today, the Lily Elder, Program Coordinator, was available during the visit. Delaney Burke, Administrator met me on site and reviewed electronic staff files and children’s files with me. The indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven (87) percentage as of 9/8/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, The Young Men`s Christian Association of Western North Carolina, Inc. is current/active as of 9/8/23. Permit type – Five-star center license issued on 2/24/23. Special Services/Restrictions – daytime care, school age only, enhanced space and ratio, Playground area does not meet Child Care Playground safety requirements, children prohibited from occupying kitchen space for any reason. The last annual compliance visit was conducted on 9/22/22. The last fire drill was practiced on 8/29/23. The last shelter-in-place drill was practiced on 7/18/23. The last fire inspection was approved on 1/31/23. The last sanitation inspection was conducted on 9/28/22 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. There were three (3) groups. Upon arriving, the children washed hands in the bathroom and met in the cafeteria. All groups had snack. The menu was wheat tortilla, jelly, WOW butter, sunflower kernels, veggie blend juice, apple sauce and milk. The items were listed on the menu for Wednesday. Group one (1) played on the playground using swings, climbers, parachute and balls. Group two (2) played in the cafeteria with games, Legos, manipulative toys, BrainFlakes, beads, books and art materials. In the gym, group three (3) played with balls, games, manipulative toys, large pillows and bean bags. The group leader lead an discussion and talked about the project(s) each child is working on. Supervision of children and interaction were adequate. Two (2) new staff files and one (1) existing staff file were reviewed. There were various items missing in the electronic files. Orientation is typically conducted by a program coordinator, and the scanned documents are sent to the main office to upload into each staff file. Five (5) children’s files were monitored and in compliance. No children are currently on medication for this program. Transportations for this program is monitored separately. Therefore, it was not monitored during today’s visit. 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 528 Food substitution was not of comparable food value or recorded on the menu prior to the meal or snack being served. The snack items, wheat tortilla, jelly, WOW butter, vegetable blend juice, sunflower kernels, apple sauce and milk were serviced. Those items were listed on the Wednesdays menu. No corrections were made on the menu. 10A NCAC 09 .0901(b) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The EMC plan was not reviewed with a staff member hired on 8/28/23. 10A NCAC 09 .0802(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. TB information was not in staff file for a staff member hired on 6/27/23. .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Medical statement was not in staff file for a staff member hired on 6/27/23. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Emergency information form for a staff member hired on 12/5/22 and a staff member hired on 8/28/23 were not in the files. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. First six (6) weeks of orientation document was not in staff file forr a staff member hired on 8/28/23. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. First two (2) weeks of orientation information for a staff member hired on 8/28/23 was not in file. .1101(a)(b) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. The EPR plan was not reviewed with a staff member hired on 8/28/23. .0607(f) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A staff member hired on 12/5/22 did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) Technical assistance was provided as follows: 528: Substitution items on the menu Substitution items must be written on the menu prior to serving children. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (b) When food is prepared by or provided by the center, menus for nutritious meals and snacks shall be planned at least one week in advance. At least one dated copy of the current week's menu shall be posted where it can be seen by parents and food preparation staff when food is prepared or provided by the center. A variety of food shall be included in meals and snacks. Any substitution shall be of comparable food value and shall be recorded on the menu prior to the meal or snack being served. 862: Emergency Medical Care Plan (EMC) review EMC shall be reviewed with staff members annually. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (a) Each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. 1033: TB record Negative TB record shall be in each staff file prior to the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Tuberculin (TB) Test or Screening is the results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. It is required for all staff, including the director and individuals who volunteer more than once per week. Due date is on or before first day of work. 1034: Medical Statement Medical Statement shall be in each staff file prior to the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Medical Report is a statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. It is required for child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. The due date is prior to employment. When submitted, the medical statement shall not be older than 12 months. 1035: Emergency information form Emergency information form shall be in staff file on or before the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Emergency Information Form includes the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. It is required for child care providers, including the director, uncompensated providers, substitute providers, and volunteers. The due date is on or before the first day of work. The emergency information shall be updated as changes occur and at least annually. 1045: First six (6) weeks of orientation The record of first six (6) weeks of orientation shall be available for review. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. 1067: First two (2) weeks of orientation The record of first two (2) weeks of orientation shall be available for review. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. 1825: Emergency Preparedness and Response (EPR) plan review EPR plan shall be reviewed annually with staff members. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. 1897: Recognizing and Responding to Suspicions of Child Maltreatment The training shall be completed within ninety(90) days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/26/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest NC, 28768 Please call me at 828-556-9013, or email kaoru.eddins@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 is provided as follows: Orientation documents: Please review your operational policy for orientation and other staff file documents. Many documents are "missing" from the staff files frequently. Additional staff training and the review of your procedures may be necessary. Reminders: CPR/FA training is due to staff member hired on 6/27/23 on or prior to 9/25/23. CPR/FA training for a staff member hired on 8/28/23 is due on or before 11/2/34. BSAC shall be completed by the staff member hired on 6/27/23 on or before 9/27/23. BSAC training shall be completed by the staff member hired on 8/28/23 on or before 11/28/23. Sanitation inspection: Your last sanitation inspection was conducted on 9/28/22. Please contact your Environmental Health specialist to complete the inspection before 9/28/23. If you have any questions or concerns regarding the Stabilization, Expansion and Access Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0102 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 9/12/2023 Number Present: 44 Completed Date: 9/12/2023 Age: From 5 To 10 Total Minutes: 190 Time In: 02:20 PM Time Out: 05:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Lily Elder, Program Coordinator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Today, the Lily Elder, Program Coordinator, was available during the visit. Delaney Burke, Administrator met me on site and reviewed electronic staff files and children’s files with me. The indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven (87) percentage as of 9/8/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, The Young Men`s Christian Association of Western North Carolina, Inc. is current/active as of 9/8/23. Permit type – Five-star center license issued on 2/24/23. Special Services/Restrictions – daytime care, school age only, enhanced space and ratio, Playground area does not meet Child Care Playground safety requirements, children prohibited from occupying kitchen space for any reason. The last annual compliance visit was conducted on 9/22/22. The last fire drill was practiced on 8/29/23. The last shelter-in-place drill was practiced on 7/18/23. The last fire inspection was approved on 1/31/23. The last sanitation inspection was conducted on 9/28/22 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. There were three (3) groups. Upon arriving, the children washed hands in the bathroom and met in the cafeteria. All groups had snack. The menu was wheat tortilla, jelly, WOW butter, sunflower kernels, veggie blend juice, apple sauce and milk. The items were listed on the menu for Wednesday. Group one (1) played on the playground using swings, climbers, parachute and balls. Group two (2) played in the cafeteria with games, Legos, manipulative toys, BrainFlakes, beads, books and art materials. In the gym, group three (3) played with balls, games, manipulative toys, large pillows and bean bags. The group leader lead an discussion and talked about the project(s) each child is working on. Supervision of children and interaction were adequate. Two (2) new staff files and one (1) existing staff file were reviewed. There were various items missing in the electronic files. Orientation is typically conducted by a program coordinator, and the scanned documents are sent to the main office to upload into each staff file. Five (5) children’s files were monitored and in compliance. No children are currently on medication for this program. Transportations for this program is monitored separately. Therefore, it was not monitored during today’s visit. 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 528 Food substitution was not of comparable food value or recorded on the menu prior to the meal or snack being served. The snack items, wheat tortilla, jelly, WOW butter, vegetable blend juice, sunflower kernels, apple sauce and milk were serviced. Those items were listed on the Wednesdays menu. No corrections were made on the menu. 10A NCAC 09 .0901(b) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The EMC plan was not reviewed with a staff member hired on 8/28/23. 10A NCAC 09 .0802(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. TB information was not in staff file for a staff member hired on 6/27/23. .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Medical statement was not in staff file for a staff member hired on 6/27/23. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Emergency information form for a staff member hired on 12/5/22 and a staff member hired on 8/28/23 were not in the files. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. First six (6) weeks of orientation document was not in staff file forr a staff member hired on 8/28/23. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. First two (2) weeks of orientation information for a staff member hired on 8/28/23 was not in file. .1101(a)(b) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. The EPR plan was not reviewed with a staff member hired on 8/28/23. .0607(f) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A staff member hired on 12/5/22 did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) Technical assistance was provided as follows: 528: Substitution items on the menu Substitution items must be written on the menu prior to serving children. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (b) When food is prepared by or provided by the center, menus for nutritious meals and snacks shall be planned at least one week in advance. At least one dated copy of the current week's menu shall be posted where it can be seen by parents and food preparation staff when food is prepared or provided by the center. A variety of food shall be included in meals and snacks. Any substitution shall be of comparable food value and shall be recorded on the menu prior to the meal or snack being served. 862: Emergency Medical Care Plan (EMC) review EMC shall be reviewed with staff members annually. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (a) Each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. 1033: TB record Negative TB record shall be in each staff file prior to the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Tuberculin (TB) Test or Screening is the results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. It is required for all staff, including the director and individuals who volunteer more than once per week. Due date is on or before first day of work. 1034: Medical Statement Medical Statement shall be in each staff file prior to the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Medical Report is a statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. It is required for child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. The due date is prior to employment. When submitted, the medical statement shall not be older than 12 months. 1035: Emergency information form Emergency information form shall be in staff file on or before the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Emergency Information Form includes the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. It is required for child care providers, including the director, uncompensated providers, substitute providers, and volunteers. The due date is on or before the first day of work. The emergency information shall be updated as changes occur and at least annually. 1045: First six (6) weeks of orientation The record of first six (6) weeks of orientation shall be available for review. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. 1067: First two (2) weeks of orientation The record of first two (2) weeks of orientation shall be available for review. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. 1825: Emergency Preparedness and Response (EPR) plan review EPR plan shall be reviewed annually with staff members. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. 1897: Recognizing and Responding to Suspicions of Child Maltreatment The training shall be completed within ninety(90) days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/26/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest NC, 28768 Please call me at 828-556-9013, or email kaoru.eddins@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 is provided as follows: Orientation documents: Please review your operational policy for orientation and other staff file documents. Many documents are "missing" from the staff files frequently. Additional staff training and the review of your procedures may be necessary. Reminders: CPR/FA training is due to staff member hired on 6/27/23 on or prior to 9/25/23. CPR/FA training for a staff member hired on 8/28/23 is due on or before 11/2/34. BSAC shall be completed by the staff member hired on 6/27/23 on or before 9/27/23. BSAC training shall be completed by the staff member hired on 8/28/23 on or before 11/28/23. Sanitation inspection: Your last sanitation inspection was conducted on 9/28/22. Please contact your Environmental Health specialist to complete the inspection before 9/28/23. If you have any questions or concerns regarding the Stabilization, Expansion and Access Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 9/12/2023 Number Present: 44 Completed Date: 9/12/2023 Age: From 5 To 10 Total Minutes: 190 Time In: 02:20 PM Time Out: 05:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Lily Elder, Program Coordinator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Today, the Lily Elder, Program Coordinator, was available during the visit. Delaney Burke, Administrator met me on site and reviewed electronic staff files and children’s files with me. The indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven (87) percentage as of 9/8/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, The Young Men`s Christian Association of Western North Carolina, Inc. is current/active as of 9/8/23. Permit type – Five-star center license issued on 2/24/23. Special Services/Restrictions – daytime care, school age only, enhanced space and ratio, Playground area does not meet Child Care Playground safety requirements, children prohibited from occupying kitchen space for any reason. The last annual compliance visit was conducted on 9/22/22. The last fire drill was practiced on 8/29/23. The last shelter-in-place drill was practiced on 7/18/23. The last fire inspection was approved on 1/31/23. The last sanitation inspection was conducted on 9/28/22 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. There were three (3) groups. Upon arriving, the children washed hands in the bathroom and met in the cafeteria. All groups had snack. The menu was wheat tortilla, jelly, WOW butter, sunflower kernels, veggie blend juice, apple sauce and milk. The items were listed on the menu for Wednesday. Group one (1) played on the playground using swings, climbers, parachute and balls. Group two (2) played in the cafeteria with games, Legos, manipulative toys, BrainFlakes, beads, books and art materials. In the gym, group three (3) played with balls, games, manipulative toys, large pillows and bean bags. The group leader lead an discussion and talked about the project(s) each child is working on. Supervision of children and interaction were adequate. Two (2) new staff files and one (1) existing staff file were reviewed. There were various items missing in the electronic files. Orientation is typically conducted by a program coordinator, and the scanned documents are sent to the main office to upload into each staff file. Five (5) children’s files were monitored and in compliance. No children are currently on medication for this program. Transportations for this program is monitored separately. Therefore, it was not monitored during today’s visit. 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 528 Food substitution was not of comparable food value or recorded on the menu prior to the meal or snack being served. The snack items, wheat tortilla, jelly, WOW butter, vegetable blend juice, sunflower kernels, apple sauce and milk were serviced. Those items were listed on the Wednesdays menu. No corrections were made on the menu. 10A NCAC 09 .0901(b) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The EMC plan was not reviewed with a staff member hired on 8/28/23. 10A NCAC 09 .0802(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. TB information was not in staff file for a staff member hired on 6/27/23. .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Medical statement was not in staff file for a staff member hired on 6/27/23. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Emergency information form for a staff member hired on 12/5/22 and a staff member hired on 8/28/23 were not in the files. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. First six (6) weeks of orientation document was not in staff file forr a staff member hired on 8/28/23. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. First two (2) weeks of orientation information for a staff member hired on 8/28/23 was not in file. .1101(a)(b) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. The EPR plan was not reviewed with a staff member hired on 8/28/23. .0607(f) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A staff member hired on 12/5/22 did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) Technical assistance was provided as follows: 528: Substitution items on the menu Substitution items must be written on the menu prior to serving children. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (b) When food is prepared by or provided by the center, menus for nutritious meals and snacks shall be planned at least one week in advance. At least one dated copy of the current week's menu shall be posted where it can be seen by parents and food preparation staff when food is prepared or provided by the center. A variety of food shall be included in meals and snacks. Any substitution shall be of comparable food value and shall be recorded on the menu prior to the meal or snack being served. 862: Emergency Medical Care Plan (EMC) review EMC shall be reviewed with staff members annually. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (a) Each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. 1033: TB record Negative TB record shall be in each staff file prior to the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Tuberculin (TB) Test or Screening is the results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. It is required for all staff, including the director and individuals who volunteer more than once per week. Due date is on or before first day of work. 1034: Medical Statement Medical Statement shall be in each staff file prior to the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Medical Report is a statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. It is required for child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. The due date is prior to employment. When submitted, the medical statement shall not be older than 12 months. 1035: Emergency information form Emergency information form shall be in staff file on or before the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Emergency Information Form includes the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. It is required for child care providers, including the director, uncompensated providers, substitute providers, and volunteers. The due date is on or before the first day of work. The emergency information shall be updated as changes occur and at least annually. 1045: First six (6) weeks of orientation The record of first six (6) weeks of orientation shall be available for review. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. 1067: First two (2) weeks of orientation The record of first two (2) weeks of orientation shall be available for review. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. 1825: Emergency Preparedness and Response (EPR) plan review EPR plan shall be reviewed annually with staff members. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. 