Ywca OF Asheville Early Learning Program

10A NCAC 09 .0803 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: 0526-017L Visit Date: 5/11/2026 Number Present: 77 Completed Date: 5/11/2026 Age: From 0 To 5 Total Minutes: 120 Time In: 09:30 AM Time Out: 11:30 AM Time In: Time Out: List to Use: Center Type Of Visit: Self Report Announced/Unannounced: Unannounced The purpose of today’s visit was to obtain information related to a self-report received by the Division. During today’s visit, Alesia Summey, Administrator, and Emilina Smith, Director of Operations, were present and available to ask and answer questions throughout the visit today. During the visit, I discussed the information with Ms. Summey, Ms. Smith and additional staff members. Limited monitoring of child care requirements was conducted today to include medication administration. There is a concern that medication was administered to an infant without written authorization from the child’s parent. I interviewed four (4) staff. I observed routine caregiving activities in classroom space 1. I reviewed the Medication Administration Error form. Based on the self-report, interviews and documents reviewed, the concern regarding medication administration is confirmed. The following violations were documented during today’s visit: Violation Number Comment Rule 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. On 4/30/26 at approximately 2:45pm, an infant in classroom space 1 was given a bottle of formula mixed with ibuprofen. The bottle was prepared by caregivers at home and the grandparents of the infant made a verbal request to teachers to give the child the medicated bottle at the facility. Written authorization from the parent was not obtained prior to administration. 10A NCAC 09 .0803(1)(a & b) Technical assistance was provided as follows: Item #842: The operator stated that they have already completed the following corrective action regarding the incident: -Medication administration procedures were reviewed with all staff on 5/8/26. -Medication training was conducted by Robin Worley, Child Care Health Consultant, on 5/8/26. Staff completed additional Medication training on the DCDEE Moodle on 5/8/26. -You stated you are in the process of revising the medication administration policy in the parent handbook to be distributed to parents and staff. To reach compliance with this item, in your letter of compliance, include a statement that indicates the revised medication administration policy has been signed by the parents of all children in classroom space 1. We discussed all parents throughout all licensed classrooms in the facility will sign the policy as well. Achieving Compliance: 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# • Name and position of individual submitting compliance statement • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 5/25/26. Email the compliance letter on signed letterhead or it must be sent from the email address registered with the DCDEE (this serves as your signature) to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable to your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and can be a resource for you while you strive to provide a safe and healthy environment for the well-being of young children. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: 0526-017L Visit Date: 5/11/2026 Number Present: 77 Completed Date: 5/11/2026 Age: From 0 To 5 Total Minutes: 120 Time In: 09:30 AM Time Out: 11:30 AM Time In: Time Out: List to Use: Center Type Of Visit: Self Report Announced/Unannounced: Unannounced The purpose of today’s visit was to obtain information related to a self-report received by the Division. During today’s visit, Alesia Summey, Administrator, and Emilina Smith, Director of Operations, were present and available to ask and answer questions throughout the visit today. During the visit, I discussed the information with Ms. Summey, Ms. Smith and additional staff members. Limited monitoring of child care requirements was conducted today to include medication administration. There is a concern that medication was administered to an infant without written authorization from the child’s parent. I interviewed four (4) staff. I observed routine caregiving activities in classroom space 1. I reviewed the Medication Administration Error form. Based on the self-report, interviews and documents reviewed, the concern regarding medication administration is confirmed. The following violations were documented during today’s visit: Violation Number Comment Rule 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. On 4/30/26 at approximately 2:45pm, an infant in classroom space 1 was given a bottle of formula mixed with ibuprofen. The bottle was prepared by caregivers at home and the grandparents of the infant made a verbal request to teachers to give the child the medicated bottle at the facility. Written authorization from the parent was not obtained prior to administration. 10A NCAC 09 .0803(1)(a & b) Technical assistance was provided as follows: Item #842: The operator stated that they have already completed the following corrective action regarding the incident: -Medication administration procedures were reviewed with all staff on 5/8/26. -Medication training was conducted by Robin Worley, Child Care Health Consultant, on 5/8/26. Staff completed additional Medication training on the DCDEE Moodle on 5/8/26. -You stated you are in the process of revising the medication administration policy in the parent handbook to be distributed to parents and staff. To reach compliance with this item, in your letter of compliance, include a statement that indicates the revised medication administration policy has been signed by the parents of all children in classroom space 1. We discussed all parents throughout all licensed classrooms in the facility will sign the policy as well. Achieving Compliance: 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# • Name and position of individual submitting compliance statement • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 5/25/26. Email the compliance letter on signed letterhead or it must be sent from the email address registered with the DCDEE (this serves as your signature) to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable to your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and can be a resource for you while you strive to provide a safe and healthy environment for the well-being of young children. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0605 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 4/29/2026 Number Present: 83 Completed Date: 4/29/2026 Age: From 0 To 5 Total Minutes: 375 Time In: 09:45 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a Routine Unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Alesia Summey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Summey was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, CPR/First Aid, special training, CBC qualification, Emergency Medical Care plan, administration of medication, storage of hazardous products, storage of medication, general safety, adequate/approved space, program records, license posted. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-five percent (85%) as of 4/27/26. Permit type – Five (5) star license issued 6/17/25. Special Services/Restrictions – 1st shift (daytime care), meets enhanced ratios, meets enhanced space, children under 2.5 years old in rooms with direct exits only. The facility is approved to provide NC Pre-K, Transportation and Field Trips. The facility has a swimming pool and serves children with special needs. The last annual compliance visit was conducted on 11/5/25. The last fire drill was practiced on 3/27/26. The last shelter-in-place drill was practiced on 3/4/26. The last fire inspection was approved on 11/10/25. The last sanitation inspection was conducted on 3/12/26 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival I was greeted by Ms. Summey and Emilina Smith, Assistant Director. In classroom space 7, children engaged in a large group painting activity, and then transitioned to use the restroom and wash hands. In classroom space 9, children completed a mother’s day art project, built large structures with blocks and pretended to grocery shop in the dramatic play center. In classroom space 4, children were engaged in a large group read aloud conducted by a visitor. In classroom space 1, children explored their environment by crawling, were soothed by caregivers and explored mouthable toys. Children from classrooms 6 and 2 were observed exploring the outdoor learning environment on the infant/toddler playground. Children pushed toy trucks and scooted around on riding toys. In classroom space 3, children participated in singing songs with the caregiver as lunch was prepared. Interactions were positive and nurturing, supervision was adequate. Upon reviewing the working file, I noted outdoor space calculations were missing for the lower playground and the infant/toddler playground. These spaces were measured today. Documentation is provided to you in the email containing this visit summary. Capacities were measured as follows: Lower Playground: Thirty-one (31) children at 75 square feet per child. Twenty-four (24) children at 100 square feet per child. Infant/Toddler Playground: Twenty-eight (28) children at 75 square feet per child. Twenty-one (21) children at 100 square feet per child. As a reminder, you are required to follow enhanced space at 100 square feet per child, per your current license. 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 892 The center's safe sleep policy was not posted in a prominent place in the infant room where parents and caregivers were able to view daily. The center’s safe sleep policy was not posted in a prominent place in the classroom for infants, classroom space 1. .0606(b) 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, hire date 10/1/25, had a First Aid certificate that expired 12/14/25 .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, hire date 10/1/25, had a CPR certificate that expired 12/14/25 .1102(d) 1757 A valid qualification letter was not on file and available to review at the facility. The criminal background check qualifying letter for L. Yom Tov was not on file at the facility. G.S. 110-90.2(b) & (d) & .2703(e) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. The Medical Action Plan for one (1) child in classroom space 9 was last updated on 2/5/25. .0801(b) Technical assistance was provided as follows: Item #1835: To reach compliance with this item, the parent must complete a new Medical Action Plan. As a reminder, Medical Action Plans must be updated on an annual basis. We discussed, the plan can be conducted by a medical professional or the child’s parent. In your letter of compliance, include a statement that indicates the medical action plan has been updated and is on file at the facility. Item #892: The policy was posted during the visit today. This is corrected. Item #1048 and #1049: To reach compliance with this item, the staff must receive a new CPR/First Aid training from an approved trainer. Please note, extensions are not typically available for this type of violation. You stated you have an approved trainer on site. Please note, back to back CPR/First Aid violations may result in an Administrative Action recommendation. Item #1757: To reach compliance with this item, a copy of the qualification letter must be on file at the facility. We discussed NCID technology challenges have prevented the staff member from accessing their ABCMS portal to retrieve their letter. Have the staff continue to log in using their updated username/password. We discussed, if the technology issues persist, you may request an extension for this item. Please send me a written extension request via email containing: the item #, the reason the extension is needed, the new date you would like the compliance due. You can also try to email the Criminal Background Check Unit to request a copy of the letter. Here is the email contact: DHHS.CBC.Unit@dhhs.nc.gov 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# • Name and position of individual submitting compliance statement • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 5/13/26. Email the compliance letter on signed letterhead or it must be sent from the email address registered with the DCDEE (this serves as your signature) to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed the QRIS Modernization: Pathways to the Stars. You stated you are still interested in pursuing Pathway 1: Program Assessment. I recommend beginning the three month self study soon, as this must be done prior to applying for the Rated License. We discussed Education for Lead Teachers and Teachers continues to be the biggest foreseeable barrier in maintaining a five (5) star license. We discussed some possibilities to adding to licensed space. For outdoor space, we discussed adding a fence to the bee garden on the west-facing side of the building to add an outdoor space to the approved floor plan. We also discussed altering the railing and gate on the porch facing the east-facing side of the building. I would need to measure and approved these spaces prior to use by children. Please allow a thirty (30) day notice for any changes to the indoor/outdoor floor plan. Please refer to section .0605 of the Child Care Rules for details. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (g) Any openings in equipment, steps, decks, handrails, and fencing shall be smaller than 3 ½ inches or greater than 9 inches to prevent entrapment. (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 4/29/2026 Number Present: 83 Completed Date: 4/29/2026 Age: From 0 To 5 Total Minutes: 375 Time In: 09:45 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a Routine Unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Alesia Summey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Summey was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, CPR/First Aid, special training, CBC qualification, Emergency Medical Care plan, administration of medication, storage of hazardous products, storage of medication, general safety, adequate/approved space, program records, license posted. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-five percent (85%) as of 4/27/26. Permit type – Five (5) star license issued 6/17/25. Special Services/Restrictions – 1st shift (daytime care), meets enhanced ratios, meets enhanced space, children under 2.5 years old in rooms with direct exits only. The facility is approved to provide NC Pre-K, Transportation and Field Trips. The facility has a swimming pool and serves children with special needs. The last annual compliance visit was conducted on 11/5/25. The last fire drill was practiced on 3/27/26. The last shelter-in-place drill was practiced on 3/4/26. The last fire inspection was approved on 11/10/25. The last sanitation inspection was conducted on 3/12/26 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival I was greeted by Ms. Summey and Emilina Smith, Assistant Director. In classroom space 7, children engaged in a large group painting activity, and then transitioned to use the restroom and wash hands. In classroom space 9, children completed a mother’s day art project, built large structures with blocks and pretended to grocery shop in the dramatic play center. In classroom space 4, children were engaged in a large group read aloud conducted by a visitor. In classroom space 1, children explored their environment by crawling, were soothed by caregivers and explored mouthable toys. Children from classrooms 6 and 2 were observed exploring the outdoor learning environment on the infant/toddler playground. Children pushed toy trucks and scooted around on riding toys. In classroom space 3, children participated in singing songs with the caregiver as lunch was prepared. Interactions were positive and nurturing, supervision was adequate. Upon reviewing the working file, I noted outdoor space calculations were missing for the lower playground and the infant/toddler playground. These spaces were measured today. Documentation is provided to you in the email containing this visit summary. Capacities were measured as follows: Lower Playground: Thirty-one (31) children at 75 square feet per child. Twenty-four (24) children at 100 square feet per child. Infant/Toddler Playground: Twenty-eight (28) children at 75 square feet per child. Twenty-one (21) children at 100 square feet per child. As a reminder, you are required to follow enhanced space at 100 square feet per child, per your current license. 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 892 The center's safe sleep policy was not posted in a prominent place in the infant room where parents and caregivers were able to view daily. The center’s safe sleep policy was not posted in a prominent place in the classroom for infants, classroom space 1. .0606(b) 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, hire date 10/1/25, had a First Aid certificate that expired 12/14/25 .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, hire date 10/1/25, had a CPR certificate that expired 12/14/25 .1102(d) 1757 A valid qualification letter was not on file and available to review at the facility. The criminal background check qualifying letter for L. Yom Tov was not on file at the facility. G.S. 110-90.2(b) & (d) & .2703(e) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. The Medical Action Plan for one (1) child in classroom space 9 was last updated on 2/5/25. .0801(b) Technical assistance was provided as follows: Item #1835: To reach compliance with this item, the parent must complete a new Medical Action Plan. As a reminder, Medical Action Plans must be updated on an annual basis. We discussed, the plan can be conducted by a medical professional or the child’s parent. In your letter of compliance, include a statement that indicates the medical action plan has been updated and is on file at the facility. Item #892: The policy was posted during the visit today. This is corrected. Item #1048 and #1049: To reach compliance with this item, the staff must receive a new CPR/First Aid training from an approved trainer. Please note, extensions are not typically available for this type of violation. You stated you have an approved trainer on site. Please note, back to back CPR/First Aid violations may result in an Administrative Action recommendation. Item #1757: To reach compliance with this item, a copy of the qualification letter must be on file at the facility. We discussed NCID technology challenges have prevented the staff member from accessing their ABCMS portal to retrieve their letter. Have the staff continue to log in using their updated username/password. We discussed, if the technology issues persist, you may request an extension for this item. Please send me a written extension request via email containing: the item #, the reason the extension is needed, the new date you would like the compliance due. You can also try to email the Criminal Background Check Unit to request a copy of the letter. Here is the email contact: DHHS.CBC.Unit@dhhs.nc.gov 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# • Name and position of individual submitting compliance statement • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 5/13/26. Email the compliance letter on signed letterhead or it must be sent from the email address registered with the DCDEE (this serves as your signature) to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed the QRIS Modernization: Pathways to the Stars. You stated you are still interested in pursuing Pathway 1: Program Assessment. I recommend beginning the three month self study soon, as this must be done prior to applying for the Rated License. We discussed Education for Lead Teachers and Teachers continues to be the biggest foreseeable barrier in maintaining a five (5) star license. We discussed some possibilities to adding to licensed space. For outdoor space, we discussed adding a fence to the bee garden on the west-facing side of the building to add an outdoor space to the approved floor plan. We also discussed altering the railing and gate on the porch facing the east-facing side of the building. I would need to measure and approved these spaces prior to use by children. Please allow a thirty (30) day notice for any changes to the indoor/outdoor floor plan. Please refer to section .0605 of the Child Care Rules for details. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (g) Any openings in equipment, steps, decks, handrails, and fencing shall be smaller than 3 ½ inches or greater than 9 inches to prevent entrapment. (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 4/29/2026 Number Present: 83 Completed Date: 4/29/2026 Age: From 0 To 5 Total Minutes: 375 Time In: 09:45 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a Routine Unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Alesia Summey, Administrator, during the visit. A signed copy of the visit summary was emailed to you. Ms. Summey was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, CPR/First Aid, special training, CBC qualification, Emergency Medical Care plan, administration of medication, storage of hazardous products, storage of medication, general safety, adequate/approved space, program records, license posted. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-five percent (85%) as of 4/27/26. Permit type – Five (5) star license issued 6/17/25. Special Services/Restrictions – 1st shift (daytime care), meets enhanced ratios, meets enhanced space, children under 2.5 years old in rooms with direct exits only. The facility is approved to provide NC Pre-K, Transportation and Field Trips. The facility has a swimming pool and serves children with special needs. The last annual compliance visit was conducted on 11/5/25. The last fire drill was practiced on 3/27/26. The last shelter-in-place drill was practiced on 3/4/26. The last fire inspection was approved on 11/10/25. The last sanitation inspection was conducted on 3/12/26 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival I was greeted by Ms. Summey and Emilina Smith, Assistant Director. In classroom space 7, children engaged in a large group painting activity, and then transitioned to use the restroom and wash hands. In classroom space 9, children completed a mother’s day art project, built large structures with blocks and pretended to grocery shop in the dramatic play center. In classroom space 4, children were engaged in a large group read aloud conducted by a visitor. In classroom space 1, children explored their environment by crawling, were soothed by caregivers and explored mouthable toys. Children from classrooms 6 and 2 were observed exploring the outdoor learning environment on the infant/toddler playground. Children pushed toy trucks and scooted around on riding toys. In classroom space 3, children participated in singing songs with the caregiver as lunch was prepared. Interactions were positive and nurturing, supervision was adequate. Upon reviewing the working file, I noted outdoor space calculations were missing for the lower playground and the infant/toddler playground. These spaces were measured today. Documentation is provided to you in the email containing this visit summary. Capacities were measured as follows: Lower Playground: Thirty-one (31) children at 75 square feet per child. Twenty-four (24) children at 100 square feet per child. Infant/Toddler Playground: Twenty-eight (28) children at 75 square feet per child. Twenty-one (21) children at 100 square feet per child. As a reminder, you are required to follow enhanced space at 100 square feet per child, per your current license. 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 892 The center's safe sleep policy was not posted in a prominent place in the infant room where parents and caregivers were able to view daily. The center’s safe sleep policy was not posted in a prominent place in the classroom for infants, classroom space 1. .0606(b) 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, hire date 10/1/25, had a First Aid certificate that expired 12/14/25 .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, hire date 10/1/25, had a CPR certificate that expired 12/14/25 .1102(d) 1757 A valid qualification letter was not on file and available to review at the facility. The criminal background check qualifying letter for L. Yom Tov was not on file at the facility. G.S. 110-90.2(b) & (d) & .2703(e) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. The Medical Action Plan for one (1) child in classroom space 9 was last updated on 2/5/25. .0801(b) Technical assistance was provided as follows: Item #1835: To reach compliance with this item, the parent must complete a new Medical Action Plan. As a reminder, Medical Action Plans must be updated on an annual basis. We discussed, the plan can be conducted by a medical professional or the child’s parent. In your letter of compliance, include a statement that indicates the medical action plan has been updated and is on file at the facility. Item #892: The policy was posted during the visit today. This is corrected. Item #1048 and #1049: To reach compliance with this item, the staff must receive a new CPR/First Aid training from an approved trainer. Please note, extensions are not typically available for this type of violation. You stated you have an approved trainer on site. Please note, back to back CPR/First Aid violations may result in an Administrative Action recommendation. Item #1757: To reach compliance with this item, a copy of the qualification letter must be on file at the facility. We discussed NCID technology challenges have prevented the staff member from accessing their ABCMS portal to retrieve their letter. Have the staff continue to log in using their updated username/password. We discussed, if the technology issues persist, you may request an extension for this item. Please send me a written extension request via email containing: the item #, the reason the extension is needed, the new date you would like the compliance due. You can also try to email the Criminal Background Check Unit to request a copy of the letter. Here is the email contact: DHHS.CBC.Unit@dhhs.nc.gov 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# • Name and position of individual submitting compliance statement • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 5/13/26. Email the compliance letter on signed letterhead or it must be sent from the email address registered with the DCDEE (this serves as your signature) to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed the QRIS Modernization: Pathways to the Stars. You stated you are still interested in pursuing Pathway 1: Program Assessment. I recommend beginning the three month self study soon, as this must be done prior to applying for the Rated License. We discussed Education for Lead Teachers and Teachers continues to be the biggest foreseeable barrier in maintaining a five (5) star license. We discussed some possibilities to adding to licensed space. For outdoor space, we discussed adding a fence to the bee garden on the west-facing side of the building to add an outdoor space to the approved floor plan. We also discussed altering the railing and gate on the porch facing the east-facing side of the building. I would need to measure and approved these spaces prior to use by children. Please allow a thirty (30) day notice for any changes to the indoor/outdoor floor plan. Please refer to section .0605 of the Child Care Rules for details. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (g) Any openings in equipment, steps, decks, handrails, and fencing shall be smaller than 3 ½ inches or greater than 9 inches to prevent entrapment. (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1801 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: 0326-190L Visit Date: 3/24/2026 Number Present: 77 Completed Date: 3/24/2026 Age: From 0 To 5 Total Minutes: 210 Time In: 09:30 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Self Report Announced/Unannounced: Unannounced The purpose of today’s visit was to obtain information related to a self-report received by the Division. During today’s visit, Alesia Summey, Administrator, and Emilina Smith, Assistant Director, accompanied me during a walk-through of the facility. During the visit, I discussed the information with Ms. Summey, Ms. Smith, and additional staff members. Limited monitoring of child care requirements was conducted today to include supervision. There is a concern of inadequate supervision. I interviewed five (5) staff. Video footage for both incidents was reviewed during the visit today. I observed all classroom spaces and the multipurpose room. Supervision was adequate during the visit today. I reviewed the supervision policy updated on 8/4/25. I reviewed the agenda from an all staff meeting that occurred on 3/19/26 in which new supervision procedures and requirements were introduced. I reviewed the corrective action plans for two (2) staff. Based on information obtained, the following was determined. On 3/11/26 at approximately 3:00pm, a three year old child was left unsupervised in classroom space 4 for approximately twenty-six (26) minutes. The incident occurred during a whole class transition to the playground. Per staff interview, a head count was conducted in the hallway. However, a staff change occurred prior to the transition. The total number of children present was not accurately communicated, resulting in a miscount. The transition sheets were not completed. On 3/13/26 at approximately 4:19pm, a two year old child walked out of classroom space 4 without the teacher’s knowledge. The child was unsupervised in the hallway for approximately thirty (30) seconds. One (1) staff was present in the classroom, assisting three (3) children in the bathroom. The two year old child left the bathroom to go wash hands as directed by the teacher. The two year old child saw their parent in the hallway and walked through the open door to follow their parent. Upon noticing the child left the classroom, the teacher called the child and parent back to the room to complete sign out procedures. Based on the self-report, interviews and video footage, the concern regarding supervision is confirmed. The following violations were documented during today’s visit: Violation Number Comment Rule 303 Children were not adequately supervised at all times. On 3/11/26 at approximately 3:01pm, a three year old child was left unsupervised in space #4 for approximately twenty-six (26) minutes. On 3/13/26 at approximately 4:19pm, a two year old child walked out of space #4 without the teacher’s knowledge. The child was unsupervised by staff in the hallway for approximately thirty (30) seconds. .1801(a)(1-5) Technical assistance was provided as follows: Item #303: Children must be adequately supervised at all times and staff must know children’s whereabouts according to rule .1801 (a)(1-5). We discussed the factors that led to the incidents that occurred on 3/11/26 and 3/13/26 including staff communication regarding head count, transition/head count/name to face sheets, and open doors in classrooms where children were present. We also discussed reminding parents of sign out procedures. The facility has already put the following procedures in place to prevent violations in the future: -A staff meeting was held at 5:00pm on 3/11/26 and at 6:00pm on 3/19/26. An agenda was provided for the staff meeting on 3/19/26. -The staff member responsible for the incident on 3/11/26 was terminated. Other staff received corrective action according to the facility’s policies. -An updated transition log was implemented and was observed in use by the facility during the visit today. Staff stated they felt the transition sheets were helpful in keeping track of head counts/name to face counts. There are plans to implement head counts on the app ProCare eventually. -Staff have been assigned supervision training, “Transitions: Creating Smooth Moves” from Southwestern Child Development Commission. The due date for completion of the training is within one week from when it is assigned. The link was received during the visit today, so the training will be completed next week. -The facility has implemented a closed-door policy when children are in care in the classroom spaces to prevent eloping. I recommend conveying this policy to parents and visitors to the facility via signage. In your letter of compliance, include all procedures, trainings and policies you have implemented, completed or updated in response to the supervision incidents. Achieving Compliance: The facility received a violation regarding supervision today. A follow-up visit may be conducted in the near future to determine if staff are adequately supervising children per Child Care Rule 10A NCAC 09 .1801(a)(1-5). 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# • Name and position of individual submitting compliance statement • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 4/7/26. Email the compliance letter on signed letterhead or it must be sent from the email address registered with the DCDEE (this serves as your signature) to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. 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. Due to the confirmation of supervision concerns, the length of time the child was left alone on 3/11/26, and the pattern of supervision concerns within the last eighteen (18) months, an Administrative Action may be recommended. Consultation is provided as follows: I was able to observe a transition in classroom space 4 today. Teachers conducted name to face counts at each threshold and documented headcounts on the transition sheet. Supervision was adequate during the transition I observed today. I noted that children waited a couple of minutes while their peers were lining up. The teacher stated they are working on trying new strategies to transition smoothly, so there could be a learning curve for both children and staff with the new procedures. I recommend working to reduce the time waiting in line for children, which may still be a difficult skill for 2.5 to 3 year old children. To help this, you can place visual indicators on the ground such as tape in various colors or shapes to give a visual target where children can stand while they are waiting for their peers to line up. The training from Southwestern Child Development Commission may offer additional strategies to assist with this. We discussed that transitions are typically difficult for this age group. I recommend adding extra support during known transition times while new strategies are being implemented. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable to your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and can be a resource for you while you strive to provide a safe and healthy environment for the well-being of young children. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: 0326-190L Visit Date: 3/24/2026 Number Present: 77 Completed Date: 3/24/2026 Age: From 0 To 5 Total Minutes: 210 Time In: 09:30 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Self Report Announced/Unannounced: Unannounced The purpose of today’s visit was to obtain information related to a self-report received by the Division. During today’s visit, Alesia Summey, Administrator, and Emilina Smith, Assistant Director, accompanied me during a walk-through of the facility. During the visit, I discussed the information with Ms. Summey, Ms. Smith, and additional staff members. Limited monitoring of child care requirements was conducted today to include supervision. There is a concern of inadequate supervision. I interviewed five (5) staff. Video footage for both incidents was reviewed during the visit today. I observed all classroom spaces and the multipurpose room. Supervision was adequate during the visit today. I reviewed the supervision policy updated on 8/4/25. I reviewed the agenda from an all staff meeting that occurred on 3/19/26 in which new supervision procedures and requirements were introduced. I reviewed the corrective action plans for two (2) staff. Based on information obtained, the following was determined. On 3/11/26 at approximately 3:00pm, a three year old child was left unsupervised in classroom space 4 for approximately twenty-six (26) minutes. The incident occurred during a whole class transition to the playground. Per staff interview, a head count was conducted in the hallway. However, a staff change occurred prior to the transition. The total number of children present was not accurately communicated, resulting in a miscount. The transition sheets were not completed. On 3/13/26 at approximately 4:19pm, a two year old child walked out of classroom space 4 without the teacher’s knowledge. The child was unsupervised in the hallway for approximately thirty (30) seconds. One (1) staff was present in the classroom, assisting three (3) children in the bathroom. The two year old child left the bathroom to go wash hands as directed by the teacher. The two year old child saw their parent in the hallway and walked through the open door to follow their parent. Upon noticing the child left the classroom, the teacher called the child and parent back to the room to complete sign out procedures. Based on the self-report, interviews and video footage, the concern regarding supervision is confirmed. The following violations were documented during today’s visit: Violation Number Comment Rule 303 Children were not adequately supervised at all times. On 3/11/26 at approximately 3:01pm, a three year old child was left unsupervised in space #4 for approximately twenty-six (26) minutes. On 3/13/26 at approximately 4:19pm, a two year old child walked out of space #4 without the teacher’s knowledge. The child was unsupervised by staff in the hallway for approximately thirty (30) seconds. .1801(a)(1-5) Technical assistance was provided as follows: Item #303: Children must be adequately supervised at all times and staff must know children’s whereabouts according to rule .1801 (a)(1-5). We discussed the factors that led to the incidents that occurred on 3/11/26 and 3/13/26 including staff communication regarding head count, transition/head count/name to face sheets, and open doors in classrooms where children were present. We also discussed reminding parents of sign out procedures. The facility has already put the following procedures in place to prevent violations in the future: -A staff meeting was held at 5:00pm on 3/11/26 and at 6:00pm on 3/19/26. An agenda was provided for the staff meeting on 3/19/26. -The staff member responsible for the incident on 3/11/26 was terminated. Other staff received corrective action according to the facility’s policies. -An updated transition log was implemented and was observed in use by the facility during the visit today. Staff stated they felt the transition sheets were helpful in keeping track of head counts/name to face counts. There are plans to implement head counts on the app ProCare eventually. -Staff have been assigned supervision training, “Transitions: Creating Smooth Moves” from Southwestern Child Development Commission. The due date for completion of the training is within one week from when it is assigned. The link was received during the visit today, so the training will be completed next week. -The facility has implemented a closed-door policy when children are in care in the classroom spaces to prevent eloping. I recommend conveying this policy to parents and visitors to the facility via signage. In your letter of compliance, include all procedures, trainings and policies you have implemented, completed or updated in response to the supervision incidents. Achieving Compliance: The facility received a violation regarding supervision today. A follow-up visit may be conducted in the near future to determine if staff are adequately supervising children per Child Care Rule 10A NCAC 09 .1801(a)(1-5). 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# • Name and position of individual submitting compliance statement • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 4/7/26. Email the compliance letter on signed letterhead or it must be sent from the email address registered with the DCDEE (this serves as your signature) to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. 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. Due to the confirmation of supervision concerns, the length of time the child was left alone on 3/11/26, and the pattern of supervision concerns within the last eighteen (18) months, an Administrative Action may be recommended. Consultation is provided as follows: I was able to observe a transition in classroom space 4 today. Teachers conducted name to face counts at each threshold and documented headcounts on the transition sheet. Supervision was adequate during the transition I observed today. I noted that children waited a couple of minutes while their peers were lining up. The teacher stated they are working on trying new strategies to transition smoothly, so there could be a learning curve for both children and staff with the new procedures. I recommend working to reduce the time waiting in line for children, which may still be a difficult skill for 2.5 to 3 year old children. To help this, you can place visual indicators on the ground such as tape in various colors or shapes to give a visual target where children can stand while they are waiting for their peers to line up. The training from Southwestern Child Development Commission may offer additional strategies to assist with this. We discussed that transitions are typically difficult for this age group. I recommend adding extra support during known transition times while new strategies are being implemented. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable to your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and can be a resource for you while you strive to provide a safe and healthy environment for the well-being of young children. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 11/5/2025 Number Present: 73 Completed Date: 11/5/2025 Age: From 0 To 5 Total Minutes: 510 Time In: 09:00 AM 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 me, Kaitlyn Marshall, Child Care Consultant and also signed by Alesia Summey, Director, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. Summey and Emilina Smith, Assistant Director, assisted me on 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 percent (90%) as of 11/5/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, YWCA of Asheville and Western North Carolina, Inc., is current/active as of 11/5/25. Permit type – Five (5) star license issued 6/17/25. Special Services/Restrictions – 1st shift (daytime care). Meets enhanced space, meets enhanced ratios, children under 2.5 years old in rooms with direct exits only. The facility is approved to provide Transportation, field trips, swimming pool and serves children with special needs. The facility is approved to provide NC Pre-K services as confirmed on the NC Pre-K Plan website. This change will be indicated on the facility input page in Regulatory following today’s visit. The last annual compliance visit was conducted on 11/14/24. The last fire drill was practiced on 10/23/25. The last lockdown drill was practiced on 9/30/25 The last playground inspection was documented on 10/17/25. The last fire inspection was approved on 2/5/25. The inspection was not documented on the form provided by the Division. The last sanitation inspection was conducted on 2/17/25 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. The approved Formative Assessment tool is Teaching Strategies Gold. Lead water testing was completed on 3/27/24 without hazards. Lead paint testing has not been completed. The Clean Classrooms for Carolina Kids Website lists the status as “Enrollment Started”. Continue to work with RTI to complete testing requirements. Asbestos testing has not been completed. The Clean Classrooms for Carolina Kids website lists the status as “Survey Review by RTI”. Continue to work with RTI to complete testing requirements. The program is approved to provide transportation. Currently, transportation is only provided for field trips. Two (2) vehicles were monitored today. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. The NC Pre-K Program Site Monitoring Tool completed on 10/28/25 was reviewed today. One (1) NC Pre-K child’s file was monitored today. The classroom operates from 8:30 a.m. to 3:00 p.m. In classroom space 7, children were engaged in free-play and were observed completing an art project using stamps, caring for animals and dolls, and exploring various sensory toys. In classroom space 9, children drew pictures and dictated to teachers, built small structures with magnatiles and explored various objects on a light table. In classroom space 1, children freely explored their environment and participated in routine caregiving activities such as feeding. In classroom space 2, children participate din routine caregiving activities such as diapering and explored the outdoor learning environment. In classroom space 6, children transitioned to the indoor learning environment from outdoors and washed hands in preparation for lunch. In classroom space 3, children transitioned indoors and washed hands for lunch. Lunch today consisted of pasta, meat sauce, milk, green beans and apples. In classroom space 4, children ate lunch with caregivers. Interactions were positive and nurturing. Supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ Due to time constraints, I was unable to complete monitoring today. I will return to complete the monitoring of staff files. The following violations were documented during today’s visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The last fire inspection was conducted on 2/5/25. The inspection was not documented on the form provided by the Division. 10A NCAC 09 .0304(a) 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. A jug of bleach was not maintained in locked storage in the kitchen. .2820(b) 898 All electrical appliances were not used in accordance with the manufacturers instruction. Appliances with heating elements, such as bottle warmers, crock pots, curling irons, irons, coffee pots, and/or their cords were accessible to preschool-age children. A coffee maker was observed in the lobby near the entrance of the building. .0604(e) 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. The medical report for one (1) staff, hire date 9/22/25, did not include a statement that indicates the individual is emotionally and physically fit to care for children. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One (1) staff, hire date 3/28/23, received nineteen (19) annual on-going training hours between 3/2024 and 3/2025. Based on education and experience, the staff member must receive twenty (20) hours of on-going training, annually. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Four (4) staff received 5.5 hours of orientation training within the first two (2) weeks of employment. .1101(a)(b) 1233 Each employee's personnel file did not contain a signed and dated statement that they received a job description and that they have received personnel and operational policies. Six (6) staff files did not contain a signed and dated statement that they received a job description. 10A NCAC 09 .0514(g) 1757 A valid qualification letter was not on file and available to review at the facility. Staff S. Warrick, hire date 8/19/25, did not have a qualification letter in the staff file. G.S. 110-90.2(b) & (d) & .2703(e) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. The authorization for one (1) Epipen in classroom space 9 expired on 10/8/25. The authorization for one (1) Ventolin in classroom space 9 expired 8/24/25. The authorization for one (1) Epipen in classroom space 3 did not include the parent signature. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 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. One (1) staff, hire date 3/28/23, did not have a certificate on file for “Recognizing and Responding to Suspicions of Child Maltreatment” training. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. The training certificates for three (3) health and safety training topics were not in the staff file for one (1) staff, hire date 3/28/23. The training topics were: Prevention of and response to emergencies due to food and allergic reactions; Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; Recognizing and reporting child abuse, child neglect, and child maltreatment. .1102(a) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One (1) child's file did not contain a signed statement that they received the policy. .0608(b)(1-6) Technical assistance was provided as follows: Item #106: Fire inspections must be documented on the inspection form provided by the Division. This form can be found on the Division's website under the Provider tab under "Provider Documents and Forms". During the visit today, you reached out to the Fire Marshal via email, requesting that the inspection is documented on the Division's form. To reach compliance with this item, please send the form to me upon receipt. Please note, if the form is handwritten, please make a copy for your records and mail the original to me at the PO box below. Item #840: The bleach was moved to locked storage during the visit. This is corrected. Moving forward, please note that bulk chemicals must be stored inside of a locked cabinet or closet in the kitchen. Item #898: To reach compliance with this item, the coffee maker must be made inaccessible to children. We discussed the lobby is used as the entrance to the program for licensed care, therefore all hazards must be removed. Item #1032: To reach compliance for this item, the one (1) staff must receive a new medical report that indicates they are emotionally and physically fit to care for children. We discussed this is best captured on the form provided by the Division. Item #1067: To reach compliance with this item, staff BW, CS, AE, and BH must receive the additional half hour of orientation training. This will meet requirements in both rule .1101 (a) and (b) as this will bring the total orientation hours received to six (6) hours in the first two (2) weeks and sixteen (16) hours in the first six weeks. Item #1757: The qualifying letter was printed and placed in the staff member’s file during the visit. This is corrected. Item #1882: To reach compliance for this item, you must obtain updated authorization for the two (2) medications in classroom space 9. You must also obtain a parent signature on the authorization for the medication in classroom space 3. Item #1908: To reach compliance with this item, the parents of the one (1) child must sign the acknowledgement that they received the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. The following violations were added during the "other" visit conducted to complete monitoring on 11/6/25: Item #1052: In your letter of compliance, please include a statement that indicates how you will ensure staff receive the required number of on-going training hours, annually. As a reminder, hours are calculated from the staff member’s hire date. In this example, the staff member’s hire date was 3/28/25. On-going training hours are not required for the first year, so the on-going training hours were calculated from March 2024-March 2025. Item #1233: To reach compliance with this item, the six (6) staff (BH, BW, ES, CS, HE, AE) must sign and date a statement that they have received a job description appropriate to their current duties and responsibilities. We discussed the signature pages for personnel policies has a line to note receipt of the job description but appears to have been left off of the form for recent hires. Plan to edit the form to ensure this line appears for future new hires. Item #1897: To reach compliance with this item, the training certificate must be placed in the file. Plan to locate the certificate from the training taken previously. If the certificate cannot be located, the staff will need to take the training again. Item #1898: To reach compliance with this item, the certificates for the three (3) training topics must be placed in the staff member’s file. If the training certificates cannot be located, the staff will need to take the training topics again. 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 11/19/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: Kaitlyn.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email Kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Orientation Training Record: As a reminder, please include the name of the provider for each topic of the orientation documentation page. CPR/First Aid Training Reminders: -Staff SW is due 11/17/25 -Staff HE is due 12/14/25 -Staff AE is due 12/29/25 Provisional Criminal Background Check: As a reminder, staff H. Etscorn currently has a Provisional qualifying letter that expires 11/14/25. Plan to have this staff check their CBC portal and email to receive the new qualifying letter. Approved Space: 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. Fire Inspection: 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.” Child Maltreatment Training: 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. WORKS: 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. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at Kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0514 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 11/5/2025 Number Present: 73 Completed Date: 11/5/2025 Age: From 0 To 5 Total Minutes: 510 Time In: 09:00 AM 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 me, Kaitlyn Marshall, Child Care Consultant and also signed by Alesia Summey, Director, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. Summey and Emilina Smith, Assistant Director, assisted me on 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 percent (90%) as of 11/5/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, YWCA of Asheville and Western North Carolina, Inc., is current/active as of 11/5/25. Permit type – Five (5) star license issued 6/17/25. Special Services/Restrictions – 1st shift (daytime care). Meets enhanced space, meets enhanced ratios, children under 2.5 years old in rooms with direct exits only. The facility is approved to provide Transportation, field trips, swimming pool and serves children with special needs. The facility is approved to provide NC Pre-K services as confirmed on the NC Pre-K Plan website. This change will be indicated on the facility input page in Regulatory following today’s visit. The last annual compliance visit was conducted on 11/14/24. The last fire drill was practiced on 10/23/25. The last lockdown drill was practiced on 9/30/25 The last playground inspection was documented on 10/17/25. The last fire inspection was approved on 2/5/25. The inspection was not documented on the form provided by the Division. The last sanitation inspection was conducted on 2/17/25 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. The approved Formative Assessment tool is Teaching Strategies Gold. Lead water testing was completed on 3/27/24 without hazards. Lead paint testing has not been completed. The Clean Classrooms for Carolina Kids Website lists the status as “Enrollment Started”. Continue to work with RTI to complete testing requirements. Asbestos testing has not been completed. The Clean Classrooms for Carolina Kids website lists the status as “Survey Review by RTI”. Continue to work with RTI to complete testing requirements. The program is approved to provide transportation. Currently, transportation is only provided for field trips. Two (2) vehicles were monitored today. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. The NC Pre-K Program Site Monitoring Tool completed on 10/28/25 was reviewed today. One (1) NC Pre-K child’s file was monitored today. The classroom operates from 8:30 a.m. to 3:00 p.m. In classroom space 7, children were engaged in free-play and were observed completing an art project using stamps, caring for animals and dolls, and exploring various sensory toys. In classroom space 9, children drew pictures and dictated to teachers, built small structures with magnatiles and explored various objects on a light table. In classroom space 1, children freely explored their environment and participated in routine caregiving activities such as feeding. In classroom space 2, children participate din routine caregiving activities such as diapering and explored the outdoor learning environment. In classroom space 6, children transitioned to the indoor learning environment from outdoors and washed hands in preparation for lunch. In classroom space 3, children transitioned indoors and washed hands for lunch. Lunch today consisted of pasta, meat sauce, milk, green beans and apples. In classroom space 4, children ate lunch with caregivers. Interactions were positive and nurturing. Supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ Due to time constraints, I was unable to complete monitoring today. I will return to complete the monitoring of staff files. The following violations were documented during today’s visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The last fire inspection was conducted on 2/5/25. The inspection was not documented on the form provided by the Division. 10A NCAC 09 .0304(a) 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. A jug of bleach was not maintained in locked storage in the kitchen. .2820(b) 898 All electrical appliances were not used in accordance with the manufacturers instruction. Appliances with heating elements, such as bottle warmers, crock pots, curling irons, irons, coffee pots, and/or their cords were accessible to preschool-age children. A coffee maker was observed in the lobby near the entrance of the building. .0604(e) 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. The medical report for one (1) staff, hire date 9/22/25, did not include a statement that indicates the individual is emotionally and physically fit to care for children. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One (1) staff, hire date 3/28/23, received nineteen (19) annual on-going training hours between 3/2024 and 3/2025. Based on education and experience, the staff member must receive twenty (20) hours of on-going training, annually. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Four (4) staff received 5.5 hours of orientation training within the first two (2) weeks of employment. .1101(a)(b) 1233 Each employee's personnel file did not contain a signed and dated statement that they received a job description and that they have received personnel and operational policies. Six (6) staff files did not contain a signed and dated statement that they received a job description. 10A NCAC 09 .0514(g) 1757 A valid qualification letter was not on file and available to review at the facility. Staff S. Warrick, hire date 8/19/25, did not have a qualification letter in the staff file. G.S. 110-90.2(b) & (d) & .2703(e) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. The authorization for one (1) Epipen in classroom space 9 expired on 10/8/25. The authorization for one (1) Ventolin in classroom space 9 expired 8/24/25. The authorization for one (1) Epipen in classroom space 3 did not include the parent signature. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 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. One (1) staff, hire date 3/28/23, did not have a certificate on file for “Recognizing and Responding to Suspicions of Child Maltreatment” training. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. The training certificates for three (3) health and safety training topics were not in the staff file for one (1) staff, hire date 3/28/23. The training topics were: Prevention of and response to emergencies due to food and allergic reactions; Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; Recognizing and reporting child abuse, child neglect, and child maltreatment. .1102(a) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One (1) child's file did not contain a signed statement that they received the policy. .0608(b)(1-6) Technical assistance was provided as follows: Item #106: Fire inspections must be documented on the inspection form provided by the Division. This form can be found on the Division's website under the Provider tab under "Provider Documents and Forms". During the visit today, you reached out to the Fire Marshal via email, requesting that the inspection is documented on the Division's form. To reach compliance with this item, please send the form to me upon receipt. Please note, if the form is handwritten, please make a copy for your records and mail the original to me at the PO box below. Item #840: The bleach was moved to locked storage during the visit. This is corrected. Moving forward, please note that bulk chemicals must be stored inside of a locked cabinet or closet in the kitchen. Item #898: To reach compliance with this item, the coffee maker must be made inaccessible to children. We discussed the lobby is used as the entrance to the program for licensed care, therefore all hazards must be removed. Item #1032: To reach compliance for this item, the one (1) staff must receive a new medical report that indicates they are emotionally and physically fit to care for children. We discussed this is best captured on the form provided by the Division. Item #1067: To reach compliance with this item, staff BW, CS, AE, and BH must receive the additional half hour of orientation training. This will meet requirements in both rule .1101 (a) and (b) as this will bring the total orientation hours received to six (6) hours in the first two (2) weeks and sixteen (16) hours in the first six weeks. Item #1757: The qualifying letter was printed and placed in the staff member’s file during the visit. This is corrected. Item #1882: To reach compliance for this item, you must obtain updated authorization for the two (2) medications in classroom space 9. You must also obtain a parent signature on the authorization for the medication in classroom space 3. Item #1908: To reach compliance with this item, the parents of the one (1) child must sign the acknowledgement that they received the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. The following violations were added during the "other" visit conducted to complete monitoring on 11/6/25: Item #1052: In your letter of compliance, please include a statement that indicates how you will ensure staff receive the required number of on-going training hours, annually. As a reminder, hours are calculated from the staff member’s hire date. In this example, the staff member’s hire date was 3/28/25. On-going training hours are not required for the first year, so the on-going training hours were calculated from March 2024-March 2025. Item #1233: To reach compliance with this item, the six (6) staff (BH, BW, ES, CS, HE, AE) must sign and date a statement that they have received a job description appropriate to their current duties and responsibilities. We discussed the signature pages for personnel policies has a line to note receipt of the job description but appears to have been left off of the form for recent hires. Plan to edit the form to ensure this line appears for future new hires. Item #1897: To reach compliance with this item, the training certificate must be placed in the file. Plan to locate the certificate from the training taken previously. If the certificate cannot be located, the staff will need to take the training again. Item #1898: To reach compliance with this item, the certificates for the three (3) training topics must be placed in the staff member’s file. If the training certificates cannot be located, the staff will need to take the training topics again. 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 11/19/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: Kaitlyn.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email Kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Orientation Training Record: As a reminder, please include the name of the provider for each topic of the orientation documentation page. CPR/First Aid Training Reminders: -Staff SW is due 11/17/25 -Staff HE is due 12/14/25 -Staff AE is due 12/29/25 Provisional Criminal Background Check: As a reminder, staff H. Etscorn currently has a Provisional qualifying letter that expires 11/14/25. Plan to have this staff check their CBC portal and email to receive the new qualifying letter. Approved Space: 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. Fire Inspection: 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.” Child Maltreatment Training: 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. WORKS: 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. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at Kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0701 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 11/5/2025 Number Present: 73 Completed Date: 11/5/2025 Age: From 0 To 5 Total Minutes: 510 Time In: 09:00 AM 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 me, Kaitlyn Marshall, Child Care Consultant and also signed by Alesia Summey, Director, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. Summey and Emilina Smith, Assistant Director, assisted me on 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 percent (90%) as of 11/5/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, YWCA of Asheville and Western North Carolina, Inc., is current/active as of 11/5/25. Permit type – Five (5) star license issued 6/17/25. Special Services/Restrictions – 1st shift (daytime care). Meets enhanced space, meets enhanced ratios, children under 2.5 years old in rooms with direct exits only. The facility is approved to provide Transportation, field trips, swimming pool and serves children with special needs. The facility is approved to provide NC Pre-K services as confirmed on the NC Pre-K Plan website. This change will be indicated on the facility input page in Regulatory following today’s visit. The last annual compliance visit was conducted on 11/14/24. The last fire drill was practiced on 10/23/25. The last lockdown drill was practiced on 9/30/25 The last playground inspection was documented on 10/17/25. The last fire inspection was approved on 2/5/25. The inspection was not documented on the form provided by the Division. The last sanitation inspection was conducted on 2/17/25 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. The approved Formative Assessment tool is Teaching Strategies Gold. Lead water testing was completed on 3/27/24 without hazards. Lead paint testing has not been completed. The Clean Classrooms for Carolina Kids Website lists the status as “Enrollment Started”. Continue to work with RTI to complete testing requirements. Asbestos testing has not been completed. The Clean Classrooms for Carolina Kids website lists the status as “Survey Review by RTI”. Continue to work with RTI to complete testing requirements. The program is approved to provide transportation. Currently, transportation is only provided for field trips. Two (2) vehicles were monitored today. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. The NC Pre-K Program Site Monitoring Tool completed on 10/28/25 was reviewed today. One (1) NC Pre-K child’s file was monitored today. The classroom operates from 8:30 a.m. to 3:00 p.m. In classroom space 7, children were engaged in free-play and were observed completing an art project using stamps, caring for animals and dolls, and exploring various sensory toys. In classroom space 9, children drew pictures and dictated to teachers, built small structures with magnatiles and explored various objects on a light table. In classroom space 1, children freely explored their environment and participated in routine caregiving activities such as feeding. In classroom space 2, children participate din routine caregiving activities such as diapering and explored the outdoor learning environment. In classroom space 6, children transitioned to the indoor learning environment from outdoors and washed hands in preparation for lunch. In classroom space 3, children transitioned indoors and washed hands for lunch. Lunch today consisted of pasta, meat sauce, milk, green beans and apples. In classroom space 4, children ate lunch with caregivers. Interactions were positive and nurturing. Supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ Due to time constraints, I was unable to complete monitoring today. I will return to complete the monitoring of staff files. The following violations were documented during today’s visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The last fire inspection was conducted on 2/5/25. The inspection was not documented on the form provided by the Division. 10A NCAC 09 .0304(a) 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. A jug of bleach was not maintained in locked storage in the kitchen. .2820(b) 898 All electrical appliances were not used in accordance with the manufacturers instruction. Appliances with heating elements, such as bottle warmers, crock pots, curling irons, irons, coffee pots, and/or their cords were accessible to preschool-age children. A coffee maker was observed in the lobby near the entrance of the building. .0604(e) 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. The medical report for one (1) staff, hire date 9/22/25, did not include a statement that indicates the individual is emotionally and physically fit to care for children. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One (1) staff, hire date 3/28/23, received nineteen (19) annual on-going training hours between 3/2024 and 3/2025. Based on education and experience, the staff member must receive twenty (20) hours of on-going training, annually. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Four (4) staff received 5.5 hours of orientation training within the first two (2) weeks of employment. .1101(a)(b) 1233 Each employee's personnel file did not contain a signed and dated statement that they received a job description and that they have received personnel and operational policies. Six (6) staff files did not contain a signed and dated statement that they received a job description. 10A NCAC 09 .0514(g) 1757 A valid qualification letter was not on file and available to review at the facility. Staff S. Warrick, hire date 8/19/25, did not have a qualification letter in the staff file. G.S. 110-90.2(b) & (d) & .2703(e) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. The authorization for one (1) Epipen in classroom space 9 expired on 10/8/25. The authorization for one (1) Ventolin in classroom space 9 expired 8/24/25. The authorization for one (1) Epipen in classroom space 3 did not include the parent signature. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 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. One (1) staff, hire date 3/28/23, did not have a certificate on file for “Recognizing and Responding to Suspicions of Child Maltreatment” training. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. The training certificates for three (3) health and safety training topics were not in the staff file for one (1) staff, hire date 3/28/23. The training topics were: Prevention of and response to emergencies due to food and allergic reactions; Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; Recognizing and reporting child abuse, child neglect, and child maltreatment. .1102(a) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One (1) child's file did not contain a signed statement that they received the policy. .0608(b)(1-6) Technical assistance was provided as follows: Item #106: Fire inspections must be documented on the inspection form provided by the Division. This form can be found on the Division's website under the Provider tab under "Provider Documents and Forms". During the visit today, you reached out to the Fire Marshal via email, requesting that the inspection is documented on the Division's form. To reach compliance with this item, please send the form to me upon receipt. Please note, if the form is handwritten, please make a copy for your records and mail the original to me at the PO box below. Item #840: The bleach was moved to locked storage during the visit. This is corrected. Moving forward, please note that bulk chemicals must be stored inside of a locked cabinet or closet in the kitchen. Item #898: To reach compliance with this item, the coffee maker must be made inaccessible to children. We discussed the lobby is used as the entrance to the program for licensed care, therefore all hazards must be removed. Item #1032: To reach compliance for this item, the one (1) staff must receive a new medical report that indicates they are emotionally and physically fit to care for children. We discussed this is best captured on the form provided by the Division. Item #1067: To reach compliance with this item, staff BW, CS, AE, and BH must receive the additional half hour of orientation training. This will meet requirements in both rule .1101 (a) and (b) as this will bring the total orientation hours received to six (6) hours in the first two (2) weeks and sixteen (16) hours in the first six weeks. Item #1757: The qualifying letter was printed and placed in the staff member’s file during the visit. This is corrected. Item #1882: To reach compliance for this item, you must obtain updated authorization for the two (2) medications in classroom space 9. You must also obtain a parent signature on the authorization for the medication in classroom space 3. Item #1908: To reach compliance with this item, the parents of the one (1) child must sign the acknowledgement that they received the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. The following violations were added during the "other" visit conducted to complete monitoring on 11/6/25: Item #1052: In your letter of compliance, please include a statement that indicates how you will ensure staff receive the required number of on-going training hours, annually. As a reminder, hours are calculated from the staff member’s hire date. In this example, the staff member’s hire date was 3/28/25. On-going training hours are not required for the first year, so the on-going training hours were calculated from March 2024-March 2025. Item #1233: To reach compliance with this item, the six (6) staff (BH, BW, ES, CS, HE, AE) must sign and date a statement that they have received a job description appropriate to their current duties and responsibilities. We discussed the signature pages for personnel policies has a line to note receipt of the job description but appears to have been left off of the form for recent hires. Plan to edit the form to ensure this line appears for future new hires. Item #1897: To reach compliance with this item, the training certificate must be placed in the file. Plan to locate the certificate from the training taken previously. If the certificate cannot be located, the staff will need to take the training again. Item #1898: To reach compliance with this item, the certificates for the three (3) training topics must be placed in the staff member’s file. If the training certificates cannot be located, the staff will need to take the training topics again. 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 11/19/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: Kaitlyn.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email Kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Orientation Training Record: As a reminder, please include the name of the provider for each topic of the orientation documentation page. CPR/First Aid Training Reminders: -Staff SW is due 11/17/25 -Staff HE is due 12/14/25 -Staff AE is due 12/29/25 Provisional Criminal Background Check: As a reminder, staff H. Etscorn currently has a Provisional qualifying letter that expires 11/14/25. Plan to have this staff check their CBC portal and email to receive the new qualifying letter. Approved Space: 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. Fire Inspection: 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.” Child Maltreatment Training: 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. WORKS: 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. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at Kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 11/5/2025 Number Present: 73 Completed Date: 11/5/2025 Age: From 0 To 5 Total Minutes: 510 Time In: 09:00 AM 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 me, Kaitlyn Marshall, Child Care Consultant and also signed by Alesia Summey, Director, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. Summey and Emilina Smith, Assistant Director, assisted me on 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 percent (90%) as of 11/5/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, YWCA of Asheville and Western North Carolina, Inc., is current/active as of 11/5/25. Permit type – Five (5) star license issued 6/17/25. Special Services/Restrictions – 1st shift (daytime care). Meets enhanced space, meets enhanced ratios, children under 2.5 years old in rooms with direct exits only. The facility is approved to provide Transportation, field trips, swimming pool and serves children with special needs. The facility is approved to provide NC Pre-K services as confirmed on the NC Pre-K Plan website. This change will be indicated on the facility input page in Regulatory following today’s visit. The last annual compliance visit was conducted on 11/14/24. The last fire drill was practiced on 10/23/25. The last lockdown drill was practiced on 9/30/25 The last playground inspection was documented on 10/17/25. The last fire inspection was approved on 2/5/25. The inspection was not documented on the form provided by the Division. The last sanitation inspection was conducted on 2/17/25 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. The approved Formative Assessment tool is Teaching Strategies Gold. Lead water testing was completed on 3/27/24 without hazards. Lead paint testing has not been completed. The Clean Classrooms for Carolina Kids Website lists the status as “Enrollment Started”. Continue to work with RTI to complete testing requirements. Asbestos testing has not been completed. The Clean Classrooms for Carolina Kids website lists the status as “Survey Review by RTI”. Continue to work with RTI to complete testing requirements. The program is approved to provide transportation. Currently, transportation is only provided for field trips. Two (2) vehicles were monitored today. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. The NC Pre-K Program Site Monitoring Tool completed on 10/28/25 was reviewed today. One (1) NC Pre-K child’s file was monitored today. The classroom operates from 8:30 a.m. to 3:00 p.m. In classroom space 7, children were engaged in free-play and were observed completing an art project using stamps, caring for animals and dolls, and exploring various sensory toys. In classroom space 9, children drew pictures and dictated to teachers, built small structures with magnatiles and explored various objects on a light table. In classroom space 1, children freely explored their environment and participated in routine caregiving activities such as feeding. In classroom space 2, children participate din routine caregiving activities such as diapering and explored the outdoor learning environment. In classroom space 6, children transitioned to the indoor learning environment from outdoors and washed hands in preparation for lunch. In classroom space 3, children transitioned indoors and washed hands for lunch. Lunch today consisted of pasta, meat sauce, milk, green beans and apples. In classroom space 4, children ate lunch with caregivers. Interactions were positive and nurturing. Supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ Due to time constraints, I was unable to complete monitoring today. I will return to complete the monitoring of staff files. The following violations were documented during today’s visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The last fire inspection was conducted on 2/5/25. The inspection was not documented on the form provided by the Division. 10A NCAC 09 .0304(a) 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. A jug of bleach was not maintained in locked storage in the kitchen. .2820(b) 898 All electrical appliances were not used in accordance with the manufacturers instruction. Appliances with heating elements, such as bottle warmers, crock pots, curling irons, irons, coffee pots, and/or their cords were accessible to preschool-age children. A coffee maker was observed in the lobby near the entrance of the building. .0604(e) 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. The medical report for one (1) staff, hire date 9/22/25, did not include a statement that indicates the individual is emotionally and physically fit to care for children. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One (1) staff, hire date 3/28/23, received nineteen (19) annual on-going training hours between 3/2024 and 3/2025. Based on education and experience, the staff member must receive twenty (20) hours of on-going training, annually. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Four (4) staff received 5.5 hours of orientation training within the first two (2) weeks of employment. .1101(a)(b) 1233 Each employee's personnel file did not contain a signed and dated statement that they received a job description and that they have received personnel and operational policies. Six (6) staff files did not contain a signed and dated statement that they received a job description. 10A NCAC 09 .0514(g) 1757 A valid qualification letter was not on file and available to review at the facility. Staff S. Warrick, hire date 8/19/25, did not have a qualification letter in the staff file. G.S. 110-90.2(b) & (d) & .2703(e) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. The authorization for one (1) Epipen in classroom space 9 expired on 10/8/25. The authorization for one (1) Ventolin in classroom space 9 expired 8/24/25. The authorization for one (1) Epipen in classroom space 3 did not include the parent signature. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 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. One (1) staff, hire date 3/28/23, did not have a certificate on file for “Recognizing and Responding to Suspicions of Child Maltreatment” training. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. The training certificates for three (3) health and safety training topics were not in the staff file for one (1) staff, hire date 3/28/23. The training topics were: Prevention of and response to emergencies due to food and allergic reactions; Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; Recognizing and reporting child abuse, child neglect, and child maltreatment. .1102(a) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One (1) child's file did not contain a signed statement that they received the policy. .0608(b)(1-6) Technical assistance was provided as follows: Item #106: Fire inspections must be documented on the inspection form provided by the Division. This form can be found on the Division's website under the Provider tab under "Provider Documents and Forms". During the visit today, you reached out to the Fire Marshal via email, requesting that the inspection is documented on the Division's form. To reach compliance with this item, please send the form to me upon receipt. Please note, if the form is handwritten, please make a copy for your records and mail the original to me at the PO box below. Item #840: The bleach was moved to locked storage during the visit. This is corrected. Moving forward, please note that bulk chemicals must be stored inside of a locked cabinet or closet in the kitchen. Item #898: To reach compliance with this item, the coffee maker must be made inaccessible to children. We discussed the lobby is used as the entrance to the program for licensed care, therefore all hazards must be removed. Item #1032: To reach compliance for this item, the one (1) staff must receive a new medical report that indicates they are emotionally and physically fit to care for children. We discussed this is best captured on the form provided by the Division. Item #1067: To reach compliance with this item, staff BW, CS, AE, and BH must receive the additional half hour of orientation training. This will meet requirements in both rule .1101 (a) and (b) as this will bring the total orientation hours received to six (6) hours in the first two (2) weeks and sixteen (16) hours in the first six weeks. Item #1757: The qualifying letter was printed and placed in the staff member’s file during the visit. This is corrected. Item #1882: To reach compliance for this item, you must obtain updated authorization for the two (2) medications in classroom space 9. You must also obtain a parent signature on the authorization for the medication in classroom space 3. Item #1908: To reach compliance with this item, the parents of the one (1) child must sign the acknowledgement that they received the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. The following violations were added during the "other" visit conducted to complete monitoring on 11/6/25: Item #1052: In your letter of compliance, please include a statement that indicates how you will ensure staff receive the required number of on-going training hours, annually. As a reminder, hours are calculated from the staff member’s hire date. In this example, the staff member’s hire date was 3/28/25. On-going training hours are not required for the first year, so the on-going training hours were calculated from March 2024-March 2025. Item #1233: To reach compliance with this item, the six (6) staff (BH, BW, ES, CS, HE, AE) must sign and date a statement that they have received a job description appropriate to their current duties and responsibilities. We discussed the signature pages for personnel policies has a line to note receipt of the job description but appears to have been left off of the form for recent hires. Plan to edit the form to ensure this line appears for future new hires. Item #1897: To reach compliance with this item, the training certificate must be placed in the file. Plan to locate the certificate from the training taken previously. If the certificate cannot be located, the staff will need to take the training again. Item #1898: To reach compliance with this item, the certificates for the three (3) training topics must be placed in the staff member’s file. If the training certificates cannot be located, the staff will need to take the training topics again. 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 11/19/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: Kaitlyn.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email Kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Orientation Training Record: As a reminder, please include the name of the provider for each topic of the orientation documentation page. CPR/First Aid Training Reminders: -Staff SW is due 11/17/25 -Staff HE is due 12/14/25 -Staff AE is due 12/29/25 Provisional Criminal Background Check: As a reminder, staff H. Etscorn currently has a Provisional qualifying letter that expires 11/14/25. Plan to have this staff check their CBC portal and email to receive the new qualifying letter. Approved Space: 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. Fire Inspection: 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.” Child Maltreatment Training: 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. WORKS: 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. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at Kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 11/5/2025 Number Present: 73 Completed Date: 11/5/2025 Age: From 0 To 5 Total Minutes: 510 Time In: 09:00 AM 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 me, Kaitlyn Marshall, Child Care Consultant and also signed by Alesia Summey, Director, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. Summey and Emilina Smith, Assistant Director, assisted me on 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 percent (90%) as of 11/5/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, YWCA of Asheville and Western North Carolina, Inc., is current/active as of 11/5/25. Permit type – Five (5) star license issued 6/17/25. Special Services/Restrictions – 1st shift (daytime care). Meets enhanced space, meets enhanced ratios, children under 2.5 years old in rooms with direct exits only. The facility is approved to provide Transportation, field trips, swimming pool and serves children with special needs. The facility is approved to provide NC Pre-K services as confirmed on the NC Pre-K Plan website. This change will be indicated on the facility input page in Regulatory following today’s visit. The last annual compliance visit was conducted on 11/14/24. The last fire drill was practiced on 10/23/25. The last lockdown drill was practiced on 9/30/25 The last playground inspection was documented on 10/17/25. The last fire inspection was approved on 2/5/25. The inspection was not documented on the form provided by the Division. The last sanitation inspection was conducted on 2/17/25 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. The approved Formative Assessment tool is Teaching Strategies Gold. Lead water testing was completed on 3/27/24 without hazards. Lead paint testing has not been completed. The Clean Classrooms for Carolina Kids Website lists the status as “Enrollment Started”. Continue to work with RTI to complete testing requirements. Asbestos testing has not been completed. The Clean Classrooms for Carolina Kids website lists the status as “Survey Review by RTI”. Continue to work with RTI to complete testing requirements. The program is approved to provide transportation. Currently, transportation is only provided for field trips. Two (2) vehicles were monitored today. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. The NC Pre-K Program Site Monitoring Tool completed on 10/28/25 was reviewed today. One (1) NC Pre-K child’s file was monitored today. The classroom operates from 8:30 a.m. to 3:00 p.m. In classroom space 7, children were engaged in free-play and were observed completing an art project using stamps, caring for animals and dolls, and exploring various sensory toys. In classroom space 9, children drew pictures and dictated to teachers, built small structures with magnatiles and explored various objects on a light table. In classroom space 1, children freely explored their environment and participated in routine caregiving activities such as feeding. In classroom space 2, children participate din routine caregiving activities such as diapering and explored the outdoor learning environment. In classroom space 6, children transitioned to the indoor learning environment from outdoors and washed hands in preparation for lunch. In classroom space 3, children transitioned indoors and washed hands for lunch. Lunch today consisted of pasta, meat sauce, milk, green beans and apples. In classroom space 4, children ate lunch with caregivers. Interactions were positive and nurturing. Supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ Due to time constraints, I was unable to complete monitoring today. I will return to complete the monitoring of staff files. The following violations were documented during today’s visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The last fire inspection was conducted on 2/5/25. The inspection was not documented on the form provided by the Division. 10A NCAC 09 .0304(a) 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. A jug of bleach was not maintained in locked storage in the kitchen. .2820(b) 898 All electrical appliances were not used in accordance with the manufacturers instruction. Appliances with heating elements, such as bottle warmers, crock pots, curling irons, irons, coffee pots, and/or their cords were accessible to preschool-age children. A coffee maker was observed in the lobby near the entrance of the building. .0604(e) 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. The medical report for one (1) staff, hire date 9/22/25, did not include a statement that indicates the individual is emotionally and physically fit to care for children. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One (1) staff, hire date 3/28/23, received nineteen (19) annual on-going training hours between 3/2024 and 3/2025. Based on education and experience, the staff member must receive twenty (20) hours of on-going training, annually. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Four (4) staff received 5.5 hours of orientation training within the first two (2) weeks of employment. .1101(a)(b) 1233 Each employee's personnel file did not contain a signed and dated statement that they received a job description and that they have received personnel and operational policies. Six (6) staff files did not contain a signed and dated statement that they received a job description. 10A NCAC 09 .0514(g) 1757 A valid qualification letter was not on file and available to review at the facility. Staff S. Warrick, hire date 8/19/25, did not have a qualification letter in the staff file. G.S. 110-90.2(b) & (d) & .2703(e) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. The authorization for one (1) Epipen in classroom space 9 expired on 10/8/25. The authorization for one (1) Ventolin in classroom space 9 expired 8/24/25. The authorization for one (1) Epipen in classroom space 3 did not include the parent signature. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 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. One (1) staff, hire date 3/28/23, did not have a certificate on file for “Recognizing and Responding to Suspicions of Child Maltreatment” training. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. The training certificates for three (3) health and safety training topics were not in the staff file for one (1) staff, hire date 3/28/23. The training topics were: Prevention of and response to emergencies due to food and allergic reactions; Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; Recognizing and reporting child abuse, child neglect, and child maltreatment. .1102(a) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One (1) child's file did not contain a signed statement that they received the policy. .0608(b)(1-6) Technical assistance was provided as follows: Item #106: Fire inspections must be documented on the inspection form provided by the Division. This form can be found on the Division's website under the Provider tab under "Provider Documents and Forms". During the visit today, you reached out to the Fire Marshal via email, requesting that the inspection is documented on the Division's form. To reach compliance with this item, please send the form to me upon receipt. Please note, if the form is handwritten, please make a copy for your records and mail the original to me at the PO box below. Item #840: The bleach was moved to locked storage during the visit. This is corrected. Moving forward, please note that bulk chemicals must be stored inside of a locked cabinet or closet in the kitchen. Item #898: To reach compliance with this item, the coffee maker must be made inaccessible to children. We discussed the lobby is used as the entrance to the program for licensed care, therefore all hazards must be removed. Item #1032: To reach compliance for this item, the one (1) staff must receive a new medical report that indicates they are emotionally and physically fit to care for children. We discussed this is best captured on the form provided by the Division. Item #1067: To reach compliance with this item, staff BW, CS, AE, and BH must receive the additional half hour of orientation training. This will meet requirements in both rule .1101 (a) and (b) as this will bring the total orientation hours received to six (6) hours in the first two (2) weeks and sixteen (16) hours in the first six weeks. Item #1757: The qualifying letter was printed and placed in the staff member’s file during the visit. This is corrected. Item #1882: To reach compliance for this item, you must obtain updated authorization for the two (2) medications in classroom space 9. You must also obtain a parent signature on the authorization for the medication in classroom space 3. Item #1908: To reach compliance with this item, the parents of the one (1) child must sign the acknowledgement that they received the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. The following violations were added during the "other" visit conducted to complete monitoring on 11/6/25: Item #1052: In your letter of compliance, please include a statement that indicates how you will ensure staff receive the required number of on-going training hours, annually. As a reminder, hours are calculated from the staff member’s hire date. In this example, the staff member’s hire date was 3/28/25. On-going training hours are not required for the first year, so the on-going training hours were calculated from March 2024-March 2025. Item #1233: To reach compliance with this item, the six (6) staff (BH, BW, ES, CS, HE, AE) must sign and date a statement that they have received a job description appropriate to their current duties and responsibilities. We discussed the signature pages for personnel policies has a line to note receipt of the job description but appears to have been left off of the form for recent hires. Plan to edit the form to ensure this line appears for future new hires. Item #1897: To reach compliance with this item, the training certificate must be placed in the file. Plan to locate the certificate from the training taken previously. If the certificate cannot be located, the staff will need to take the training again. Item #1898: To reach compliance with this item, the certificates for the three (3) training topics must be placed in the staff member’s file. If the training certificates cannot be located, the staff will need to take the training topics again. 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 11/19/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: Kaitlyn.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email Kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Orientation Training Record: As a reminder, please include the name of the provider for each topic of the orientation documentation page. CPR/First Aid Training Reminders: -Staff SW is due 11/17/25 -Staff HE is due 12/14/25 -Staff AE is due 12/29/25 Provisional Criminal Background Check: As a reminder, staff H. Etscorn currently has a Provisional qualifying letter that expires 11/14/25. Plan to have this staff check their CBC portal and email to receive the new qualifying letter. Approved Space: 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. Fire Inspection: 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.” Child Maltreatment Training: 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. WORKS: 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. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at Kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 11/5/2025 Number Present: 73 Completed Date: 11/5/2025 Age: From 0 To 5 Total Minutes: 510 Time In: 09:00 AM 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 me, Kaitlyn Marshall, Child Care Consultant and also signed by Alesia Summey, Director, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. Summey and Emilina Smith, Assistant Director, assisted me on 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 percent (90%) as of 11/5/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, YWCA of Asheville and Western North Carolina, Inc., is current/active as of 11/5/25. Permit type – Five (5) star license issued 6/17/25. Special Services/Restrictions – 1st shift (daytime care). Meets enhanced space, meets enhanced ratios, children under 2.5 years old in rooms with direct exits only. The facility is approved to provide Transportation, field trips, swimming pool and serves children with special needs. The facility is approved to provide NC Pre-K services as confirmed on the NC Pre-K Plan website. This change will be indicated on the facility input page in Regulatory following today’s visit. The last annual compliance visit was conducted on 11/14/24. The last fire drill was practiced on 10/23/25. The last lockdown drill was practiced on 9/30/25 The last playground inspection was documented on 10/17/25. The last fire inspection was approved on 2/5/25. The inspection was not documented on the form provided by the Division. The last sanitation inspection was conducted on 2/17/25 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. The approved Formative Assessment tool is Teaching Strategies Gold. Lead water testing was completed on 3/27/24 without hazards. Lead paint testing has not been completed. The Clean Classrooms for Carolina Kids Website lists the status as “Enrollment Started”. Continue to work with RTI to complete testing requirements. Asbestos testing has not been completed. The Clean Classrooms for Carolina Kids website lists the status as “Survey Review by RTI”. Continue to work with RTI to complete testing requirements. The program is approved to provide transportation. Currently, transportation is only provided for field trips. Two (2) vehicles were monitored today. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. The NC Pre-K Program Site Monitoring Tool completed on 10/28/25 was reviewed today. One (1) NC Pre-K child’s file was monitored today. The classroom operates from 8:30 a.m. to 3:00 p.m. In classroom space 7, children were engaged in free-play and were observed completing an art project using stamps, caring for animals and dolls, and exploring various sensory toys. In classroom space 9, children drew pictures and dictated to teachers, built small structures with magnatiles and explored various objects on a light table. In classroom space 1, children freely explored their environment and participated in routine caregiving activities such as feeding. In classroom space 2, children participate din routine caregiving activities such as diapering and explored the outdoor learning environment. In classroom space 6, children transitioned to the indoor learning environment from outdoors and washed hands in preparation for lunch. In classroom space 3, children transitioned indoors and washed hands for lunch. Lunch today consisted of pasta, meat sauce, milk, green beans and apples. In classroom space 4, children ate lunch with caregivers. Interactions were positive and nurturing. Supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ Due to time constraints, I was unable to complete monitoring today. I will return to complete the monitoring of staff files. The following violations were documented during today’s visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The last fire inspection was conducted on 2/5/25. The inspection was not documented on the form provided by the Division. 10A NCAC 09 .0304(a) 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. A jug of bleach was not maintained in locked storage in the kitchen. .2820(b) 898 All electrical appliances were not used in accordance with the manufacturers instruction. Appliances with heating elements, such as bottle warmers, crock pots, curling irons, irons, coffee pots, and/or their cords were accessible to preschool-age children. A coffee maker was observed in the lobby near the entrance of the building. .0604(e) 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. The medical report for one (1) staff, hire date 9/22/25, did not include a statement that indicates the individual is emotionally and physically fit to care for children. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One (1) staff, hire date 3/28/23, received nineteen (19) annual on-going training hours between 3/2024 and 3/2025. Based on education and experience, the staff member must receive twenty (20) hours of on-going training, annually. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Four (4) staff received 5.5 hours of orientation training within the first two (2) weeks of employment. .1101(a)(b) 1233 Each employee's personnel file did not contain a signed and dated statement that they received a job description and that they have received personnel and operational policies. Six (6) staff files did not contain a signed and dated statement that they received a job description. 10A NCAC 09 .0514(g) 1757 A valid qualification letter was not on file and available to review at the facility. Staff S. Warrick, hire date 8/19/25, did not have a qualification letter in the staff file. G.S. 110-90.2(b) & (d) & .2703(e) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. The authorization for one (1) Epipen in classroom space 9 expired on 10/8/25. The authorization for one (1) Ventolin in classroom space 9 expired 8/24/25. The authorization for one (1) Epipen in classroom space 3 did not include the parent signature. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 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. One (1) staff, hire date 3/28/23, did not have a certificate on file for “Recognizing and Responding to Suspicions of Child Maltreatment” training. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. The training certificates for three (3) health and safety training topics were not in the staff file for one (1) staff, hire date 3/28/23. The training topics were: Prevention of and response to emergencies due to food and allergic reactions; Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; Recognizing and reporting child abuse, child neglect, and child maltreatment. .1102(a) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One (1) child's file did not contain a signed statement that they received the policy. .0608(b)(1-6) Technical assistance was provided as follows: Item #106: Fire inspections must be documented on the inspection form provided by the Division. This form can be found on the Division's website under the Provider tab under "Provider Documents and Forms". During the visit today, you reached out to the Fire Marshal via email, requesting that the inspection is documented on the Division's form. To reach compliance with this item, please send the form to me upon receipt. Please note, if the form is handwritten, please make a copy for your records and mail the original to me at the PO box below. Item #840: The bleach was moved to locked storage during the visit. This is corrected. Moving forward, please note that bulk chemicals must be stored inside of a locked cabinet or closet in the kitchen. Item #898: To reach compliance with this item, the coffee maker must be made inaccessible to children. We discussed the lobby is used as the entrance to the program for licensed care, therefore all hazards must be removed. Item #1032: To reach compliance for this item, the one (1) staff must receive a new medical report that indicates they are emotionally and physically fit to care for children. We discussed this is best captured on the form provided by the Division. Item #1067: To reach compliance with this item, staff BW, CS, AE, and BH must receive the additional half hour of orientation training. This will meet requirements in both rule .1101 (a) and (b) as this will bring the total orientation hours received to six (6) hours in the first two (2) weeks and sixteen (16) hours in the first six weeks. Item #1757: The qualifying letter was printed and placed in the staff member’s file during the visit. This is corrected. Item #1882: To reach compliance for this item, you must obtain updated authorization for the two (2) medications in classroom space 9. You must also obtain a parent signature on the authorization for the medication in classroom space 3. Item #1908: To reach compliance with this item, the parents of the one (1) child must sign the acknowledgement that they received the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. The following violations were added during the "other" visit conducted to complete monitoring on 11/6/25: Item #1052: In your letter of compliance, please include a statement that indicates how you will ensure staff receive the required number of on-going training hours, annually. As a reminder, hours are calculated from the staff member’s hire date. In this example, the staff member’s hire date was 3/28/25. On-going training hours are not required for the first year, so the on-going training hours were calculated from March 2024-March 2025. Item #1233: To reach compliance with this item, the six (6) staff (BH, BW, ES, CS, HE, AE) must sign and date a statement that they have received a job description appropriate to their current duties and responsibilities. We discussed the signature pages for personnel policies has a line to note receipt of the job description but appears to have been left off of the form for recent hires. Plan to edit the form to ensure this line appears for future new hires. Item #1897: To reach compliance with this item, the training certificate must be placed in the file. Plan to locate the certificate from the training taken previously. If the certificate cannot be located, the staff will need to take the training again. Item #1898: To reach compliance with this item, the certificates for the three (3) training topics must be placed in the staff member’s file. If the training certificates cannot be located, the staff will need to take the training topics again. 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 11/19/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: Kaitlyn.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email Kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Orientation Training Record: As a reminder, please include the name of the provider for each topic of the orientation documentation page. CPR/First Aid Training Reminders: -Staff SW is due 11/17/25 -Staff HE is due 12/14/25 -Staff AE is due 12/29/25 Provisional Criminal Background Check: As a reminder, staff H. Etscorn currently has a Provisional qualifying letter that expires 11/14/25. Plan to have this staff check their CBC portal and email to receive the new qualifying letter. Approved Space: 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. Fire Inspection: 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.” Child Maltreatment Training: 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. WORKS: 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. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at Kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 11/5/2025 Number Present: 73 Completed Date: 11/5/2025 Age: From 0 To 5 Total Minutes: 510 Time In: 09:00 AM 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 me, Kaitlyn Marshall, Child Care Consultant and also signed by Alesia Summey, Director, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. Summey and Emilina Smith, Assistant Director, assisted me on 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 percent (90%) as of 11/5/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, YWCA of Asheville and Western North Carolina, Inc., is current/active as of 11/5/25. Permit type – Five (5) star license issued 6/17/25. Special Services/Restrictions – 1st shift (daytime care). Meets enhanced space, meets enhanced ratios, children under 2.5 years old in rooms with direct exits only. The facility is approved to provide Transportation, field trips, swimming pool and serves children with special needs. The facility is approved to provide NC Pre-K services as confirmed on the NC Pre-K Plan website. This change will be indicated on the facility input page in Regulatory following today’s visit. The last annual compliance visit was conducted on 11/14/24. The last fire drill was practiced on 10/23/25. The last lockdown drill was practiced on 9/30/25 The last playground inspection was documented on 10/17/25. The last fire inspection was approved on 2/5/25. The inspection was not documented on the form provided by the Division. The last sanitation inspection was conducted on 2/17/25 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. The approved Formative Assessment tool is Teaching Strategies Gold. Lead water testing was completed on 3/27/24 without hazards. Lead paint testing has not been completed. The Clean Classrooms for Carolina Kids Website lists the status as “Enrollment Started”. Continue to work with RTI to complete testing requirements. Asbestos testing has not been completed. The Clean Classrooms for Carolina Kids website lists the status as “Survey Review by RTI”. Continue to work with RTI to complete testing requirements. The program is approved to provide transportation. Currently, transportation is only provided for field trips. Two (2) vehicles were monitored today. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. The NC Pre-K Program Site Monitoring Tool completed on 10/28/25 was reviewed today. One (1) NC Pre-K child’s file was monitored today. The classroom operates from 8:30 a.m. to 3:00 p.m. In classroom space 7, children were engaged in free-play and were observed completing an art project using stamps, caring for animals and dolls, and exploring various sensory toys. In classroom space 9, children drew pictures and dictated to teachers, built small structures with magnatiles and explored various objects on a light table. In classroom space 1, children freely explored their environment and participated in routine caregiving activities such as feeding. In classroom space 2, children participate din routine caregiving activities such as diapering and explored the outdoor learning environment. In classroom space 6, children transitioned to the indoor learning environment from outdoors and washed hands in preparation for lunch. In classroom space 3, children transitioned indoors and washed hands for lunch. Lunch today consisted of pasta, meat sauce, milk, green beans and apples. In classroom space 4, children ate lunch with caregivers. Interactions were positive and nurturing. Supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ Due to time constraints, I was unable to complete monitoring today. I will return to complete the monitoring of staff files. The following violations were documented during today’s visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The last fire inspection was conducted on 2/5/25. The inspection was not documented on the form provided by the Division. 10A NCAC 09 .0304(a) 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. A jug of bleach was not maintained in locked storage in the kitchen. .2820(b) 898 All electrical appliances were not used in accordance with the manufacturers instruction. Appliances with heating elements, such as bottle warmers, crock pots, curling irons, irons, coffee pots, and/or their cords were accessible to preschool-age children. A coffee maker was observed in the lobby near the entrance of the building. .0604(e) 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. The medical report for one (1) staff, hire date 9/22/25, did not include a statement that indicates the individual is emotionally and physically fit to care for children. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One (1) staff, hire date 3/28/23, received nineteen (19) annual on-going training hours between 3/2024 and 3/2025. Based on education and experience, the staff member must receive twenty (20) hours of on-going training, annually. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Four (4) staff received 5.5 hours of orientation training within the first two (2) weeks of employment. .1101(a)(b) 1233 Each employee's personnel file did not contain a signed and dated statement that they received a job description and that they have received personnel and operational policies. Six (6) staff files did not contain a signed and dated statement that they received a job description. 10A NCAC 09 .0514(g) 1757 A valid qualification letter was not on file and available to review at the facility. Staff S. Warrick, hire date 8/19/25, did not have a qualification letter in the staff file. G.S. 110-90.2(b) & (d) & .2703(e) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. The authorization for one (1) Epipen in classroom space 9 expired on 10/8/25. The authorization for one (1) Ventolin in classroom space 9 expired 8/24/25. The authorization for one (1) Epipen in classroom space 3 did not include the parent signature. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 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. One (1) staff, hire date 3/28/23, did not have a certificate on file for “Recognizing and Responding to Suspicions of Child Maltreatment” training. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. The training certificates for three (3) health and safety training topics were not in the staff file for one (1) staff, hire date 3/28/23. The training topics were: Prevention of and response to emergencies due to food and allergic reactions; Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; Recognizing and reporting child abuse, child neglect, and child maltreatment. .1102(a) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One (1) child's file did not contain a signed statement that they received the policy. .0608(b)(1-6) Technical assistance was provided as follows: Item #106: Fire inspections must be documented on the inspection form provided by the Division. This form can be found on the Division's website under the Provider tab under "Provider Documents and Forms". During the visit today, you reached out to the Fire Marshal via email, requesting that the inspection is documented on the Division's form. To reach compliance with this item, please send the form to me upon receipt. Please note, if the form is handwritten, please make a copy for your records and mail the original to me at the PO box below. Item #840: The bleach was moved to locked storage during the visit. This is corrected. Moving forward, please note that bulk chemicals must be stored inside of a locked cabinet or closet in the kitchen. Item #898: To reach compliance with this item, the coffee maker must be made inaccessible to children. We discussed the lobby is used as the entrance to the program for licensed care, therefore all hazards must be removed. Item #1032: To reach compliance for this item, the one (1) staff must receive a new medical report that indicates they are emotionally and physically fit to care for children. We discussed this is best captured on the form provided by the Division. Item #1067: To reach compliance with this item, staff BW, CS, AE, and BH must receive the additional half hour of orientation training. This will meet requirements in both rule .1101 (a) and (b) as this will bring the total orientation hours received to six (6) hours in the first two (2) weeks and sixteen (16) hours in the first six weeks. Item #1757: The qualifying letter was printed and placed in the staff member’s file during the visit. This is corrected. Item #1882: To reach compliance for this item, you must obtain updated authorization for the two (2) medications in classroom space 9. You must also obtain a parent signature on the authorization for the medication in classroom space 3. Item #1908: To reach compliance with this item, the parents of the one (1) child must sign the acknowledgement that they received the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. The following violations were added during the "other" visit conducted to complete monitoring on 11/6/25: Item #1052: In your letter of compliance, please include a statement that indicates how you will ensure staff receive the required number of on-going training hours, annually. As a reminder, hours are calculated from the staff member’s hire date. In this example, the staff member’s hire date was 3/28/25. On-going training hours are not required for the first year, so the on-going training hours were calculated from March 2024-March 2025. Item #1233: To reach compliance with this item, the six (6) staff (BH, BW, ES, CS, HE, AE) must sign and date a statement that they have received a job description appropriate to their current duties and responsibilities. We discussed the signature pages for personnel policies has a line to note receipt of the job description but appears to have been left off of the form for recent hires. Plan to edit the form to ensure this line appears for future new hires. Item #1897: To reach compliance with this item, the training certificate must be placed in the file. Plan to locate the certificate from the training taken previously. If the certificate cannot be located, the staff will need to take the training again. Item #1898: To reach compliance with this item, the certificates for the three (3) training topics must be placed in the staff member’s file. If the training certificates cannot be located, the staff will need to take the training topics again. 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 11/19/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: Kaitlyn.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email Kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Orientation Training Record: As a reminder, please include the name of the provider for each topic of the orientation documentation page. CPR/First Aid Training Reminders: -Staff SW is due 11/17/25 -Staff HE is due 12/14/25 -Staff AE is due 12/29/25 Provisional Criminal Background Check: As a reminder, staff H. Etscorn currently has a Provisional qualifying letter that expires 11/14/25. Plan to have this staff check their CBC portal and email to receive the new qualifying letter. Approved Space: 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. Fire Inspection: 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.” Child Maltreatment Training: 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. WORKS: 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. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at Kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0701 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: MORGAN BROCK Operation Type: Center Case Number: 0525-256A Visit Date: 5/23/2025 Number Present: 23 Completed Date: 5/23/2025 Age: From 2 To 5 Total Minutes: 240 Time In: 10:30 AM Time Out: 02:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of this unannounced visit was to investigate allegations of violations of child care requirements at this child care facility. Natosha Lambeth, Western Investigations Team Supervisor, was also present during the visit. Alesia Summey, Director of Early Childhood Education, accompanied us during a walk-through of the facility. During the visit, I discussed the allegations with Ms. Summey and additional staff members. Limited monitoring of child care requirements occurred during today’s visit. The following violation was confirmed during today’s visit. Violation Number Comment Rule 303 Children were not adequately supervised at all times. On May 20, 2025, staff members were unaware of a three-year-old child's activities when the child left the fenced in playground. .1801(a)(1-5) 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. The TB test or screening for a volunteer was not available for review. .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. The Emergency Information Form for a volunteer was not available for review. .0701(a) 1958 Substitute providers and volunteers did not have a health questionnaire on or before the first day of work and annually thereafter. The health questionnaire for a volunteer was not available for review. 10A NCAC 09 .0701(a) 9995 A violation was found for which there is no item number. The Medical Report and statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children was not available for review, as required by Child Care Rule 10A NCAC 09 .0701(a). Violations must be corrected immediately. By June 2, 2025, you must submit documentation of the corrections you made and your plan to maintain compliance with the identified child care requirements to me at Morgan Brock, Investigations Consultant, morgan.brock@dhhs.nc.gov. You may contact me at Morgan Brock, Investigations Consultant, morgan.brock@dhhs.nc.gov, 828-788-0011 or Natosha Lambeth, Western Investigations Team Supervisor, natosha.lambeth@dhhs.nc.gov. Thank you for your time. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1801 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: 0125-014L Visit Date: 1/8/2025 Number Present: 69 Completed Date: 1/8/2025 Age: From 0 To 5 Total Minutes: 360 Time In: 09:30 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s visit is to investigate allegations of child care requirements. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Lisa McKnight, Early Learning Coordinator, during the visit. A signed copy of the visit summary was emailed to you. Ms. McKnight and Alesia Summey, Director of Early Childhood Education, assisted me today. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety percent (90%) as of 1/6/25. The facility operates with a Provisional license issued on 7/12/24. The Special Services/Restrictions includes 1st shift (daytime care), meets enhanced ratios, meets enhanced space, children under 2.5 years old in rooms with direct exits only. The facility is approved to provide transportation. The facility offers a pool, field trips, and serves children with special needs. The complaint was received by the Division of Child Development and Early Education on 1/2/25 and sent to me on 1/2/25. The complaint was self-reported. There is a concern that children are not receiving appropriate care. There is a concern that children are not adequately supervised. Video footage was available for review today. I reviewed video footage for 11/5/24, 11/6/24 and 11/11/24. I interviewed five (5) staff members. A brief observation was conducted in classroom space 7 today during rest time. Children were observed resting on their cots while teachers helped them get settled by covering them with blankets. There were fourteen (14) children ages three to four years old present with two (2) caregivers. Based on the interview and video footage, the allegation regarding supervision is substantiated. Based on the interview and video footage, the allegation regarding children not receiving appropriate care is unsubstantiated. The following violations were documented during today’s visit: Violation Number Comment Rule 303 Children were not adequately supervised at all times. One (1) staff member was asleep while serving in ratio and caring for children in classroom space 7 during a large group activity on 11/11/24 from 11:05am-11:11am. The staff member continued to nod off intermittently until 11:25am. One (1) additional staff member was present in the classroom but was observed using their cell phone for the duration of the incident. There were thirteen children ages three to four years old present during the incident. .1801(a)(1-5) 524 When children 3 years and older were in care, screen time was not used to stimulate a developmental domain; was not limited to 30 minutes a day and no more than a total of two and a half hours per week, per child; and/or was not documented on a cumulative log or the activity plan that is available for review. A screen time activity that occurred in classroom 7 from approximately 11:04am-11:30am on 11/11/24 was not documented on a log or activity plan. .0510(d)(2)(A-C) Technical assistance was provided as follows: Item #303 Supervision: We discussed the details of the supervision rule below that includes staff awareness of children’s activities and interacting with children while moving around the environment. If staff members are asleep or on their phones for extended periods of time, they are not aware of children’s activities. We discussed the facility’s cell phone policy that was reviewed during the visit today. The policy prohibits staff from using cell phones in the classroom or in front of children. We discussed the importance of reviewing this policy with all staff to clarify expectations. We discussed staff who take their breaks in a classroom with children present. We discussed that, even if a staff member is clocked out on break, if they are present with the children, the expectation remains that they are supervising children adequately. It is recommended that staff take their breaks in designated staff break rooms or off campus, if staffing allows. Please see the Supervision rules below for details: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (1) staff must be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff must interact with the children while moving about the indoor or outdoor area; (3) staff must know where each child is located and be aware of the children's activities at all times; (4) staff must provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff must be able to see and hear children aged birth to five years old while the children are eating. All of the conditions in this Paragraph shall apply except when emergencies necessitate that adequate supervision is impossible. Documentation of emergencies shall be maintained and available for review by Division representatives upon request. (b) For groups of children aged two years or older, the staff/child ratio during nap time shall comply with the requirements of this Chapter if at least one person remains in the room, all children are visible to that person, and the total number of required staff are on the premises and within calling distance of the rooms occupied by children. In your letter of compliance, please include statements indicating the steps you have taken or plan to take to prevent recurrence of this violation. Include information regarding staff termination. Item #524 Screen time: All screen time must be documented on a log or on the classroom’s activity plan. Be sure to indicate the children who are participating in screen time activities on the log or activity plan. As a reminder, all screen time activities must support a developmental domain. In your letter of compliance state how you will ensure screen time activities are documented on the log or activity plan. Achieving Compliance: The facility received a violation regarding supervision today. A follow-up visit will be conducted in the near future to determine if staff are adequately supervising children per Child Care Rule 10A NCAC 09 .1801(a)(1-5). Based on today’s findings, this child care facility received a substantiated complaint regarding supervision. This may warrant an administrative action as identified by Child Care Rule 10A NCAC 09 .2201. Additional monitoring visits may be required. 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 1/22/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Physical Contact: We discussed facility expectations for physical contact between staff and children. Plan to update your policies to include specific examples of acceptable or unacceptable forms of physical contact between staff and children. We discussed that children often enjoy physical contact with their caregivers with whom they have formed a special bond. This physical contact may include sitting in laps. We discussed that hugging and kissing may also occur, but expectations should be set for staff to know what is acceptable for your program. Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable to your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and can be a resource for you while you strive to provide a safe and healthy environment for the well-being of young children. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2201 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: 0125-014L Visit Date: 1/8/2025 Number Present: 69 Completed Date: 1/8/2025 Age: From 0 To 5 Total Minutes: 360 Time In: 09:30 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s visit is to investigate allegations of child care requirements. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Lisa McKnight, Early Learning Coordinator, during the visit. A signed copy of the visit summary was emailed to you. Ms. McKnight and Alesia Summey, Director of Early Childhood Education, assisted me today. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety percent (90%) as of 1/6/25. The facility operates with a Provisional license issued on 7/12/24. The Special Services/Restrictions includes 1st shift (daytime care), meets enhanced ratios, meets enhanced space, children under 2.5 years old in rooms with direct exits only. The facility is approved to provide transportation. The facility offers a pool, field trips, and serves children with special needs. The complaint was received by the Division of Child Development and Early Education on 1/2/25 and sent to me on 1/2/25. The complaint was self-reported. There is a concern that children are not receiving appropriate care. There is a concern that children are not adequately supervised. Video footage was available for review today. I reviewed video footage for 11/5/24, 11/6/24 and 11/11/24. I interviewed five (5) staff members. A brief observation was conducted in classroom space 7 today during rest time. Children were observed resting on their cots while teachers helped them get settled by covering them with blankets. There were fourteen (14) children ages three to four years old present with two (2) caregivers. Based on the interview and video footage, the allegation regarding supervision is substantiated. Based on the interview and video footage, the allegation regarding children not receiving appropriate care is unsubstantiated. The following violations were documented during today’s visit: Violation Number Comment Rule 303 Children were not adequately supervised at all times. One (1) staff member was asleep while serving in ratio and caring for children in classroom space 7 during a large group activity on 11/11/24 from 11:05am-11:11am. The staff member continued to nod off intermittently until 11:25am. One (1) additional staff member was present in the classroom but was observed using their cell phone for the duration of the incident. There were thirteen children ages three to four years old present during the incident. .1801(a)(1-5) 524 When children 3 years and older were in care, screen time was not used to stimulate a developmental domain; was not limited to 30 minutes a day and no more than a total of two and a half hours per week, per child; and/or was not documented on a cumulative log or the activity plan that is available for review. A screen time activity that occurred in classroom 7 from approximately 11:04am-11:30am on 11/11/24 was not documented on a log or activity plan. .0510(d)(2)(A-C) Technical assistance was provided as follows: Item #303 Supervision: We discussed the details of the supervision rule below that includes staff awareness of children’s activities and interacting with children while moving around the environment. If staff members are asleep or on their phones for extended periods of time, they are not aware of children’s activities. We discussed the facility’s cell phone policy that was reviewed during the visit today. The policy prohibits staff from using cell phones in the classroom or in front of children. We discussed the importance of reviewing this policy with all staff to clarify expectations. We discussed staff who take their breaks in a classroom with children present. We discussed that, even if a staff member is clocked out on break, if they are present with the children, the expectation remains that they are supervising children adequately. It is recommended that staff take their breaks in designated staff break rooms or off campus, if staffing allows. Please see the Supervision rules below for details: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (1) staff must be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff must interact with the children while moving about the indoor or outdoor area; (3) staff must know where each child is located and be aware of the children's activities at all times; (4) staff must provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff must be able to see and hear children aged birth to five years old while the children are eating. All of the conditions in this Paragraph shall apply except when emergencies necessitate that adequate supervision is impossible. Documentation of emergencies shall be maintained and available for review by Division representatives upon request. (b) For groups of children aged two years or older, the staff/child ratio during nap time shall comply with the requirements of this Chapter if at least one person remains in the room, all children are visible to that person, and the total number of required staff are on the premises and within calling distance of the rooms occupied by children. In your letter of compliance, please include statements indicating the steps you have taken or plan to take to prevent recurrence of this violation. Include information regarding staff termination. Item #524 Screen time: All screen time must be documented on a log or on the classroom’s activity plan. Be sure to indicate the children who are participating in screen time activities on the log or activity plan. As a reminder, all screen time activities must support a developmental domain. In your letter of compliance state how you will ensure screen time activities are documented on the log or activity plan. Achieving Compliance: The facility received a violation regarding supervision today. A follow-up visit will be conducted in the near future to determine if staff are adequately supervising children per Child Care Rule 10A NCAC 09 .1801(a)(1-5). Based on today’s findings, this child care facility received a substantiated complaint regarding supervision. This may warrant an administrative action as identified by Child Care Rule 10A NCAC 09 .2201. Additional monitoring visits may be required. 