1897: Recognizing and Responding to Suspicions of Child Maltreatment The training shall be completed within ninety(90) days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/26/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest NC, 28768 Please call me at 828-556-9013, or email kaoru.eddins@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 is provided as follows: Orientation documents: Please review your operational policy for orientation and other staff file documents. Many documents are "missing" from the staff files frequently. Additional staff training and the review of your procedures may be necessary. Reminders: CPR/FA training is due to staff member hired on 6/27/23 on or prior to 9/25/23. CPR/FA training for a staff member hired on 8/28/23 is due on or before 11/2/34. BSAC shall be completed by the staff member hired on 6/27/23 on or before 9/27/23. BSAC training shall be completed by the staff member hired on 8/28/23 on or before 11/28/23. Sanitation inspection: Your last sanitation inspection was conducted on 9/28/22. Please contact your Environmental Health specialist to complete the inspection before 9/28/23. If you have any questions or concerns regarding the Stabilization, Expansion and Access Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0607 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 9/12/2023 Number Present: 44 Completed Date: 9/12/2023 Age: From 5 To 10 Total Minutes: 190 Time In: 02:20 PM Time Out: 05:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Lily Elder, Program Coordinator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Today, the Lily Elder, Program Coordinator, was available during the visit. Delaney Burke, Administrator met me on site and reviewed electronic staff files and children’s files with me. The indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven (87) percentage as of 9/8/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, The Young Men`s Christian Association of Western North Carolina, Inc. is current/active as of 9/8/23. Permit type – Five-star center license issued on 2/24/23. Special Services/Restrictions – daytime care, school age only, enhanced space and ratio, Playground area does not meet Child Care Playground safety requirements, children prohibited from occupying kitchen space for any reason. The last annual compliance visit was conducted on 9/22/22. The last fire drill was practiced on 8/29/23. The last shelter-in-place drill was practiced on 7/18/23. The last fire inspection was approved on 1/31/23. The last sanitation inspection was conducted on 9/28/22 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. There were three (3) groups. Upon arriving, the children washed hands in the bathroom and met in the cafeteria. All groups had snack. The menu was wheat tortilla, jelly, WOW butter, sunflower kernels, veggie blend juice, apple sauce and milk. The items were listed on the menu for Wednesday. Group one (1) played on the playground using swings, climbers, parachute and balls. Group two (2) played in the cafeteria with games, Legos, manipulative toys, BrainFlakes, beads, books and art materials. In the gym, group three (3) played with balls, games, manipulative toys, large pillows and bean bags. The group leader lead an discussion and talked about the project(s) each child is working on. Supervision of children and interaction were adequate. Two (2) new staff files and one (1) existing staff file were reviewed. There were various items missing in the electronic files. Orientation is typically conducted by a program coordinator, and the scanned documents are sent to the main office to upload into each staff file. Five (5) children’s files were monitored and in compliance. No children are currently on medication for this program. Transportations for this program is monitored separately. Therefore, it was not monitored during today’s visit. 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 528 Food substitution was not of comparable food value or recorded on the menu prior to the meal or snack being served. The snack items, wheat tortilla, jelly, WOW butter, vegetable blend juice, sunflower kernels, apple sauce and milk were serviced. Those items were listed on the Wednesdays menu. No corrections were made on the menu. 10A NCAC 09 .0901(b) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The EMC plan was not reviewed with a staff member hired on 8/28/23. 10A NCAC 09 .0802(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. TB information was not in staff file for a staff member hired on 6/27/23. .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Medical statement was not in staff file for a staff member hired on 6/27/23. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Emergency information form for a staff member hired on 12/5/22 and a staff member hired on 8/28/23 were not in the files. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. First six (6) weeks of orientation document was not in staff file forr a staff member hired on 8/28/23. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. First two (2) weeks of orientation information for a staff member hired on 8/28/23 was not in file. .1101(a)(b) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. The EPR plan was not reviewed with a staff member hired on 8/28/23. .0607(f) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A staff member hired on 12/5/22 did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) Technical assistance was provided as follows: 528: Substitution items on the menu Substitution items must be written on the menu prior to serving children. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (b) When food is prepared by or provided by the center, menus for nutritious meals and snacks shall be planned at least one week in advance. At least one dated copy of the current week's menu shall be posted where it can be seen by parents and food preparation staff when food is prepared or provided by the center. A variety of food shall be included in meals and snacks. Any substitution shall be of comparable food value and shall be recorded on the menu prior to the meal or snack being served. 862: Emergency Medical Care Plan (EMC) review EMC shall be reviewed with staff members annually. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (a) Each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. 1033: TB record Negative TB record shall be in each staff file prior to the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Tuberculin (TB) Test or Screening is the results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. It is required for all staff, including the director and individuals who volunteer more than once per week. Due date is on or before first day of work. 1034: Medical Statement Medical Statement shall be in each staff file prior to the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Medical Report is a statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. It is required for child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. The due date is prior to employment. When submitted, the medical statement shall not be older than 12 months. 1035: Emergency information form Emergency information form shall be in staff file on or before the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Emergency Information Form includes the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. It is required for child care providers, including the director, uncompensated providers, substitute providers, and volunteers. The due date is on or before the first day of work. The emergency information shall be updated as changes occur and at least annually. 1045: First six (6) weeks of orientation The record of first six (6) weeks of orientation shall be available for review. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. 1067: First two (2) weeks of orientation The record of first two (2) weeks of orientation shall be available for review. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. 1825: Emergency Preparedness and Response (EPR) plan review EPR plan shall be reviewed annually with staff members. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. 1897: Recognizing and Responding to Suspicions of Child Maltreatment The training shall be completed within ninety(90) days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/26/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest NC, 28768 Please call me at 828-556-9013, or email kaoru.eddins@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 is provided as follows: Orientation documents: Please review your operational policy for orientation and other staff file documents. Many documents are "missing" from the staff files frequently. Additional staff training and the review of your procedures may be necessary. Reminders: CPR/FA training is due to staff member hired on 6/27/23 on or prior to 9/25/23. CPR/FA training for a staff member hired on 8/28/23 is due on or before 11/2/34. BSAC shall be completed by the staff member hired on 6/27/23 on or before 9/27/23. BSAC training shall be completed by the staff member hired on 8/28/23 on or before 11/28/23. Sanitation inspection: Your last sanitation inspection was conducted on 9/28/22. Please contact your Environmental Health specialist to complete the inspection before 9/28/23. If you have any questions or concerns regarding the Stabilization, Expansion and Access Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0701 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 9/12/2023 Number Present: 44 Completed Date: 9/12/2023 Age: From 5 To 10 Total Minutes: 190 Time In: 02:20 PM Time Out: 05:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Lily Elder, Program Coordinator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Today, the Lily Elder, Program Coordinator, was available during the visit. Delaney Burke, Administrator met me on site and reviewed electronic staff files and children’s files with me. The indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven (87) percentage as of 9/8/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, The Young Men`s Christian Association of Western North Carolina, Inc. is current/active as of 9/8/23. Permit type – Five-star center license issued on 2/24/23. Special Services/Restrictions – daytime care, school age only, enhanced space and ratio, Playground area does not meet Child Care Playground safety requirements, children prohibited from occupying kitchen space for any reason. The last annual compliance visit was conducted on 9/22/22. The last fire drill was practiced on 8/29/23. The last shelter-in-place drill was practiced on 7/18/23. The last fire inspection was approved on 1/31/23. The last sanitation inspection was conducted on 9/28/22 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. There were three (3) groups. Upon arriving, the children washed hands in the bathroom and met in the cafeteria. All groups had snack. The menu was wheat tortilla, jelly, WOW butter, sunflower kernels, veggie blend juice, apple sauce and milk. The items were listed on the menu for Wednesday. Group one (1) played on the playground using swings, climbers, parachute and balls. Group two (2) played in the cafeteria with games, Legos, manipulative toys, BrainFlakes, beads, books and art materials. In the gym, group three (3) played with balls, games, manipulative toys, large pillows and bean bags. The group leader lead an discussion and talked about the project(s) each child is working on. Supervision of children and interaction were adequate. Two (2) new staff files and one (1) existing staff file were reviewed. There were various items missing in the electronic files. Orientation is typically conducted by a program coordinator, and the scanned documents are sent to the main office to upload into each staff file. Five (5) children’s files were monitored and in compliance. No children are currently on medication for this program. Transportations for this program is monitored separately. Therefore, it was not monitored during today’s visit. 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 528 Food substitution was not of comparable food value or recorded on the menu prior to the meal or snack being served. The snack items, wheat tortilla, jelly, WOW butter, vegetable blend juice, sunflower kernels, apple sauce and milk were serviced. Those items were listed on the Wednesdays menu. No corrections were made on the menu. 10A NCAC 09 .0901(b) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The EMC plan was not reviewed with a staff member hired on 8/28/23. 10A NCAC 09 .0802(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. TB information was not in staff file for a staff member hired on 6/27/23. .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Medical statement was not in staff file for a staff member hired on 6/27/23. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Emergency information form for a staff member hired on 12/5/22 and a staff member hired on 8/28/23 were not in the files. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. First six (6) weeks of orientation document was not in staff file forr a staff member hired on 8/28/23. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. First two (2) weeks of orientation information for a staff member hired on 8/28/23 was not in file. .1101(a)(b) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. The EPR plan was not reviewed with a staff member hired on 8/28/23. .0607(f) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A staff member hired on 12/5/22 did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) Technical assistance was provided as follows: 528: Substitution items on the menu Substitution items must be written on the menu prior to serving children. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (b) When food is prepared by or provided by the center, menus for nutritious meals and snacks shall be planned at least one week in advance. At least one dated copy of the current week's menu shall be posted where it can be seen by parents and food preparation staff when food is prepared or provided by the center. A variety of food shall be included in meals and snacks. Any substitution shall be of comparable food value and shall be recorded on the menu prior to the meal or snack being served. 862: Emergency Medical Care Plan (EMC) review EMC shall be reviewed with staff members annually. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (a) Each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. 1033: TB record Negative TB record shall be in each staff file prior to the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Tuberculin (TB) Test or Screening is the results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. It is required for all staff, including the director and individuals who volunteer more than once per week. Due date is on or before first day of work. 1034: Medical Statement Medical Statement shall be in each staff file prior to the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Medical Report is a statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. It is required for child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. The due date is prior to employment. When submitted, the medical statement shall not be older than 12 months. 1035: Emergency information form Emergency information form shall be in staff file on or before the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Emergency Information Form includes the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. It is required for child care providers, including the director, uncompensated providers, substitute providers, and volunteers. The due date is on or before the first day of work. The emergency information shall be updated as changes occur and at least annually. 1045: First six (6) weeks of orientation The record of first six (6) weeks of orientation shall be available for review. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. 1067: First two (2) weeks of orientation The record of first two (2) weeks of orientation shall be available for review. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. 1825: Emergency Preparedness and Response (EPR) plan review EPR plan shall be reviewed annually with staff members. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. 1897: Recognizing and Responding to Suspicions of Child Maltreatment The training shall be completed within ninety(90) days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/26/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest NC, 28768 Please call me at 828-556-9013, or email kaoru.eddins@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 is provided as follows: Orientation documents: Please review your operational policy for orientation and other staff file documents. Many documents are "missing" from the staff files frequently. Additional staff training and the review of your procedures may be necessary. Reminders: CPR/FA training is due to staff member hired on 6/27/23 on or prior to 9/25/23. CPR/FA training for a staff member hired on 8/28/23 is due on or before 11/2/34. BSAC shall be completed by the staff member hired on 6/27/23 on or before 9/27/23. BSAC training shall be completed by the staff member hired on 8/28/23 on or before 11/28/23. Sanitation inspection: Your last sanitation inspection was conducted on 9/28/22. Please contact your Environmental Health specialist to complete the inspection before 9/28/23. If you have any questions or concerns regarding the Stabilization, Expansion and Access Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0802 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 9/12/2023 Number Present: 44 Completed Date: 9/12/2023 Age: From 5 To 10 Total Minutes: 190 Time In: 02:20 PM Time Out: 05:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Lily Elder, Program Coordinator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Today, the Lily Elder, Program Coordinator, was available during the visit. Delaney Burke, Administrator met me on site and reviewed electronic staff files and children’s files with me. The indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven (87) percentage as of 9/8/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, The Young Men`s Christian Association of Western North Carolina, Inc. is current/active as of 9/8/23. Permit type – Five-star center license issued on 2/24/23. Special Services/Restrictions – daytime care, school age only, enhanced space and ratio, Playground area does not meet Child Care Playground safety requirements, children prohibited from occupying kitchen space for any reason. The last annual compliance visit was conducted on 9/22/22. The last fire drill was practiced on 8/29/23. The last shelter-in-place drill was practiced on 7/18/23. The last fire inspection was approved on 1/31/23. The last sanitation inspection was conducted on 9/28/22 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. There were three (3) groups. Upon arriving, the children washed hands in the bathroom and met in the cafeteria. All groups had snack. The menu was wheat tortilla, jelly, WOW butter, sunflower kernels, veggie blend juice, apple sauce and milk. The items were listed on the menu for Wednesday. Group one (1) played on the playground using swings, climbers, parachute and balls. Group two (2) played in the cafeteria with games, Legos, manipulative toys, BrainFlakes, beads, books and art materials. In the gym, group three (3) played with balls, games, manipulative toys, large pillows and bean bags. The group leader lead an discussion and talked about the project(s) each child is working on. Supervision of children and interaction were adequate. Two (2) new staff files and one (1) existing staff file were reviewed. There were various items missing in the electronic files. Orientation is typically conducted by a program coordinator, and the scanned documents are sent to the main office to upload into each staff file. Five (5) children’s files were monitored and in compliance. No children are currently on medication for this program. Transportations for this program is monitored separately. Therefore, it was not monitored during today’s visit. 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 528 Food substitution was not of comparable food value or recorded on the menu prior to the meal or snack being served. The snack items, wheat tortilla, jelly, WOW butter, vegetable blend juice, sunflower kernels, apple sauce and milk were serviced. Those items were listed on the Wednesdays menu. No corrections were made on the menu. 10A NCAC 09 .0901(b) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The EMC plan was not reviewed with a staff member hired on 8/28/23. 10A NCAC 09 .0802(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. TB information was not in staff file for a staff member hired on 6/27/23. .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Medical statement was not in staff file for a staff member hired on 6/27/23. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Emergency information form for a staff member hired on 12/5/22 and a staff member hired on 8/28/23 were not in the files. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. First six (6) weeks of orientation document was not in staff file forr a staff member hired on 8/28/23. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. First two (2) weeks of orientation information for a staff member hired on 8/28/23 was not in file. .1101(a)(b) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. The EPR plan was not reviewed with a staff member hired on 8/28/23. .0607(f) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A staff member hired on 12/5/22 did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) Technical assistance was provided as follows: 528: Substitution items on the menu Substitution items must be written on the menu prior to serving children. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (b) When food is prepared by or provided by the center, menus for nutritious meals and snacks shall be planned at least one week in advance. At least one dated copy of the current week's menu shall be posted where it can be seen by parents and food preparation staff when food is prepared or provided by the center. A variety of food shall be included in meals and snacks. Any substitution shall be of comparable food value and shall be recorded on the menu prior to the meal or snack being served. 862: Emergency Medical Care Plan (EMC) review EMC shall be reviewed with staff members annually. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (a) Each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. 1033: TB record Negative TB record shall be in each staff file prior to the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Tuberculin (TB) Test or Screening is the results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. It is required for all staff, including the director and individuals who volunteer more than once per week. Due date is on or before first day of work. 1034: Medical Statement Medical Statement shall be in each staff file prior to the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Medical Report is a statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. It is required for child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. The due date is prior to employment. When submitted, the medical statement shall not be older than 12 months. 1035: Emergency information form Emergency information form shall be in staff file on or before the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Emergency Information Form includes the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. It is required for child care providers, including the director, uncompensated providers, substitute providers, and volunteers. The due date is on or before the first day of work. The emergency information shall be updated as changes occur and at least annually. 1045: First six (6) weeks of orientation The record of first six (6) weeks of orientation shall be available for review. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. 1067: First two (2) weeks of orientation The record of first two (2) weeks of orientation shall be available for review. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. 1825: Emergency Preparedness and Response (EPR) plan review EPR plan shall be reviewed annually with staff members. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. 1897: Recognizing and Responding to Suspicions of Child Maltreatment The training shall be completed within ninety(90) days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/26/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest NC, 28768 Please call me at 828-556-9013, or email kaoru.eddins@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 is provided as follows: Orientation documents: Please review your operational policy for orientation and other staff file documents. Many documents are "missing" from the staff files frequently. Additional staff training and the review of your procedures may be necessary. Reminders: CPR/FA training is due to staff member hired on 6/27/23 on or prior to 9/25/23. CPR/FA training for a staff member hired on 8/28/23 is due on or before 11/2/34. BSAC shall be completed by the staff member hired on 6/27/23 on or before 9/27/23. BSAC training shall be completed by the staff member hired on 8/28/23 on or before 11/28/23. Sanitation inspection: Your last sanitation inspection was conducted on 9/28/22. Please contact your Environmental Health specialist to complete the inspection before 9/28/23. If you have any questions or concerns regarding the Stabilization, Expansion and Access Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0901 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 9/12/2023 Number Present: 44 Completed Date: 9/12/2023 Age: From 5 To 10 Total Minutes: 190 Time In: 02:20 PM Time Out: 05:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Lily Elder, Program Coordinator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Today, the Lily Elder, Program Coordinator, was available during the visit. Delaney Burke, Administrator met me on site and reviewed electronic staff files and children’s files with me. The indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven (87) percentage as of 9/8/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, The Young Men`s Christian Association of Western North Carolina, Inc. is current/active as of 9/8/23. Permit type – Five-star center license issued on 2/24/23. Special Services/Restrictions – daytime care, school age only, enhanced space and ratio, Playground area does not meet Child Care Playground safety requirements, children prohibited from occupying kitchen space for any reason. The last annual compliance visit was conducted on 9/22/22. The last fire drill was practiced on 8/29/23. The last shelter-in-place drill was practiced on 7/18/23. The last fire inspection was approved on 1/31/23. The last sanitation inspection was conducted on 9/28/22 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. There were three (3) groups. Upon arriving, the children washed hands in the bathroom and met in the cafeteria. All groups had snack. The menu was wheat tortilla, jelly, WOW butter, sunflower kernels, veggie blend juice, apple sauce and milk. The items were listed on the menu for Wednesday. Group one (1) played on the playground using swings, climbers, parachute and balls. Group two (2) played in the cafeteria with games, Legos, manipulative toys, BrainFlakes, beads, books and art materials. In the gym, group three (3) played with balls, games, manipulative toys, large pillows and bean bags. The group leader lead an discussion and talked about the project(s) each child is working on. Supervision of children and interaction were adequate. Two (2) new staff files and one (1) existing staff file were reviewed. There were various items missing in the electronic files. Orientation is typically conducted by a program coordinator, and the scanned documents are sent to the main office to upload into each staff file. Five (5) children’s files were monitored and in compliance. No children are currently on medication for this program. Transportations for this program is monitored separately. Therefore, it was not monitored during today’s visit. 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 528 Food substitution was not of comparable food value or recorded on the menu prior to the meal or snack being served. The snack items, wheat tortilla, jelly, WOW butter, vegetable blend juice, sunflower kernels, apple sauce and milk were serviced. Those items were listed on the Wednesdays menu. No corrections were made on the menu. 10A NCAC 09 .0901(b) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The EMC plan was not reviewed with a staff member hired on 8/28/23. 10A NCAC 09 .0802(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. TB information was not in staff file for a staff member hired on 6/27/23. .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Medical statement was not in staff file for a staff member hired on 6/27/23. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Emergency information form for a staff member hired on 12/5/22 and a staff member hired on 8/28/23 were not in the files. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. First six (6) weeks of orientation document was not in staff file forr a staff member hired on 8/28/23. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. First two (2) weeks of orientation information for a staff member hired on 8/28/23 was not in file. .1101(a)(b) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. The EPR plan was not reviewed with a staff member hired on 8/28/23. .0607(f) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A staff member hired on 12/5/22 did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) Technical assistance was provided as follows: 528: Substitution items on the menu Substitution items must be written on the menu prior to serving children. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (b) When food is prepared by or provided by the center, menus for nutritious meals and snacks shall be planned at least one week in advance. At least one dated copy of the current week's menu shall be posted where it can be seen by parents and food preparation staff when food is prepared or provided by the center. A variety of food shall be included in meals and snacks. Any substitution shall be of comparable food value and shall be recorded on the menu prior to the meal or snack being served. 862: Emergency Medical Care Plan (EMC) review EMC shall be reviewed with staff members annually. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (a) Each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. 1033: TB record Negative TB record shall be in each staff file prior to the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Tuberculin (TB) Test or Screening is the results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. It is required for all staff, including the director and individuals who volunteer more than once per week. Due date is on or before first day of work. 1034: Medical Statement Medical Statement shall be in each staff file prior to the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Medical Report is a statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. It is required for child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. The due date is prior to employment. When submitted, the medical statement shall not be older than 12 months. 1035: Emergency information form Emergency information form shall be in staff file on or before the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Emergency Information Form includes the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. It is required for child care providers, including the director, uncompensated providers, substitute providers, and volunteers. The due date is on or before the first day of work. The emergency information shall be updated as changes occur and at least annually. 1045: First six (6) weeks of orientation The record of first six (6) weeks of orientation shall be available for review. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. 1067: First two (2) weeks of orientation The record of first two (2) weeks of orientation shall be available for review. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. 1825: Emergency Preparedness and Response (EPR) plan review EPR plan shall be reviewed annually with staff members. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. 1897: Recognizing and Responding to Suspicions of Child Maltreatment The training shall be completed within ninety(90) days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/26/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest NC, 28768 Please call me at 828-556-9013, or email kaoru.eddins@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 is provided as follows: Orientation documents: Please review your operational policy for orientation and other staff file documents. Many documents are "missing" from the staff files frequently. Additional staff training and the review of your procedures may be necessary. Reminders: CPR/FA training is due to staff member hired on 6/27/23 on or prior to 9/25/23. CPR/FA training for a staff member hired on 8/28/23 is due on or before 11/2/34. BSAC shall be completed by the staff member hired on 6/27/23 on or before 9/27/23. BSAC training shall be completed by the staff member hired on 8/28/23 on or before 11/28/23. Sanitation inspection: Your last sanitation inspection was conducted on 9/28/22. Please contact your Environmental Health specialist to complete the inspection before 9/28/23. If you have any questions or concerns regarding the Stabilization, Expansion and Access Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1101 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 9/12/2023 Number Present: 44 Completed Date: 9/12/2023 Age: From 5 To 10 Total Minutes: 190 Time In: 02:20 PM Time Out: 05:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Lily Elder, Program Coordinator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Today, the Lily Elder, Program Coordinator, was available during the visit. Delaney Burke, Administrator met me on site and reviewed electronic staff files and children’s files with me. The indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven (87) percentage as of 9/8/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, The Young Men`s Christian Association of Western North Carolina, Inc. is current/active as of 9/8/23. Permit type – Five-star center license issued on 2/24/23. Special Services/Restrictions – daytime care, school age only, enhanced space and ratio, Playground area does not meet Child Care Playground safety requirements, children prohibited from occupying kitchen space for any reason. The last annual compliance visit was conducted on 9/22/22. The last fire drill was practiced on 8/29/23. The last shelter-in-place drill was practiced on 7/18/23. The last fire inspection was approved on 1/31/23. The last sanitation inspection was conducted on 9/28/22 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. There were three (3) groups. Upon arriving, the children washed hands in the bathroom and met in the cafeteria. All groups had snack. The menu was wheat tortilla, jelly, WOW butter, sunflower kernels, veggie blend juice, apple sauce and milk. The items were listed on the menu for Wednesday. Group one (1) played on the playground using swings, climbers, parachute and balls. Group two (2) played in the cafeteria with games, Legos, manipulative toys, BrainFlakes, beads, books and art materials. In the gym, group three (3) played with balls, games, manipulative toys, large pillows and bean bags. The group leader lead an discussion and talked about the project(s) each child is working on. Supervision of children and interaction were adequate. Two (2) new staff files and one (1) existing staff file were reviewed. There were various items missing in the electronic files. Orientation is typically conducted by a program coordinator, and the scanned documents are sent to the main office to upload into each staff file. Five (5) children’s files were monitored and in compliance. No children are currently on medication for this program. Transportations for this program is monitored separately. Therefore, it was not monitored during today’s visit. 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 528 Food substitution was not of comparable food value or recorded on the menu prior to the meal or snack being served. The snack items, wheat tortilla, jelly, WOW butter, vegetable blend juice, sunflower kernels, apple sauce and milk were serviced. Those items were listed on the Wednesdays menu. No corrections were made on the menu. 10A NCAC 09 .0901(b) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The EMC plan was not reviewed with a staff member hired on 8/28/23. 10A NCAC 09 .0802(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. TB information was not in staff file for a staff member hired on 6/27/23. .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Medical statement was not in staff file for a staff member hired on 6/27/23. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Emergency information form for a staff member hired on 12/5/22 and a staff member hired on 8/28/23 were not in the files. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. First six (6) weeks of orientation document was not in staff file forr a staff member hired on 8/28/23. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. First two (2) weeks of orientation information for a staff member hired on 8/28/23 was not in file. .1101(a)(b) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. The EPR plan was not reviewed with a staff member hired on 8/28/23. .0607(f) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A staff member hired on 12/5/22 did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) Technical assistance was provided as follows: 528: Substitution items on the menu Substitution items must be written on the menu prior to serving children. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (b) When food is prepared by or provided by the center, menus for nutritious meals and snacks shall be planned at least one week in advance. At least one dated copy of the current week's menu shall be posted where it can be seen by parents and food preparation staff when food is prepared or provided by the center. A variety of food shall be included in meals and snacks. Any substitution shall be of comparable food value and shall be recorded on the menu prior to the meal or snack being served. 862: Emergency Medical Care Plan (EMC) review EMC shall be reviewed with staff members annually. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (a) Each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. 1033: TB record Negative TB record shall be in each staff file prior to the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Tuberculin (TB) Test or Screening is the results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. It is required for all staff, including the director and individuals who volunteer more than once per week. Due date is on or before first day of work. 1034: Medical Statement Medical Statement shall be in each staff file prior to the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Medical Report is a statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. It is required for child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. The due date is prior to employment. When submitted, the medical statement shall not be older than 12 months. 1035: Emergency information form Emergency information form shall be in staff file on or before the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Emergency Information Form includes the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. It is required for child care providers, including the director, uncompensated providers, substitute providers, and volunteers. The due date is on or before the first day of work. The emergency information shall be updated as changes occur and at least annually. 1045: First six (6) weeks of orientation The record of first six (6) weeks of orientation shall be available for review. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. 1067: First two (2) weeks of orientation The record of first two (2) weeks of orientation shall be available for review. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. 1825: Emergency Preparedness and Response (EPR) plan review EPR plan shall be reviewed annually with staff members. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. 1897: Recognizing and Responding to Suspicions of Child Maltreatment The training shall be completed within ninety(90) days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/26/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest NC, 28768 Please call me at 828-556-9013, or email kaoru.eddins@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 is provided as follows: Orientation documents: Please review your operational policy for orientation and other staff file documents. Many documents are "missing" from the staff files frequently. Additional staff training and the review of your procedures may be necessary. Reminders: CPR/FA training is due to staff member hired on 6/27/23 on or prior to 9/25/23. CPR/FA training for a staff member hired on 8/28/23 is due on or before 11/2/34. BSAC shall be completed by the staff member hired on 6/27/23 on or before 9/27/23. BSAC training shall be completed by the staff member hired on 8/28/23 on or before 11/28/23. Sanitation inspection: Your last sanitation inspection was conducted on 9/28/22. Please contact your Environmental Health specialist to complete the inspection before 9/28/23. If you have any questions or concerns regarding the Stabilization, Expansion and Access Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 9/12/2023 Number Present: 44 Completed Date: 9/12/2023 Age: From 5 To 10 Total Minutes: 190 Time In: 02:20 PM Time Out: 05:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Lily Elder, Program Coordinator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Today, the Lily Elder, Program Coordinator, was available during the visit. Delaney Burke, Administrator met me on site and reviewed electronic staff files and children’s files with me. The indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven (87) percentage as of 9/8/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, The Young Men`s Christian Association of Western North Carolina, Inc. is current/active as of 9/8/23. Permit type – Five-star center license issued on 2/24/23. Special Services/Restrictions – daytime care, school age only, enhanced space and ratio, Playground area does not meet Child Care Playground safety requirements, children prohibited from occupying kitchen space for any reason. The last annual compliance visit was conducted on 9/22/22. The last fire drill was practiced on 8/29/23. The last shelter-in-place drill was practiced on 7/18/23. The last fire inspection was approved on 1/31/23. The last sanitation inspection was conducted on 9/28/22 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. There were three (3) groups. Upon arriving, the children washed hands in the bathroom and met in the cafeteria. All groups had snack. The menu was wheat tortilla, jelly, WOW butter, sunflower kernels, veggie blend juice, apple sauce and milk. The items were listed on the menu for Wednesday. Group one (1) played on the playground using swings, climbers, parachute and balls. Group two (2) played in the cafeteria with games, Legos, manipulative toys, BrainFlakes, beads, books and art materials. In the gym, group three (3) played with balls, games, manipulative toys, large pillows and bean bags. The group leader lead an discussion and talked about the project(s) each child is working on. Supervision of children and interaction were adequate. Two (2) new staff files and one (1) existing staff file were reviewed. There were various items missing in the electronic files. Orientation is typically conducted by a program coordinator, and the scanned documents are sent to the main office to upload into each staff file. Five (5) children’s files were monitored and in compliance. No children are currently on medication for this program. Transportations for this program is monitored separately. Therefore, it was not monitored during today’s visit. 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 528 Food substitution was not of comparable food value or recorded on the menu prior to the meal or snack being served. The snack items, wheat tortilla, jelly, WOW butter, vegetable blend juice, sunflower kernels, apple sauce and milk were serviced. Those items were listed on the Wednesdays menu. No corrections were made on the menu. 10A NCAC 09 .0901(b) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The EMC plan was not reviewed with a staff member hired on 8/28/23. 10A NCAC 09 .0802(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. TB information was not in staff file for a staff member hired on 6/27/23. .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Medical statement was not in staff file for a staff member hired on 6/27/23. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Emergency information form for a staff member hired on 12/5/22 and a staff member hired on 8/28/23 were not in the files. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. First six (6) weeks of orientation document was not in staff file forr a staff member hired on 8/28/23. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. First two (2) weeks of orientation information for a staff member hired on 8/28/23 was not in file. .1101(a)(b) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. The EPR plan was not reviewed with a staff member hired on 8/28/23. .0607(f) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A staff member hired on 12/5/22 did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) Technical assistance was provided as follows: 528: Substitution items on the menu Substitution items must be written on the menu prior to serving children. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (b) When food is prepared by or provided by the center, menus for nutritious meals and snacks shall be planned at least one week in advance. At least one dated copy of the current week's menu shall be posted where it can be seen by parents and food preparation staff when food is prepared or provided by the center. A variety of food shall be included in meals and snacks. Any substitution shall be of comparable food value and shall be recorded on the menu prior to the meal or snack being served. 862: Emergency Medical Care Plan (EMC) review EMC shall be reviewed with staff members annually. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (a) Each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. 1033: TB record Negative TB record shall be in each staff file prior to the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Tuberculin (TB) Test or Screening is the results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. It is required for all staff, including the director and individuals who volunteer more than once per week. Due date is on or before first day of work. 1034: Medical Statement Medical Statement shall be in each staff file prior to the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Medical Report is a statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. It is required for child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. The due date is prior to employment. When submitted, the medical statement shall not be older than 12 months. 1035: Emergency information form Emergency information form shall be in staff file on or before the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Emergency Information Form includes the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. It is required for child care providers, including the director, uncompensated providers, substitute providers, and volunteers. The due date is on or before the first day of work. The emergency information shall be updated as changes occur and at least annually. 1045: First six (6) weeks of orientation The record of first six (6) weeks of orientation shall be available for review. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. 1067: First two (2) weeks of orientation The record of first two (2) weeks of orientation shall be available for review. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. 1825: Emergency Preparedness and Response (EPR) plan review EPR plan shall be reviewed annually with staff members. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. 1897: Recognizing and Responding to Suspicions of Child Maltreatment The training shall be completed within ninety(90) days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/26/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest NC, 28768 Please call me at 828-556-9013, or email kaoru.eddins@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 is provided as follows: Orientation documents: Please review your operational policy for orientation and other staff file documents. Many documents are "missing" from the staff files frequently. Additional staff training and the review of your procedures may be necessary. Reminders: CPR/FA training is due to staff member hired on 6/27/23 on or prior to 9/25/23. CPR/FA training for a staff member hired on 8/28/23 is due on or before 11/2/34. BSAC shall be completed by the staff member hired on 6/27/23 on or before 9/27/23. BSAC training shall be completed by the staff member hired on 8/28/23 on or before 11/28/23. Sanitation inspection: Your last sanitation inspection was conducted on 9/28/22. Please contact your Environmental Health specialist to complete the inspection before 9/28/23. If you have any questions or concerns regarding the Stabilization, Expansion and Access Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 9/12/2023 Number Present: 44 Completed Date: 9/12/2023 Age: From 5 To 10 Total Minutes: 190 Time In: 02:20 PM Time Out: 05:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Lily Elder, Program Coordinator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Today, the Lily Elder, Program Coordinator, was available during the visit. Delaney Burke, Administrator met me on site and reviewed electronic staff files and children’s files with me. The indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven (87) percentage as of 9/8/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, The Young Men`s Christian Association of Western North Carolina, Inc. is current/active as of 9/8/23. Permit type – Five-star center license issued on 2/24/23. Special Services/Restrictions – daytime care, school age only, enhanced space and ratio, Playground area does not meet Child Care Playground safety requirements, children prohibited from occupying kitchen space for any reason. The last annual compliance visit was conducted on 9/22/22. The last fire drill was practiced on 8/29/23. The last shelter-in-place drill was practiced on 7/18/23. The last fire inspection was approved on 1/31/23. The last sanitation inspection was conducted on 9/28/22 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. There were three (3) groups. Upon arriving, the children washed hands in the bathroom and met in the cafeteria. All groups had snack. The menu was wheat tortilla, jelly, WOW butter, sunflower kernels, veggie blend juice, apple sauce and milk. The items were listed on the menu for Wednesday. Group one (1) played on the playground using swings, climbers, parachute and balls. Group two (2) played in the cafeteria with games, Legos, manipulative toys, BrainFlakes, beads, books and art materials. In the gym, group three (3) played with balls, games, manipulative toys, large pillows and bean bags. The group leader lead an discussion and talked about the project(s) each child is working on. Supervision of children and interaction were adequate. Two (2) new staff files and one (1) existing staff file were reviewed. There were various items missing in the electronic files. Orientation is typically conducted by a program coordinator, and the scanned documents are sent to the main office to upload into each staff file. Five (5) children’s files were monitored and in compliance. No children are currently on medication for this program. Transportations for this program is monitored separately. Therefore, it was not monitored during today’s visit. 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 528 Food substitution was not of comparable food value or recorded on the menu prior to the meal or snack being served. The snack items, wheat tortilla, jelly, WOW butter, vegetable blend juice, sunflower kernels, apple sauce and milk were serviced. Those items were listed on the Wednesdays menu. No corrections were made on the menu. 10A NCAC 09 .0901(b) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The EMC plan was not reviewed with a staff member hired on 8/28/23. 10A NCAC 09 .0802(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. TB information was not in staff file for a staff member hired on 6/27/23. .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Medical statement was not in staff file for a staff member hired on 6/27/23. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Emergency information form for a staff member hired on 12/5/22 and a staff member hired on 8/28/23 were not in the files. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. First six (6) weeks of orientation document was not in staff file forr a staff member hired on 8/28/23. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. First two (2) weeks of orientation information for a staff member hired on 8/28/23 was not in file. .1101(a)(b) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. The EPR plan was not reviewed with a staff member hired on 8/28/23. .0607(f) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A staff member hired on 12/5/22 did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) Technical assistance was provided as follows: 528: Substitution items on the menu Substitution items must be written on the menu prior to serving children. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (b) When food is prepared by or provided by the center, menus for nutritious meals and snacks shall be planned at least one week in advance. At least one dated copy of the current week's menu shall be posted where it can be seen by parents and food preparation staff when food is prepared or provided by the center. A variety of food shall be included in meals and snacks. Any substitution shall be of comparable food value and shall be recorded on the menu prior to the meal or snack being served. 862: Emergency Medical Care Plan (EMC) review EMC shall be reviewed with staff members annually. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (a) Each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. 1033: TB record Negative TB record shall be in each staff file prior to the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Tuberculin (TB) Test or Screening is the results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. It is required for all staff, including the director and individuals who volunteer more than once per week. Due date is on or before first day of work. 1034: Medical Statement Medical Statement shall be in each staff file prior to the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Medical Report is a statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. It is required for child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. The due date is prior to employment. When submitted, the medical statement shall not be older than 12 months. 1035: Emergency information form Emergency information form shall be in staff file on or before the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Emergency Information Form includes the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. It is required for child care providers, including the director, uncompensated providers, substitute providers, and volunteers. The due date is on or before the first day of work. The emergency information shall be updated as changes occur and at least annually. 1045: First six (6) weeks of orientation The record of first six (6) weeks of orientation shall be available for review. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. 1067: First two (2) weeks of orientation The record of first two (2) weeks of orientation shall be available for review. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. 1825: Emergency Preparedness and Response (EPR) plan review EPR plan shall be reviewed annually with staff members. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. 1897: Recognizing and Responding to Suspicions of Child Maltreatment The training shall be completed within ninety(90) days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/26/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest NC, 28768 Please call me at 828-556-9013, or email kaoru.eddins@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 is provided as follows: Orientation documents: Please review your operational policy for orientation and other staff file documents. Many documents are "missing" from the staff files frequently. Additional staff training and the review of your procedures may be necessary. Reminders: CPR/FA training is due to staff member hired on 6/27/23 on or prior to 9/25/23. CPR/FA training for a staff member hired on 8/28/23 is due on or before 11/2/34. BSAC shall be completed by the staff member hired on 6/27/23 on or before 9/27/23. BSAC training shall be completed by the staff member hired on 8/28/23 on or before 11/28/23. Sanitation inspection: Your last sanitation inspection was conducted on 9/28/22. Please contact your Environmental Health specialist to complete the inspection before 9/28/23. If you have any questions or concerns regarding the Stabilization, Expansion and Access Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 9/12/2023 Number Present: 44 Completed Date: 9/12/2023 Age: From 5 To 10 Total Minutes: 190 Time In: 02:20 PM Time Out: 05:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Lily Elder, Program Coordinator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Today, the Lily Elder, Program Coordinator, was available during the visit. Delaney Burke, Administrator met me on site and reviewed electronic staff files and children’s files with me. The indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven (87) percentage as of 9/8/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, The Young Men`s Christian Association of Western North Carolina, Inc. is current/active as of 9/8/23. Permit type – Five-star center license issued on 2/24/23. Special Services/Restrictions – daytime care, school age only, enhanced space and ratio, Playground area does not meet Child Care Playground safety requirements, children prohibited from occupying kitchen space for any reason. The last annual compliance visit was conducted on 9/22/22. The last fire drill was practiced on 8/29/23. The last shelter-in-place drill was practiced on 7/18/23. The last fire inspection was approved on 1/31/23. The last sanitation inspection was conducted on 9/28/22 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. There were three (3) groups. Upon arriving, the children washed hands in the bathroom and met in the cafeteria. All groups had snack. The menu was wheat tortilla, jelly, WOW butter, sunflower kernels, veggie blend juice, apple sauce and milk. The items were listed on the menu for Wednesday. Group one (1) played on the playground using swings, climbers, parachute and balls. Group two (2) played in the cafeteria with games, Legos, manipulative toys, BrainFlakes, beads, books and art materials. In the gym, group three (3) played with balls, games, manipulative toys, large pillows and bean bags. The group leader lead an discussion and talked about the project(s) each child is working on. Supervision of children and interaction were adequate. Two (2) new staff files and one (1) existing staff file were reviewed. There were various items missing in the electronic files. Orientation is typically conducted by a program coordinator, and the scanned documents are sent to the main office to upload into each staff file. Five (5) children’s files were monitored and in compliance. No children are currently on medication for this program. Transportations for this program is monitored separately. Therefore, it was not monitored during today’s visit. 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 528 Food substitution was not of comparable food value or recorded on the menu prior to the meal or snack being served. The snack items, wheat tortilla, jelly, WOW butter, vegetable blend juice, sunflower kernels, apple sauce and milk were serviced. Those items were listed on the Wednesdays menu. No corrections were made on the menu. 10A NCAC 09 .0901(b) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The EMC plan was not reviewed with a staff member hired on 8/28/23. 10A NCAC 09 .0802(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. TB information was not in staff file for a staff member hired on 6/27/23. .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Medical statement was not in staff file for a staff member hired on 6/27/23. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Emergency information form for a staff member hired on 12/5/22 and a staff member hired on 8/28/23 were not in the files. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. First six (6) weeks of orientation document was not in staff file forr a staff member hired on 8/28/23. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. First two (2) weeks of orientation information for a staff member hired on 8/28/23 was not in file. .1101(a)(b) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. The EPR plan was not reviewed with a staff member hired on 8/28/23. .0607(f) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A staff member hired on 12/5/22 did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) Technical assistance was provided as follows: 528: Substitution items on the menu Substitution items must be written on the menu prior to serving children. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (b) When food is prepared by or provided by the center, menus for nutritious meals and snacks shall be planned at least one week in advance. At least one dated copy of the current week's menu shall be posted where it can be seen by parents and food preparation staff when food is prepared or provided by the center. A variety of food shall be included in meals and snacks. Any substitution shall be of comparable food value and shall be recorded on the menu prior to the meal or snack being served. 862: Emergency Medical Care Plan (EMC) review EMC shall be reviewed with staff members annually. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (a) Each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. 1033: TB record Negative TB record shall be in each staff file prior to the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Tuberculin (TB) Test or Screening is the results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. It is required for all staff, including the director and individuals who volunteer more than once per week. Due date is on or before first day of work. 1034: Medical Statement Medical Statement shall be in each staff file prior to the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Medical Report is a statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. It is required for child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. The due date is prior to employment. When submitted, the medical statement shall not be older than 12 months. 1035: Emergency information form Emergency information form shall be in staff file on or before the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Emergency Information Form includes the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. It is required for child care providers, including the director, uncompensated providers, substitute providers, and volunteers. The due date is on or before the first day of work. The emergency information shall be updated as changes occur and at least annually. 1045: First six (6) weeks of orientation The record of first six (6) weeks of orientation shall be available for review. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. 1067: First two (2) weeks of orientation The record of first two (2) weeks of orientation shall be available for review. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. 1825: Emergency Preparedness and Response (EPR) plan review EPR plan shall be reviewed annually with staff members. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. 1897: Recognizing and Responding to Suspicions of Child Maltreatment The training shall be completed within ninety(90) days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/26/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest NC, 28768 Please call me at 828-556-9013, or email kaoru.eddins@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 is provided as follows: Orientation documents: Please review your operational policy for orientation and other staff file documents. Many documents are "missing" from the staff files frequently. Additional staff training and the review of your procedures may be necessary. Reminders: CPR/FA training is due to staff member hired on 6/27/23 on or prior to 9/25/23. CPR/FA training for a staff member hired on 8/28/23 is due on or before 11/2/34. BSAC shall be completed by the staff member hired on 6/27/23 on or before 9/27/23. BSAC training shall be completed by the staff member hired on 8/28/23 on or before 11/28/23. Sanitation inspection: Your last sanitation inspection was conducted on 9/28/22. Please contact your Environmental Health specialist to complete the inspection before 9/28/23. If you have any questions or concerns regarding the Stabilization, Expansion and Access Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: YMCA SANDHILL-VENABLE AFTERSCHOOL Facility ID: 11000688 Consultant: KAORU EDDINS Operation Type: Center Case Number: Visit Date: 9/12/2023 Number Present: 44 Completed Date: 9/12/2023 Age: From 5 To 10 Total Minutes: 190 Time In: 02:20 PM Time Out: 05:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaoru Eddins, Child Care Consultant and also signed by Lily Elder, Program Coordinator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Today, the Lily Elder, Program Coordinator, was available during the visit. Delaney Burke, Administrator met me on site and reviewed electronic staff files and children’s files with me. The indoor and outdoor areas were monitored today, including but not limited to supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven (87) percentage as of 9/8/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, The Young Men`s Christian Association of Western North Carolina, Inc. is current/active as of 9/8/23. Permit type – Five-star center license issued on 2/24/23. Special Services/Restrictions – daytime care, school age only, enhanced space and ratio, Playground area does not meet Child Care Playground safety requirements, children prohibited from occupying kitchen space for any reason. The last annual compliance visit was conducted on 9/22/22. The last fire drill was practiced on 8/29/23. The last shelter-in-place drill was practiced on 7/18/23. The last fire inspection was approved on 1/31/23. The last sanitation inspection was conducted on 9/28/22 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I announced my presence and the purpose of the visit. There were three (3) groups. Upon arriving, the children washed hands in the bathroom and met in the cafeteria. All groups had snack. The menu was wheat tortilla, jelly, WOW butter, sunflower kernels, veggie blend juice, apple sauce and milk. The items were listed on the menu for Wednesday. Group one (1) played on the playground using swings, climbers, parachute and balls. Group two (2) played in the cafeteria with games, Legos, manipulative toys, BrainFlakes, beads, books and art materials. In the gym, group three (3) played with balls, games, manipulative toys, large pillows and bean bags. The group leader lead an discussion and talked about the project(s) each child is working on. Supervision of children and interaction were adequate. Two (2) new staff files and one (1) existing staff file were reviewed. There were various items missing in the electronic files. Orientation is typically conducted by a program coordinator, and the scanned documents are sent to the main office to upload into each staff file. Five (5) children’s files were monitored and in compliance. No children are currently on medication for this program. Transportations for this program is monitored separately. Therefore, it was not monitored during today’s visit. 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 528 Food substitution was not of comparable food value or recorded on the menu prior to the meal or snack being served. The snack items, wheat tortilla, jelly, WOW butter, vegetable blend juice, sunflower kernels, apple sauce and milk were serviced. Those items were listed on the Wednesdays menu. No corrections were made on the menu. 10A NCAC 09 .0901(b) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The EMC plan was not reviewed with a staff member hired on 8/28/23. 10A NCAC 09 .0802(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. TB information was not in staff file for a staff member hired on 6/27/23. .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Medical statement was not in staff file for a staff member hired on 6/27/23. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Emergency information form for a staff member hired on 12/5/22 and a staff member hired on 8/28/23 were not in the files. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. First six (6) weeks of orientation document was not in staff file forr a staff member hired on 8/28/23. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. First two (2) weeks of orientation information for a staff member hired on 8/28/23 was not in file. .1101(a)(b) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. The EPR plan was not reviewed with a staff member hired on 8/28/23. .0607(f) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A staff member hired on 12/5/22 did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) Technical assistance was provided as follows: 528: Substitution items on the menu Substitution items must be written on the menu prior to serving children. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (b) When food is prepared by or provided by the center, menus for nutritious meals and snacks shall be planned at least one week in advance. At least one dated copy of the current week's menu shall be posted where it can be seen by parents and food preparation staff when food is prepared or provided by the center. A variety of food shall be included in meals and snacks. Any substitution shall be of comparable food value and shall be recorded on the menu prior to the meal or snack being served. 862: Emergency Medical Care Plan (EMC) review EMC shall be reviewed with staff members annually. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (a) Each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. 1033: TB record Negative TB record shall be in each staff file prior to the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Tuberculin (TB) Test or Screening is the results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. It is required for all staff, including the director and individuals who volunteer more than once per week. Due date is on or before first day of work. 1034: Medical Statement Medical Statement shall be in each staff file prior to the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Medical Report is a statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. It is required for child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. The due date is prior to employment. When submitted, the medical statement shall not be older than 12 months. 1035: Emergency information form Emergency information form shall be in staff file on or before the first day of employment. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Emergency Information Form includes the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. It is required for child care providers, including the director, uncompensated providers, substitute providers, and volunteers. The due date is on or before the first day of work. The emergency information shall be updated as changes occur and at least annually. 1045: First six (6) weeks of orientation The record of first six (6) weeks of orientation shall be available for review. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. 1067: First two (2) weeks of orientation The record of first two (2) weeks of orientation shall be available for review. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. 1825: Emergency Preparedness and Response (EPR) plan review EPR plan shall be reviewed annually with staff members. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. 1897: Recognizing and Responding to Suspicions of Child Maltreatment The training shall be completed within ninety(90) days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/26/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaoru.eddins@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaoru Eddins PO Box 795 Pisgah Forest NC, 28768 Please call me at 828-556-9013, or email kaoru.eddins@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 is provided as follows: Orientation documents: Please review your operational policy for orientation and other staff file documents. Many documents are "missing" from the staff files frequently. Additional staff training and the review of your procedures may be necessary. Reminders: CPR/FA training is due to staff member hired on 6/27/23 on or prior to 9/25/23. CPR/FA training for a staff member hired on 8/28/23 is due on or before 11/2/34. BSAC shall be completed by the staff member hired on 6/27/23 on or before 9/27/23. BSAC training shall be completed by the staff member hired on 8/28/23 on or before 11/28/23. Sanitation inspection: Your last sanitation inspection was conducted on 9/28/22. Please contact your Environmental Health specialist to complete the inspection before 9/28/23. If you have any questions or concerns regarding the Stabilization, Expansion and Access Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaoru.eddins@dhhs.nc.gov or 828.556.9013, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times