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 1/22/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Physical Contact: We discussed facility expectations for physical contact between staff and children. Plan to update your policies to include specific examples of acceptable or unacceptable forms of physical contact between staff and children. We discussed that children often enjoy physical contact with their caregivers with whom they have formed a special bond. This physical contact may include sitting in laps. We discussed that hugging and kissing may also occur, but expectations should be set for staff to know what is acceptable for your program. Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable to your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and can be a resource for you while you strive to provide a safe and healthy environment for the well-being of young children. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: 0125-014L Visit Date: 1/8/2025 Number Present: 69 Completed Date: 1/8/2025 Age: From 0 To 5 Total Minutes: 360 Time In: 09:30 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s visit is to investigate allegations of child care requirements. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Lisa McKnight, Early Learning Coordinator, during the visit. A signed copy of the visit summary was emailed to you. Ms. McKnight and Alesia Summey, Director of Early Childhood Education, assisted me today. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety percent (90%) as of 1/6/25. The facility operates with a Provisional license issued on 7/12/24. The Special Services/Restrictions includes 1st shift (daytime care), meets enhanced ratios, meets enhanced space, children under 2.5 years old in rooms with direct exits only. The facility is approved to provide transportation. The facility offers a pool, field trips, and serves children with special needs. The complaint was received by the Division of Child Development and Early Education on 1/2/25 and sent to me on 1/2/25. The complaint was self-reported. There is a concern that children are not receiving appropriate care. There is a concern that children are not adequately supervised. Video footage was available for review today. I reviewed video footage for 11/5/24, 11/6/24 and 11/11/24. I interviewed five (5) staff members. A brief observation was conducted in classroom space 7 today during rest time. Children were observed resting on their cots while teachers helped them get settled by covering them with blankets. There were fourteen (14) children ages three to four years old present with two (2) caregivers. Based on the interview and video footage, the allegation regarding supervision is substantiated. Based on the interview and video footage, the allegation regarding children not receiving appropriate care is unsubstantiated. The following violations were documented during today’s visit: Violation Number Comment Rule 303 Children were not adequately supervised at all times. One (1) staff member was asleep while serving in ratio and caring for children in classroom space 7 during a large group activity on 11/11/24 from 11:05am-11:11am. The staff member continued to nod off intermittently until 11:25am. One (1) additional staff member was present in the classroom but was observed using their cell phone for the duration of the incident. There were thirteen children ages three to four years old present during the incident. .1801(a)(1-5) 524 When children 3 years and older were in care, screen time was not used to stimulate a developmental domain; was not limited to 30 minutes a day and no more than a total of two and a half hours per week, per child; and/or was not documented on a cumulative log or the activity plan that is available for review. A screen time activity that occurred in classroom 7 from approximately 11:04am-11:30am on 11/11/24 was not documented on a log or activity plan. .0510(d)(2)(A-C) Technical assistance was provided as follows: Item #303 Supervision: We discussed the details of the supervision rule below that includes staff awareness of children’s activities and interacting with children while moving around the environment. If staff members are asleep or on their phones for extended periods of time, they are not aware of children’s activities. We discussed the facility’s cell phone policy that was reviewed during the visit today. The policy prohibits staff from using cell phones in the classroom or in front of children. We discussed the importance of reviewing this policy with all staff to clarify expectations. We discussed staff who take their breaks in a classroom with children present. We discussed that, even if a staff member is clocked out on break, if they are present with the children, the expectation remains that they are supervising children adequately. It is recommended that staff take their breaks in designated staff break rooms or off campus, if staffing allows. Please see the Supervision rules below for details: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (1) staff must be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff must interact with the children while moving about the indoor or outdoor area; (3) staff must know where each child is located and be aware of the children's activities at all times; (4) staff must provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff must be able to see and hear children aged birth to five years old while the children are eating. All of the conditions in this Paragraph shall apply except when emergencies necessitate that adequate supervision is impossible. Documentation of emergencies shall be maintained and available for review by Division representatives upon request. (b) For groups of children aged two years or older, the staff/child ratio during nap time shall comply with the requirements of this Chapter if at least one person remains in the room, all children are visible to that person, and the total number of required staff are on the premises and within calling distance of the rooms occupied by children. In your letter of compliance, please include statements indicating the steps you have taken or plan to take to prevent recurrence of this violation. Include information regarding staff termination. Item #524 Screen time: All screen time must be documented on a log or on the classroom’s activity plan. Be sure to indicate the children who are participating in screen time activities on the log or activity plan. As a reminder, all screen time activities must support a developmental domain. In your letter of compliance state how you will ensure screen time activities are documented on the log or activity plan. Achieving Compliance: The facility received a violation regarding supervision today. A follow-up visit will be conducted in the near future to determine if staff are adequately supervising children per Child Care Rule 10A NCAC 09 .1801(a)(1-5). Based on today’s findings, this child care facility received a substantiated complaint regarding supervision. This may warrant an administrative action as identified by Child Care Rule 10A NCAC 09 .2201. Additional monitoring visits may be required. 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 1/22/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Physical Contact: We discussed facility expectations for physical contact between staff and children. Plan to update your policies to include specific examples of acceptable or unacceptable forms of physical contact between staff and children. We discussed that children often enjoy physical contact with their caregivers with whom they have formed a special bond. This physical contact may include sitting in laps. We discussed that hugging and kissing may also occur, but expectations should be set for staff to know what is acceptable for your program. Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable to your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and can be a resource for you while you strive to provide a safe and healthy environment for the well-being of young children. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 11/14/2024 Number Present: 71 Completed Date: 11/14/2024 Age: From 0 To 5 Total Minutes: 435 Time In: 09:00 AM Time Out: 04:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Mary Virella, Early Learning Specialist, during the visit. Monica Houck, Lead Child Care Consultant, accompanied me today. A signed copy of the visit summary was emailed to you. Ms. Virella was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine percent (89%) as of 11/13/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, YWCA of Asheville and Western North Carolina, Inc, is current/active as of 11/13/24. Permit type – Provisional License due to Lead issued 7/12/24. Special Services/Restrictions – 1st shift (daytime care), meets enhanced ratios, meets enhanced space, children under 2.5 years old in rooms with direct exits only. The facility is approved to provide transportation, offers a swimming pool, fields trips, and serves children with special needs. The last annual compliance visit was conducted on 11/16/23. The last fire drill was practiced on 10/31/24. The last lockdown drill was practiced on 11/12/24. The last playground inspection was documented on 10/28/24. The last fire inspection was approved on 7/10/24. The last sanitation inspection was conducted on 2/13/24 with fifteen (15) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. The facility is no longer an approved NC Pre-K site. NC Pre-K was deselected in Regulatory today. The facility is currently under an Administrative Action Provisional License for Lead, issued 7/12/24. The Administrative Action is posted in an area visible to parents and visitors. The program is approved to provide transportation. No children are currently being transported on a regular basis. The facility uses the buses primarily for field trips. I monitored two (2) vehicles today. There are eighty-eight (88) children enrolled. Nine (9) children’s files were monitored today. There are twenty (20) staff. Three (3) new staff files and two (2) existing staff files were monitored today. The facility is currently under an Emergency Operation Plan for a Boil Water Notice. The plan is implemented as approved. Aquatics are unable to be monitored today. The pool is closed for renovations and swimming lessons are currently paused. Monitoring for aquatics may occur during the Routine Unannounced visit. Upon arrival I was greeted by Ms. Virella, Lisa McKnight, Early Learning Coordinator/Administrator, and Alesia Summey, Director of Early Childhood Education, Lesley Webber, Early Learning Specialist. In classroom space 1, children were being fed and soothed by caregivers. In classroom space 2, children were exploring tactile animal cards with the caregiver, interlocking blocks and animal figurines. In classroom space 3, children explored puzzles, books and danced to music with a Volunteer grandparent. In classroom space 6, children engaged in gross motor exploration with plush seesaws, read books with caregivers and participated in routine caregiving activities such as diaper changing. In classroom space 5, children were soothed by teachers as they rolled cars on various surfaces, pretended to care for baby dolls and participated in routine caregiving activities such as diapering. In classroom space 4, children participated in a community art projects using crayons and paper, solved age appropriate puzzles and built small structures with magnatiles. In classroom space 7, children were engaged in a large group meeting with the caregivers, discussing the next steps to prepare for lunch. Children washed hands in small groups and ate lunch brought from home. In classroom space 8, children participated in a large group read aloud and discussion about owls. Interactions were positive and nurturing. Children were actively supervised at all times. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One (1) child with an enrollment date of 8/26/24 did not have documentation to verify the parent was given a summary of the NC Child Care Law. GS 110-102 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Sleep checks for two (2) children were not documented on 11/13/24. .0606(g) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. One (1) child with an enrollment date of 8/26/24 did not have documentation on file that the parent participation plan was discussed with parents on or before the child's first day of attendance. 10A NCAC 09 .0515(a) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. One (1) child with an enrollment date of 7/17/23 has emergency medical care information last updated on 6/29/23. One (1) child with an enrollment date of 11/16/20 has emergency medical care information last updated on 10/20/20. One (1) child with an enrollment date of 1/3/23 has emergency medical care information last updated on 12/10/22. .0802(c) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. One (1) child with an enrollment date of 8/26/24 did not have on file a signed and dated statement by parent that the discipline policy was received and explained at enrollment. .1804(c) The following items were not cited as violations today. Due to the effects of Tropical Storm Helene, additional guidance and time is given to meet compliance for the following items. Please note, monitoring for these items may occur during future visits. If these items remain out of compliance, a violation may be cited: Fire Inspection Fire inspections must be submitted to the Division within one week after the inspection has been conducted. Please note, if the inspection report is handwritten, it must be mailed to the PO box listed below. If the inspection is digitally completed, it can be forwarded to me via email. Children's Records- Operational Policy The operational policies must be reviewed with all families by the first day of enrollment. A copy of the operational policies must be given to the parent and an acknowledgement of this review must be obtained and placed in the child's file by the first day of enrollment. One (1) child's file was missing the policy signature page that included the acknowledgment for receipt of the operational policies. We discussed to have all paperwork required by the first day of enrollment on file before the child attends and is being cared for in the classroom Health and Safety Training All Health and Safety training topics must be completed within the first year of employment and every five years after. To achieve compliance, the one staff hired 10/13/23 must complete all Health and Safety training topics and the one staff hired 11/9/23 must complete the topic of Precautions in Transporting Children. We discussed that the one (1) staff hired 10/13/23 is part time. Plan to work with this staff member to create a schedule that ensure Health and Safety trainings are completed within the first year of employment and every five years after. The following items were cited as a violations during the visit today. Technical Assistance for achieving compliance as follows: Safe Sleep The staff member completed the sleep chart during the visit today. In your letter of compliance, include a statement that indicates how you will ensure sleep checks are documented on the sleep charts every fifteen minutes, according to the safe sleep policy. Children's Records- Summary of NC Child Care Law, Discipline Policy and Parent Participation Plan: The required records for children must be on file to ensure safety for children and provide information for staff in case of emergency. Lisa McKnight, Early Learning Coordinator, stated she was unaware that the emergency medical care information for children needed to be updated as changes occur and at least annually for each child. Ms. McKnight also stated she was aware that the one child with an enrollment date of 8/26/24 was missing the signed and dated statement/acknowledgment for the summary of the NC Child Care law, the discipline policy, and the parent participation plan. It is recommended to audit all child files for accuracy and completion. We discussed to have all paperwork required by the first day of enrollment on file before the child attends and is being cared for in the classroom. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/28/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: The facility was closed due to Tropical Storm Helene from 9/26/24 to 10/28/24. The facility was unable to conduct the planned lockdown drill for September due to the closure. A lockdown drill was conducted on 11/12/24. Additional guidance was given today regarding the additional time needed to conduct the drill. Please continue to conduct safety drills every three months. We discussed aquatics staff requirements. Staff who are left alone with children or who are counted in ratio during the swim lessons need a staff file, including a DCDEE Criminal Background Check qualifying letter. We discussed existing teaching staff can accompany the children to count in ratio, however, according to the aquatics rule below, at least half of the staff required to meet ratio for swimming must be in the pool. 10A NCAC 09 .1403 ACTIVITIES INVOLVING WATER IN CHILD CARE CENTERS (e) The following staff/child ratios shall be maintained whenever children participate in aquatic activities: Age of Children Ratio Staff/Children 3 to 4 Years 1/8 4 to 5 Years 1/10 5 Years and Older 1/13 Notwithstanding the staff/child ratios, at no time shall there be fewer than two staff members supervising the aquatic activity. (f) Children shall be adequately supervised by center staff at all times while participating in aquatic activities. For purposes of this Rule, "Adequate supervision" means that half of the center staff needed to meet the staff/child ratios in Paragraph (e) of this Rule is in the water and the other half is out of the water. If an uneven number of staff are needed to meet the required staff/child ratios, the majority shall be in the water. Staff shall be stationed in pre-assigned areas that will enable them at all times to hear, see, and respond to the children whether in or out of the water. Children shall not enter the water before center staff are stationed in their pre-assigned areas. Center staff shall devote their full attention to supervising the children in their pre-assigned areas of coverage and shall communicate with one another about children moving from one area to another area. As a reminder, the lifeguard does not count in ratio. We discussed that the facility would like to place Ms. Virella as the Administrator. The Preservice Requirements for Administrator form must be completed in order to make this change. A copy was left with you today. 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 kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0515 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 11/14/2024 Number Present: 71 Completed Date: 11/14/2024 Age: From 0 To 5 Total Minutes: 435 Time In: 09:00 AM Time Out: 04:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Mary Virella, Early Learning Specialist, during the visit. Monica Houck, Lead Child Care Consultant, accompanied me today. A signed copy of the visit summary was emailed to you. Ms. Virella was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine percent (89%) as of 11/13/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, YWCA of Asheville and Western North Carolina, Inc, is current/active as of 11/13/24. Permit type – Provisional License due to Lead issued 7/12/24. Special Services/Restrictions – 1st shift (daytime care), meets enhanced ratios, meets enhanced space, children under 2.5 years old in rooms with direct exits only. The facility is approved to provide transportation, offers a swimming pool, fields trips, and serves children with special needs. The last annual compliance visit was conducted on 11/16/23. The last fire drill was practiced on 10/31/24. The last lockdown drill was practiced on 11/12/24. The last playground inspection was documented on 10/28/24. The last fire inspection was approved on 7/10/24. The last sanitation inspection was conducted on 2/13/24 with fifteen (15) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. The facility is no longer an approved NC Pre-K site. NC Pre-K was deselected in Regulatory today. The facility is currently under an Administrative Action Provisional License for Lead, issued 7/12/24. The Administrative Action is posted in an area visible to parents and visitors. The program is approved to provide transportation. No children are currently being transported on a regular basis. The facility uses the buses primarily for field trips. I monitored two (2) vehicles today. There are eighty-eight (88) children enrolled. Nine (9) children’s files were monitored today. There are twenty (20) staff. Three (3) new staff files and two (2) existing staff files were monitored today. The facility is currently under an Emergency Operation Plan for a Boil Water Notice. The plan is implemented as approved. Aquatics are unable to be monitored today. The pool is closed for renovations and swimming lessons are currently paused. Monitoring for aquatics may occur during the Routine Unannounced visit. Upon arrival I was greeted by Ms. Virella, Lisa McKnight, Early Learning Coordinator/Administrator, and Alesia Summey, Director of Early Childhood Education, Lesley Webber, Early Learning Specialist. In classroom space 1, children were being fed and soothed by caregivers. In classroom space 2, children were exploring tactile animal cards with the caregiver, interlocking blocks and animal figurines. In classroom space 3, children explored puzzles, books and danced to music with a Volunteer grandparent. In classroom space 6, children engaged in gross motor exploration with plush seesaws, read books with caregivers and participated in routine caregiving activities such as diaper changing. In classroom space 5, children were soothed by teachers as they rolled cars on various surfaces, pretended to care for baby dolls and participated in routine caregiving activities such as diapering. In classroom space 4, children participated in a community art projects using crayons and paper, solved age appropriate puzzles and built small structures with magnatiles. In classroom space 7, children were engaged in a large group meeting with the caregivers, discussing the next steps to prepare for lunch. Children washed hands in small groups and ate lunch brought from home. In classroom space 8, children participated in a large group read aloud and discussion about owls. Interactions were positive and nurturing. Children were actively supervised at all times. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One (1) child with an enrollment date of 8/26/24 did not have documentation to verify the parent was given a summary of the NC Child Care Law. GS 110-102 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Sleep checks for two (2) children were not documented on 11/13/24. .0606(g) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. One (1) child with an enrollment date of 8/26/24 did not have documentation on file that the parent participation plan was discussed with parents on or before the child's first day of attendance. 10A NCAC 09 .0515(a) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. One (1) child with an enrollment date of 7/17/23 has emergency medical care information last updated on 6/29/23. One (1) child with an enrollment date of 11/16/20 has emergency medical care information last updated on 10/20/20. One (1) child with an enrollment date of 1/3/23 has emergency medical care information last updated on 12/10/22. .0802(c) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. One (1) child with an enrollment date of 8/26/24 did not have on file a signed and dated statement by parent that the discipline policy was received and explained at enrollment. .1804(c) The following items were not cited as violations today. Due to the effects of Tropical Storm Helene, additional guidance and time is given to meet compliance for the following items. Please note, monitoring for these items may occur during future visits. If these items remain out of compliance, a violation may be cited: Fire Inspection Fire inspections must be submitted to the Division within one week after the inspection has been conducted. Please note, if the inspection report is handwritten, it must be mailed to the PO box listed below. If the inspection is digitally completed, it can be forwarded to me via email. Children's Records- Operational Policy The operational policies must be reviewed with all families by the first day of enrollment. A copy of the operational policies must be given to the parent and an acknowledgement of this review must be obtained and placed in the child's file by the first day of enrollment. One (1) child's file was missing the policy signature page that included the acknowledgment for receipt of the operational policies. We discussed to have all paperwork required by the first day of enrollment on file before the child attends and is being cared for in the classroom Health and Safety Training All Health and Safety training topics must be completed within the first year of employment and every five years after. To achieve compliance, the one staff hired 10/13/23 must complete all Health and Safety training topics and the one staff hired 11/9/23 must complete the topic of Precautions in Transporting Children. We discussed that the one (1) staff hired 10/13/23 is part time. Plan to work with this staff member to create a schedule that ensure Health and Safety trainings are completed within the first year of employment and every five years after. The following items were cited as a violations during the visit today. Technical Assistance for achieving compliance as follows: Safe Sleep The staff member completed the sleep chart during the visit today. In your letter of compliance, include a statement that indicates how you will ensure sleep checks are documented on the sleep charts every fifteen minutes, according to the safe sleep policy. Children's Records- Summary of NC Child Care Law, Discipline Policy and Parent Participation Plan: The required records for children must be on file to ensure safety for children and provide information for staff in case of emergency. Lisa McKnight, Early Learning Coordinator, stated she was unaware that the emergency medical care information for children needed to be updated as changes occur and at least annually for each child. Ms. McKnight also stated she was aware that the one child with an enrollment date of 8/26/24 was missing the signed and dated statement/acknowledgment for the summary of the NC Child Care law, the discipline policy, and the parent participation plan. It is recommended to audit all child files for accuracy and completion. We discussed to have all paperwork required by the first day of enrollment on file before the child attends and is being cared for in the classroom. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/28/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: The facility was closed due to Tropical Storm Helene from 9/26/24 to 10/28/24. The facility was unable to conduct the planned lockdown drill for September due to the closure. A lockdown drill was conducted on 11/12/24. Additional guidance was given today regarding the additional time needed to conduct the drill. Please continue to conduct safety drills every three months. We discussed aquatics staff requirements. Staff who are left alone with children or who are counted in ratio during the swim lessons need a staff file, including a DCDEE Criminal Background Check qualifying letter. We discussed existing teaching staff can accompany the children to count in ratio, however, according to the aquatics rule below, at least half of the staff required to meet ratio for swimming must be in the pool. 10A NCAC 09 .1403 ACTIVITIES INVOLVING WATER IN CHILD CARE CENTERS (e) The following staff/child ratios shall be maintained whenever children participate in aquatic activities: Age of Children Ratio Staff/Children 3 to 4 Years 1/8 4 to 5 Years 1/10 5 Years and Older 1/13 Notwithstanding the staff/child ratios, at no time shall there be fewer than two staff members supervising the aquatic activity. (f) Children shall be adequately supervised by center staff at all times while participating in aquatic activities. For purposes of this Rule, "Adequate supervision" means that half of the center staff needed to meet the staff/child ratios in Paragraph (e) of this Rule is in the water and the other half is out of the water. If an uneven number of staff are needed to meet the required staff/child ratios, the majority shall be in the water. Staff shall be stationed in pre-assigned areas that will enable them at all times to hear, see, and respond to the children whether in or out of the water. Children shall not enter the water before center staff are stationed in their pre-assigned areas. Center staff shall devote their full attention to supervising the children in their pre-assigned areas of coverage and shall communicate with one another about children moving from one area to another area. As a reminder, the lifeguard does not count in ratio. We discussed that the facility would like to place Ms. Virella as the Administrator. The Preservice Requirements for Administrator form must be completed in order to make this change. A copy was left with you today. 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 kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 11/14/2024 Number Present: 71 Completed Date: 11/14/2024 Age: From 0 To 5 Total Minutes: 435 Time In: 09:00 AM Time Out: 04:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Mary Virella, Early Learning Specialist, during the visit. Monica Houck, Lead Child Care Consultant, accompanied me today. A signed copy of the visit summary was emailed to you. Ms. Virella was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine percent (89%) as of 11/13/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, YWCA of Asheville and Western North Carolina, Inc, is current/active as of 11/13/24. Permit type – Provisional License due to Lead issued 7/12/24. Special Services/Restrictions – 1st shift (daytime care), meets enhanced ratios, meets enhanced space, children under 2.5 years old in rooms with direct exits only. The facility is approved to provide transportation, offers a swimming pool, fields trips, and serves children with special needs. The last annual compliance visit was conducted on 11/16/23. The last fire drill was practiced on 10/31/24. The last lockdown drill was practiced on 11/12/24. The last playground inspection was documented on 10/28/24. The last fire inspection was approved on 7/10/24. The last sanitation inspection was conducted on 2/13/24 with fifteen (15) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. The facility is no longer an approved NC Pre-K site. NC Pre-K was deselected in Regulatory today. The facility is currently under an Administrative Action Provisional License for Lead, issued 7/12/24. The Administrative Action is posted in an area visible to parents and visitors. The program is approved to provide transportation. No children are currently being transported on a regular basis. The facility uses the buses primarily for field trips. I monitored two (2) vehicles today. There are eighty-eight (88) children enrolled. Nine (9) children’s files were monitored today. There are twenty (20) staff. Three (3) new staff files and two (2) existing staff files were monitored today. The facility is currently under an Emergency Operation Plan for a Boil Water Notice. The plan is implemented as approved. Aquatics are unable to be monitored today. The pool is closed for renovations and swimming lessons are currently paused. Monitoring for aquatics may occur during the Routine Unannounced visit. Upon arrival I was greeted by Ms. Virella, Lisa McKnight, Early Learning Coordinator/Administrator, and Alesia Summey, Director of Early Childhood Education, Lesley Webber, Early Learning Specialist. In classroom space 1, children were being fed and soothed by caregivers. In classroom space 2, children were exploring tactile animal cards with the caregiver, interlocking blocks and animal figurines. In classroom space 3, children explored puzzles, books and danced to music with a Volunteer grandparent. In classroom space 6, children engaged in gross motor exploration with plush seesaws, read books with caregivers and participated in routine caregiving activities such as diaper changing. In classroom space 5, children were soothed by teachers as they rolled cars on various surfaces, pretended to care for baby dolls and participated in routine caregiving activities such as diapering. In classroom space 4, children participated in a community art projects using crayons and paper, solved age appropriate puzzles and built small structures with magnatiles. In classroom space 7, children were engaged in a large group meeting with the caregivers, discussing the next steps to prepare for lunch. Children washed hands in small groups and ate lunch brought from home. In classroom space 8, children participated in a large group read aloud and discussion about owls. Interactions were positive and nurturing. Children were actively supervised at all times. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One (1) child with an enrollment date of 8/26/24 did not have documentation to verify the parent was given a summary of the NC Child Care Law. GS 110-102 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Sleep checks for two (2) children were not documented on 11/13/24. .0606(g) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. One (1) child with an enrollment date of 8/26/24 did not have documentation on file that the parent participation plan was discussed with parents on or before the child's first day of attendance. 10A NCAC 09 .0515(a) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. One (1) child with an enrollment date of 7/17/23 has emergency medical care information last updated on 6/29/23. One (1) child with an enrollment date of 11/16/20 has emergency medical care information last updated on 10/20/20. One (1) child with an enrollment date of 1/3/23 has emergency medical care information last updated on 12/10/22. .0802(c) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. One (1) child with an enrollment date of 8/26/24 did not have on file a signed and dated statement by parent that the discipline policy was received and explained at enrollment. .1804(c) The following items were not cited as violations today. Due to the effects of Tropical Storm Helene, additional guidance and time is given to meet compliance for the following items. Please note, monitoring for these items may occur during future visits. If these items remain out of compliance, a violation may be cited: Fire Inspection Fire inspections must be submitted to the Division within one week after the inspection has been conducted. Please note, if the inspection report is handwritten, it must be mailed to the PO box listed below. If the inspection is digitally completed, it can be forwarded to me via email. Children's Records- Operational Policy The operational policies must be reviewed with all families by the first day of enrollment. A copy of the operational policies must be given to the parent and an acknowledgement of this review must be obtained and placed in the child's file by the first day of enrollment. One (1) child's file was missing the policy signature page that included the acknowledgment for receipt of the operational policies. We discussed to have all paperwork required by the first day of enrollment on file before the child attends and is being cared for in the classroom Health and Safety Training All Health and Safety training topics must be completed within the first year of employment and every five years after. To achieve compliance, the one staff hired 10/13/23 must complete all Health and Safety training topics and the one staff hired 11/9/23 must complete the topic of Precautions in Transporting Children. We discussed that the one (1) staff hired 10/13/23 is part time. Plan to work with this staff member to create a schedule that ensure Health and Safety trainings are completed within the first year of employment and every five years after. The following items were cited as a violations during the visit today. Technical Assistance for achieving compliance as follows: Safe Sleep The staff member completed the sleep chart during the visit today. In your letter of compliance, include a statement that indicates how you will ensure sleep checks are documented on the sleep charts every fifteen minutes, according to the safe sleep policy. Children's Records- Summary of NC Child Care Law, Discipline Policy and Parent Participation Plan: The required records for children must be on file to ensure safety for children and provide information for staff in case of emergency. Lisa McKnight, Early Learning Coordinator, stated she was unaware that the emergency medical care information for children needed to be updated as changes occur and at least annually for each child. Ms. McKnight also stated she was aware that the one child with an enrollment date of 8/26/24 was missing the signed and dated statement/acknowledgment for the summary of the NC Child Care law, the discipline policy, and the parent participation plan. It is recommended to audit all child files for accuracy and completion. We discussed to have all paperwork required by the first day of enrollment on file before the child attends and is being cared for in the classroom. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/28/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: The facility was closed due to Tropical Storm Helene from 9/26/24 to 10/28/24. The facility was unable to conduct the planned lockdown drill for September due to the closure. A lockdown drill was conducted on 11/12/24. Additional guidance was given today regarding the additional time needed to conduct the drill. Please continue to conduct safety drills every three months. We discussed aquatics staff requirements. Staff who are left alone with children or who are counted in ratio during the swim lessons need a staff file, including a DCDEE Criminal Background Check qualifying letter. We discussed existing teaching staff can accompany the children to count in ratio, however, according to the aquatics rule below, at least half of the staff required to meet ratio for swimming must be in the pool. 10A NCAC 09 .1403 ACTIVITIES INVOLVING WATER IN CHILD CARE CENTERS (e) The following staff/child ratios shall be maintained whenever children participate in aquatic activities: Age of Children Ratio Staff/Children 3 to 4 Years 1/8 4 to 5 Years 1/10 5 Years and Older 1/13 Notwithstanding the staff/child ratios, at no time shall there be fewer than two staff members supervising the aquatic activity. (f) Children shall be adequately supervised by center staff at all times while participating in aquatic activities. For purposes of this Rule, "Adequate supervision" means that half of the center staff needed to meet the staff/child ratios in Paragraph (e) of this Rule is in the water and the other half is out of the water. If an uneven number of staff are needed to meet the required staff/child ratios, the majority shall be in the water. Staff shall be stationed in pre-assigned areas that will enable them at all times to hear, see, and respond to the children whether in or out of the water. Children shall not enter the water before center staff are stationed in their pre-assigned areas. Center staff shall devote their full attention to supervising the children in their pre-assigned areas of coverage and shall communicate with one another about children moving from one area to another area. As a reminder, the lifeguard does not count in ratio. We discussed that the facility would like to place Ms. Virella as the Administrator. The Preservice Requirements for Administrator form must be completed in order to make this change. A copy was left with you today. 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 kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1403 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 11/14/2024 Number Present: 71 Completed Date: 11/14/2024 Age: From 0 To 5 Total Minutes: 435 Time In: 09:00 AM Time Out: 04:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Mary Virella, Early Learning Specialist, during the visit. Monica Houck, Lead Child Care Consultant, accompanied me today. A signed copy of the visit summary was emailed to you. Ms. Virella was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine percent (89%) as of 11/13/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, YWCA of Asheville and Western North Carolina, Inc, is current/active as of 11/13/24. Permit type – Provisional License due to Lead issued 7/12/24. Special Services/Restrictions – 1st shift (daytime care), meets enhanced ratios, meets enhanced space, children under 2.5 years old in rooms with direct exits only. The facility is approved to provide transportation, offers a swimming pool, fields trips, and serves children with special needs. The last annual compliance visit was conducted on 11/16/23. The last fire drill was practiced on 10/31/24. The last lockdown drill was practiced on 11/12/24. The last playground inspection was documented on 10/28/24. The last fire inspection was approved on 7/10/24. The last sanitation inspection was conducted on 2/13/24 with fifteen (15) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. The facility is no longer an approved NC Pre-K site. NC Pre-K was deselected in Regulatory today. The facility is currently under an Administrative Action Provisional License for Lead, issued 7/12/24. The Administrative Action is posted in an area visible to parents and visitors. The program is approved to provide transportation. No children are currently being transported on a regular basis. The facility uses the buses primarily for field trips. I monitored two (2) vehicles today. There are eighty-eight (88) children enrolled. Nine (9) children’s files were monitored today. There are twenty (20) staff. Three (3) new staff files and two (2) existing staff files were monitored today. The facility is currently under an Emergency Operation Plan for a Boil Water Notice. The plan is implemented as approved. Aquatics are unable to be monitored today. The pool is closed for renovations and swimming lessons are currently paused. Monitoring for aquatics may occur during the Routine Unannounced visit. Upon arrival I was greeted by Ms. Virella, Lisa McKnight, Early Learning Coordinator/Administrator, and Alesia Summey, Director of Early Childhood Education, Lesley Webber, Early Learning Specialist. In classroom space 1, children were being fed and soothed by caregivers. In classroom space 2, children were exploring tactile animal cards with the caregiver, interlocking blocks and animal figurines. In classroom space 3, children explored puzzles, books and danced to music with a Volunteer grandparent. In classroom space 6, children engaged in gross motor exploration with plush seesaws, read books with caregivers and participated in routine caregiving activities such as diaper changing. In classroom space 5, children were soothed by teachers as they rolled cars on various surfaces, pretended to care for baby dolls and participated in routine caregiving activities such as diapering. In classroom space 4, children participated in a community art projects using crayons and paper, solved age appropriate puzzles and built small structures with magnatiles. In classroom space 7, children were engaged in a large group meeting with the caregivers, discussing the next steps to prepare for lunch. Children washed hands in small groups and ate lunch brought from home. In classroom space 8, children participated in a large group read aloud and discussion about owls. Interactions were positive and nurturing. Children were actively supervised at all times. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One (1) child with an enrollment date of 8/26/24 did not have documentation to verify the parent was given a summary of the NC Child Care Law. GS 110-102 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Sleep checks for two (2) children were not documented on 11/13/24. .0606(g) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. One (1) child with an enrollment date of 8/26/24 did not have documentation on file that the parent participation plan was discussed with parents on or before the child's first day of attendance. 10A NCAC 09 .0515(a) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. One (1) child with an enrollment date of 7/17/23 has emergency medical care information last updated on 6/29/23. One (1) child with an enrollment date of 11/16/20 has emergency medical care information last updated on 10/20/20. One (1) child with an enrollment date of 1/3/23 has emergency medical care information last updated on 12/10/22. .0802(c) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. One (1) child with an enrollment date of 8/26/24 did not have on file a signed and dated statement by parent that the discipline policy was received and explained at enrollment. .1804(c) The following items were not cited as violations today. Due to the effects of Tropical Storm Helene, additional guidance and time is given to meet compliance for the following items. Please note, monitoring for these items may occur during future visits. If these items remain out of compliance, a violation may be cited: Fire Inspection Fire inspections must be submitted to the Division within one week after the inspection has been conducted. Please note, if the inspection report is handwritten, it must be mailed to the PO box listed below. If the inspection is digitally completed, it can be forwarded to me via email. Children's Records- Operational Policy The operational policies must be reviewed with all families by the first day of enrollment. A copy of the operational policies must be given to the parent and an acknowledgement of this review must be obtained and placed in the child's file by the first day of enrollment. One (1) child's file was missing the policy signature page that included the acknowledgment for receipt of the operational policies. We discussed to have all paperwork required by the first day of enrollment on file before the child attends and is being cared for in the classroom Health and Safety Training All Health and Safety training topics must be completed within the first year of employment and every five years after. To achieve compliance, the one staff hired 10/13/23 must complete all Health and Safety training topics and the one staff hired 11/9/23 must complete the topic of Precautions in Transporting Children. We discussed that the one (1) staff hired 10/13/23 is part time. Plan to work with this staff member to create a schedule that ensure Health and Safety trainings are completed within the first year of employment and every five years after. The following items were cited as a violations during the visit today. Technical Assistance for achieving compliance as follows: Safe Sleep The staff member completed the sleep chart during the visit today. In your letter of compliance, include a statement that indicates how you will ensure sleep checks are documented on the sleep charts every fifteen minutes, according to the safe sleep policy. Children's Records- Summary of NC Child Care Law, Discipline Policy and Parent Participation Plan: The required records for children must be on file to ensure safety for children and provide information for staff in case of emergency. Lisa McKnight, Early Learning Coordinator, stated she was unaware that the emergency medical care information for children needed to be updated as changes occur and at least annually for each child. Ms. McKnight also stated she was aware that the one child with an enrollment date of 8/26/24 was missing the signed and dated statement/acknowledgment for the summary of the NC Child Care law, the discipline policy, and the parent participation plan. It is recommended to audit all child files for accuracy and completion. We discussed to have all paperwork required by the first day of enrollment on file before the child attends and is being cared for in the classroom. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/28/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: The facility was closed due to Tropical Storm Helene from 9/26/24 to 10/28/24. The facility was unable to conduct the planned lockdown drill for September due to the closure. A lockdown drill was conducted on 11/12/24. Additional guidance was given today regarding the additional time needed to conduct the drill. Please continue to conduct safety drills every three months. We discussed aquatics staff requirements. Staff who are left alone with children or who are counted in ratio during the swim lessons need a staff file, including a DCDEE Criminal Background Check qualifying letter. We discussed existing teaching staff can accompany the children to count in ratio, however, according to the aquatics rule below, at least half of the staff required to meet ratio for swimming must be in the pool. 10A NCAC 09 .1403 ACTIVITIES INVOLVING WATER IN CHILD CARE CENTERS (e) The following staff/child ratios shall be maintained whenever children participate in aquatic activities: Age of Children Ratio Staff/Children 3 to 4 Years 1/8 4 to 5 Years 1/10 5 Years and Older 1/13 Notwithstanding the staff/child ratios, at no time shall there be fewer than two staff members supervising the aquatic activity. (f) Children shall be adequately supervised by center staff at all times while participating in aquatic activities. For purposes of this Rule, "Adequate supervision" means that half of the center staff needed to meet the staff/child ratios in Paragraph (e) of this Rule is in the water and the other half is out of the water. If an uneven number of staff are needed to meet the required staff/child ratios, the majority shall be in the water. Staff shall be stationed in pre-assigned areas that will enable them at all times to hear, see, and respond to the children whether in or out of the water. Children shall not enter the water before center staff are stationed in their pre-assigned areas. Center staff shall devote their full attention to supervising the children in their pre-assigned areas of coverage and shall communicate with one another about children moving from one area to another area. As a reminder, the lifeguard does not count in ratio. We discussed that the facility would like to place Ms. Virella as the Administrator. The Preservice Requirements for Administrator form must be completed in order to make this change. A copy was left with you today. 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 kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 11/14/2024 Number Present: 71 Completed Date: 11/14/2024 Age: From 0 To 5 Total Minutes: 435 Time In: 09:00 AM Time Out: 04:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Mary Virella, Early Learning Specialist, during the visit. Monica Houck, Lead Child Care Consultant, accompanied me today. A signed copy of the visit summary was emailed to you. Ms. Virella was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine percent (89%) as of 11/13/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, YWCA of Asheville and Western North Carolina, Inc, is current/active as of 11/13/24. Permit type – Provisional License due to Lead issued 7/12/24. Special Services/Restrictions – 1st shift (daytime care), meets enhanced ratios, meets enhanced space, children under 2.5 years old in rooms with direct exits only. The facility is approved to provide transportation, offers a swimming pool, fields trips, and serves children with special needs. The last annual compliance visit was conducted on 11/16/23. The last fire drill was practiced on 10/31/24. The last lockdown drill was practiced on 11/12/24. The last playground inspection was documented on 10/28/24. The last fire inspection was approved on 7/10/24. The last sanitation inspection was conducted on 2/13/24 with fifteen (15) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. The facility is no longer an approved NC Pre-K site. NC Pre-K was deselected in Regulatory today. The facility is currently under an Administrative Action Provisional License for Lead, issued 7/12/24. The Administrative Action is posted in an area visible to parents and visitors. The program is approved to provide transportation. No children are currently being transported on a regular basis. The facility uses the buses primarily for field trips. I monitored two (2) vehicles today. There are eighty-eight (88) children enrolled. Nine (9) children’s files were monitored today. There are twenty (20) staff. Three (3) new staff files and two (2) existing staff files were monitored today. The facility is currently under an Emergency Operation Plan for a Boil Water Notice. The plan is implemented as approved. Aquatics are unable to be monitored today. The pool is closed for renovations and swimming lessons are currently paused. Monitoring for aquatics may occur during the Routine Unannounced visit. Upon arrival I was greeted by Ms. Virella, Lisa McKnight, Early Learning Coordinator/Administrator, and Alesia Summey, Director of Early Childhood Education, Lesley Webber, Early Learning Specialist. In classroom space 1, children were being fed and soothed by caregivers. In classroom space 2, children were exploring tactile animal cards with the caregiver, interlocking blocks and animal figurines. In classroom space 3, children explored puzzles, books and danced to music with a Volunteer grandparent. In classroom space 6, children engaged in gross motor exploration with plush seesaws, read books with caregivers and participated in routine caregiving activities such as diaper changing. In classroom space 5, children were soothed by teachers as they rolled cars on various surfaces, pretended to care for baby dolls and participated in routine caregiving activities such as diapering. In classroom space 4, children participated in a community art projects using crayons and paper, solved age appropriate puzzles and built small structures with magnatiles. In classroom space 7, children were engaged in a large group meeting with the caregivers, discussing the next steps to prepare for lunch. Children washed hands in small groups and ate lunch brought from home. In classroom space 8, children participated in a large group read aloud and discussion about owls. Interactions were positive and nurturing. Children were actively supervised at all times. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One (1) child with an enrollment date of 8/26/24 did not have documentation to verify the parent was given a summary of the NC Child Care Law. GS 110-102 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Sleep checks for two (2) children were not documented on 11/13/24. .0606(g) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. One (1) child with an enrollment date of 8/26/24 did not have documentation on file that the parent participation plan was discussed with parents on or before the child's first day of attendance. 10A NCAC 09 .0515(a) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. One (1) child with an enrollment date of 7/17/23 has emergency medical care information last updated on 6/29/23. One (1) child with an enrollment date of 11/16/20 has emergency medical care information last updated on 10/20/20. One (1) child with an enrollment date of 1/3/23 has emergency medical care information last updated on 12/10/22. .0802(c) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. One (1) child with an enrollment date of 8/26/24 did not have on file a signed and dated statement by parent that the discipline policy was received and explained at enrollment. .1804(c) The following items were not cited as violations today. Due to the effects of Tropical Storm Helene, additional guidance and time is given to meet compliance for the following items. Please note, monitoring for these items may occur during future visits. If these items remain out of compliance, a violation may be cited: Fire Inspection Fire inspections must be submitted to the Division within one week after the inspection has been conducted. Please note, if the inspection report is handwritten, it must be mailed to the PO box listed below. If the inspection is digitally completed, it can be forwarded to me via email. Children's Records- Operational Policy The operational policies must be reviewed with all families by the first day of enrollment. A copy of the operational policies must be given to the parent and an acknowledgement of this review must be obtained and placed in the child's file by the first day of enrollment. One (1) child's file was missing the policy signature page that included the acknowledgment for receipt of the operational policies. We discussed to have all paperwork required by the first day of enrollment on file before the child attends and is being cared for in the classroom Health and Safety Training All Health and Safety training topics must be completed within the first year of employment and every five years after. To achieve compliance, the one staff hired 10/13/23 must complete all Health and Safety training topics and the one staff hired 11/9/23 must complete the topic of Precautions in Transporting Children. We discussed that the one (1) staff hired 10/13/23 is part time. Plan to work with this staff member to create a schedule that ensure Health and Safety trainings are completed within the first year of employment and every five years after. The following items were cited as a violations during the visit today. Technical Assistance for achieving compliance as follows: Safe Sleep The staff member completed the sleep chart during the visit today. In your letter of compliance, include a statement that indicates how you will ensure sleep checks are documented on the sleep charts every fifteen minutes, according to the safe sleep policy. Children's Records- Summary of NC Child Care Law, Discipline Policy and Parent Participation Plan: The required records for children must be on file to ensure safety for children and provide information for staff in case of emergency. Lisa McKnight, Early Learning Coordinator, stated she was unaware that the emergency medical care information for children needed to be updated as changes occur and at least annually for each child. Ms. McKnight also stated she was aware that the one child with an enrollment date of 8/26/24 was missing the signed and dated statement/acknowledgment for the summary of the NC Child Care law, the discipline policy, and the parent participation plan. It is recommended to audit all child files for accuracy and completion. We discussed to have all paperwork required by the first day of enrollment on file before the child attends and is being cared for in the classroom. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/28/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: The facility was closed due to Tropical Storm Helene from 9/26/24 to 10/28/24. The facility was unable to conduct the planned lockdown drill for September due to the closure. A lockdown drill was conducted on 11/12/24. Additional guidance was given today regarding the additional time needed to conduct the drill. Please continue to conduct safety drills every three months. We discussed aquatics staff requirements. Staff who are left alone with children or who are counted in ratio during the swim lessons need a staff file, including a DCDEE Criminal Background Check qualifying letter. We discussed existing teaching staff can accompany the children to count in ratio, however, according to the aquatics rule below, at least half of the staff required to meet ratio for swimming must be in the pool. 10A NCAC 09 .1403 ACTIVITIES INVOLVING WATER IN CHILD CARE CENTERS (e) The following staff/child ratios shall be maintained whenever children participate in aquatic activities: Age of Children Ratio Staff/Children 3 to 4 Years 1/8 4 to 5 Years 1/10 5 Years and Older 1/13 Notwithstanding the staff/child ratios, at no time shall there be fewer than two staff members supervising the aquatic activity. (f) Children shall be adequately supervised by center staff at all times while participating in aquatic activities. For purposes of this Rule, "Adequate supervision" means that half of the center staff needed to meet the staff/child ratios in Paragraph (e) of this Rule is in the water and the other half is out of the water. If an uneven number of staff are needed to meet the required staff/child ratios, the majority shall be in the water. Staff shall be stationed in pre-assigned areas that will enable them at all times to hear, see, and respond to the children whether in or out of the water. Children shall not enter the water before center staff are stationed in their pre-assigned areas. Center staff shall devote their full attention to supervising the children in their pre-assigned areas of coverage and shall communicate with one another about children moving from one area to another area. As a reminder, the lifeguard does not count in ratio. We discussed that the facility would like to place Ms. Virella as the Administrator. The Preservice Requirements for Administrator form must be completed in order to make this change. A copy was left with you today. 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 kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 11/14/2024 Number Present: 71 Completed Date: 11/14/2024 Age: From 0 To 5 Total Minutes: 435 Time In: 09:00 AM Time Out: 04:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Mary Virella, Early Learning Specialist, during the visit. Monica Houck, Lead Child Care Consultant, accompanied me today. A signed copy of the visit summary was emailed to you. Ms. Virella was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine percent (89%) as of 11/13/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, YWCA of Asheville and Western North Carolina, Inc, is current/active as of 11/13/24. Permit type – Provisional License due to Lead issued 7/12/24. Special Services/Restrictions – 1st shift (daytime care), meets enhanced ratios, meets enhanced space, children under 2.5 years old in rooms with direct exits only. The facility is approved to provide transportation, offers a swimming pool, fields trips, and serves children with special needs. The last annual compliance visit was conducted on 11/16/23. The last fire drill was practiced on 10/31/24. The last lockdown drill was practiced on 11/12/24. The last playground inspection was documented on 10/28/24. The last fire inspection was approved on 7/10/24. The last sanitation inspection was conducted on 2/13/24 with fifteen (15) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. The facility is no longer an approved NC Pre-K site. NC Pre-K was deselected in Regulatory today. The facility is currently under an Administrative Action Provisional License for Lead, issued 7/12/24. The Administrative Action is posted in an area visible to parents and visitors. The program is approved to provide transportation. No children are currently being transported on a regular basis. The facility uses the buses primarily for field trips. I monitored two (2) vehicles today. There are eighty-eight (88) children enrolled. Nine (9) children’s files were monitored today. There are twenty (20) staff. Three (3) new staff files and two (2) existing staff files were monitored today. The facility is currently under an Emergency Operation Plan for a Boil Water Notice. The plan is implemented as approved. Aquatics are unable to be monitored today. The pool is closed for renovations and swimming lessons are currently paused. Monitoring for aquatics may occur during the Routine Unannounced visit. Upon arrival I was greeted by Ms. Virella, Lisa McKnight, Early Learning Coordinator/Administrator, and Alesia Summey, Director of Early Childhood Education, Lesley Webber, Early Learning Specialist. In classroom space 1, children were being fed and soothed by caregivers. In classroom space 2, children were exploring tactile animal cards with the caregiver, interlocking blocks and animal figurines. In classroom space 3, children explored puzzles, books and danced to music with a Volunteer grandparent. In classroom space 6, children engaged in gross motor exploration with plush seesaws, read books with caregivers and participated in routine caregiving activities such as diaper changing. In classroom space 5, children were soothed by teachers as they rolled cars on various surfaces, pretended to care for baby dolls and participated in routine caregiving activities such as diapering. In classroom space 4, children participated in a community art projects using crayons and paper, solved age appropriate puzzles and built small structures with magnatiles. In classroom space 7, children were engaged in a large group meeting with the caregivers, discussing the next steps to prepare for lunch. Children washed hands in small groups and ate lunch brought from home. In classroom space 8, children participated in a large group read aloud and discussion about owls. Interactions were positive and nurturing. Children were actively supervised at all times. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One (1) child with an enrollment date of 8/26/24 did not have documentation to verify the parent was given a summary of the NC Child Care Law. GS 110-102 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Sleep checks for two (2) children were not documented on 11/13/24. .0606(g) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. One (1) child with an enrollment date of 8/26/24 did not have documentation on file that the parent participation plan was discussed with parents on or before the child's first day of attendance. 10A NCAC 09 .0515(a) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. One (1) child with an enrollment date of 7/17/23 has emergency medical care information last updated on 6/29/23. One (1) child with an enrollment date of 11/16/20 has emergency medical care information last updated on 10/20/20. One (1) child with an enrollment date of 1/3/23 has emergency medical care information last updated on 12/10/22. .0802(c) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. One (1) child with an enrollment date of 8/26/24 did not have on file a signed and dated statement by parent that the discipline policy was received and explained at enrollment. .1804(c) The following items were not cited as violations today. Due to the effects of Tropical Storm Helene, additional guidance and time is given to meet compliance for the following items. Please note, monitoring for these items may occur during future visits. If these items remain out of compliance, a violation may be cited: Fire Inspection Fire inspections must be submitted to the Division within one week after the inspection has been conducted. Please note, if the inspection report is handwritten, it must be mailed to the PO box listed below. If the inspection is digitally completed, it can be forwarded to me via email. Children's Records- Operational Policy The operational policies must be reviewed with all families by the first day of enrollment. A copy of the operational policies must be given to the parent and an acknowledgement of this review must be obtained and placed in the child's file by the first day of enrollment. One (1) child's file was missing the policy signature page that included the acknowledgment for receipt of the operational policies. We discussed to have all paperwork required by the first day of enrollment on file before the child attends and is being cared for in the classroom Health and Safety Training All Health and Safety training topics must be completed within the first year of employment and every five years after. To achieve compliance, the one staff hired 10/13/23 must complete all Health and Safety training topics and the one staff hired 11/9/23 must complete the topic of Precautions in Transporting Children. We discussed that the one (1) staff hired 10/13/23 is part time. Plan to work with this staff member to create a schedule that ensure Health and Safety trainings are completed within the first year of employment and every five years after. The following items were cited as a violations during the visit today. Technical Assistance for achieving compliance as follows: Safe Sleep The staff member completed the sleep chart during the visit today. In your letter of compliance, include a statement that indicates how you will ensure sleep checks are documented on the sleep charts every fifteen minutes, according to the safe sleep policy. Children's Records- Summary of NC Child Care Law, Discipline Policy and Parent Participation Plan: The required records for children must be on file to ensure safety for children and provide information for staff in case of emergency. Lisa McKnight, Early Learning Coordinator, stated she was unaware that the emergency medical care information for children needed to be updated as changes occur and at least annually for each child. Ms. McKnight also stated she was aware that the one child with an enrollment date of 8/26/24 was missing the signed and dated statement/acknowledgment for the summary of the NC Child Care law, the discipline policy, and the parent participation plan. It is recommended to audit all child files for accuracy and completion. We discussed to have all paperwork required by the first day of enrollment on file before the child attends and is being cared for in the classroom. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/28/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: The facility was closed due to Tropical Storm Helene from 9/26/24 to 10/28/24. The facility was unable to conduct the planned lockdown drill for September due to the closure. A lockdown drill was conducted on 11/12/24. Additional guidance was given today regarding the additional time needed to conduct the drill. Please continue to conduct safety drills every three months. We discussed aquatics staff requirements. Staff who are left alone with children or who are counted in ratio during the swim lessons need a staff file, including a DCDEE Criminal Background Check qualifying letter. We discussed existing teaching staff can accompany the children to count in ratio, however, according to the aquatics rule below, at least half of the staff required to meet ratio for swimming must be in the pool. 10A NCAC 09 .1403 ACTIVITIES INVOLVING WATER IN CHILD CARE CENTERS (e) The following staff/child ratios shall be maintained whenever children participate in aquatic activities: Age of Children Ratio Staff/Children 3 to 4 Years 1/8 4 to 5 Years 1/10 5 Years and Older 1/13 Notwithstanding the staff/child ratios, at no time shall there be fewer than two staff members supervising the aquatic activity. (f) Children shall be adequately supervised by center staff at all times while participating in aquatic activities. For purposes of this Rule, "Adequate supervision" means that half of the center staff needed to meet the staff/child ratios in Paragraph (e) of this Rule is in the water and the other half is out of the water. If an uneven number of staff are needed to meet the required staff/child ratios, the majority shall be in the water. Staff shall be stationed in pre-assigned areas that will enable them at all times to hear, see, and respond to the children whether in or out of the water. Children shall not enter the water before center staff are stationed in their pre-assigned areas. Center staff shall devote their full attention to supervising the children in their pre-assigned areas of coverage and shall communicate with one another about children moving from one area to another area. As a reminder, the lifeguard does not count in ratio. We discussed that the facility would like to place Ms. Virella as the Administrator. The Preservice Requirements for Administrator form must be completed in order to make this change. A copy was left with you today. 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 kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-102 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 11/14/2024 Number Present: 71 Completed Date: 11/14/2024 Age: From 0 To 5 Total Minutes: 435 Time In: 09:00 AM Time Out: 04:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Mary Virella, Early Learning Specialist, during the visit. Monica Houck, Lead Child Care Consultant, accompanied me today. A signed copy of the visit summary was emailed to you. Ms. Virella was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine percent (89%) as of 11/13/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, YWCA of Asheville and Western North Carolina, Inc, is current/active as of 11/13/24. Permit type – Provisional License due to Lead issued 7/12/24. Special Services/Restrictions – 1st shift (daytime care), meets enhanced ratios, meets enhanced space, children under 2.5 years old in rooms with direct exits only. The facility is approved to provide transportation, offers a swimming pool, fields trips, and serves children with special needs. The last annual compliance visit was conducted on 11/16/23. The last fire drill was practiced on 10/31/24. The last lockdown drill was practiced on 11/12/24. The last playground inspection was documented on 10/28/24. The last fire inspection was approved on 7/10/24. The last sanitation inspection was conducted on 2/13/24 with fifteen (15) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. The facility is no longer an approved NC Pre-K site. NC Pre-K was deselected in Regulatory today. The facility is currently under an Administrative Action Provisional License for Lead, issued 7/12/24. The Administrative Action is posted in an area visible to parents and visitors. The program is approved to provide transportation. No children are currently being transported on a regular basis. The facility uses the buses primarily for field trips. I monitored two (2) vehicles today. There are eighty-eight (88) children enrolled. Nine (9) children’s files were monitored today. There are twenty (20) staff. Three (3) new staff files and two (2) existing staff files were monitored today. The facility is currently under an Emergency Operation Plan for a Boil Water Notice. The plan is implemented as approved. Aquatics are unable to be monitored today. The pool is closed for renovations and swimming lessons are currently paused. Monitoring for aquatics may occur during the Routine Unannounced visit. Upon arrival I was greeted by Ms. Virella, Lisa McKnight, Early Learning Coordinator/Administrator, and Alesia Summey, Director of Early Childhood Education, Lesley Webber, Early Learning Specialist. In classroom space 1, children were being fed and soothed by caregivers. In classroom space 2, children were exploring tactile animal cards with the caregiver, interlocking blocks and animal figurines. In classroom space 3, children explored puzzles, books and danced to music with a Volunteer grandparent. In classroom space 6, children engaged in gross motor exploration with plush seesaws, read books with caregivers and participated in routine caregiving activities such as diaper changing. In classroom space 5, children were soothed by teachers as they rolled cars on various surfaces, pretended to care for baby dolls and participated in routine caregiving activities such as diapering. In classroom space 4, children participated in a community art projects using crayons and paper, solved age appropriate puzzles and built small structures with magnatiles. In classroom space 7, children were engaged in a large group meeting with the caregivers, discussing the next steps to prepare for lunch. Children washed hands in small groups and ate lunch brought from home. In classroom space 8, children participated in a large group read aloud and discussion about owls. Interactions were positive and nurturing. Children were actively supervised at all times. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One (1) child with an enrollment date of 8/26/24 did not have documentation to verify the parent was given a summary of the NC Child Care Law. GS 110-102 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Sleep checks for two (2) children were not documented on 11/13/24. .0606(g) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. One (1) child with an enrollment date of 8/26/24 did not have documentation on file that the parent participation plan was discussed with parents on or before the child's first day of attendance. 10A NCAC 09 .0515(a) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. One (1) child with an enrollment date of 7/17/23 has emergency medical care information last updated on 6/29/23. One (1) child with an enrollment date of 11/16/20 has emergency medical care information last updated on 10/20/20. One (1) child with an enrollment date of 1/3/23 has emergency medical care information last updated on 12/10/22. .0802(c) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. One (1) child with an enrollment date of 8/26/24 did not have on file a signed and dated statement by parent that the discipline policy was received and explained at enrollment. .1804(c) The following items were not cited as violations today. Due to the effects of Tropical Storm Helene, additional guidance and time is given to meet compliance for the following items. Please note, monitoring for these items may occur during future visits. If these items remain out of compliance, a violation may be cited: Fire Inspection Fire inspections must be submitted to the Division within one week after the inspection has been conducted. Please note, if the inspection report is handwritten, it must be mailed to the PO box listed below. If the inspection is digitally completed, it can be forwarded to me via email. Children's Records- Operational Policy The operational policies must be reviewed with all families by the first day of enrollment. A copy of the operational policies must be given to the parent and an acknowledgement of this review must be obtained and placed in the child's file by the first day of enrollment. One (1) child's file was missing the policy signature page that included the acknowledgment for receipt of the operational policies. We discussed to have all paperwork required by the first day of enrollment on file before the child attends and is being cared for in the classroom Health and Safety Training All Health and Safety training topics must be completed within the first year of employment and every five years after. To achieve compliance, the one staff hired 10/13/23 must complete all Health and Safety training topics and the one staff hired 11/9/23 must complete the topic of Precautions in Transporting Children. We discussed that the one (1) staff hired 10/13/23 is part time. Plan to work with this staff member to create a schedule that ensure Health and Safety trainings are completed within the first year of employment and every five years after. The following items were cited as a violations during the visit today. Technical Assistance for achieving compliance as follows: Safe Sleep The staff member completed the sleep chart during the visit today. In your letter of compliance, include a statement that indicates how you will ensure sleep checks are documented on the sleep charts every fifteen minutes, according to the safe sleep policy. Children's Records- Summary of NC Child Care Law, Discipline Policy and Parent Participation Plan: The required records for children must be on file to ensure safety for children and provide information for staff in case of emergency. Lisa McKnight, Early Learning Coordinator, stated she was unaware that the emergency medical care information for children needed to be updated as changes occur and at least annually for each child. Ms. McKnight also stated she was aware that the one child with an enrollment date of 8/26/24 was missing the signed and dated statement/acknowledgment for the summary of the NC Child Care law, the discipline policy, and the parent participation plan. It is recommended to audit all child files for accuracy and completion. We discussed to have all paperwork required by the first day of enrollment on file before the child attends and is being cared for in the classroom. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/28/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: The facility was closed due to Tropical Storm Helene from 9/26/24 to 10/28/24. The facility was unable to conduct the planned lockdown drill for September due to the closure. A lockdown drill was conducted on 11/12/24. Additional guidance was given today regarding the additional time needed to conduct the drill. Please continue to conduct safety drills every three months. We discussed aquatics staff requirements. Staff who are left alone with children or who are counted in ratio during the swim lessons need a staff file, including a DCDEE Criminal Background Check qualifying letter. We discussed existing teaching staff can accompany the children to count in ratio, however, according to the aquatics rule below, at least half of the staff required to meet ratio for swimming must be in the pool. 10A NCAC 09 .1403 ACTIVITIES INVOLVING WATER IN CHILD CARE CENTERS (e) The following staff/child ratios shall be maintained whenever children participate in aquatic activities: Age of Children Ratio Staff/Children 3 to 4 Years 1/8 4 to 5 Years 1/10 5 Years and Older 1/13 Notwithstanding the staff/child ratios, at no time shall there be fewer than two staff members supervising the aquatic activity. (f) Children shall be adequately supervised by center staff at all times while participating in aquatic activities. For purposes of this Rule, "Adequate supervision" means that half of the center staff needed to meet the staff/child ratios in Paragraph (e) of this Rule is in the water and the other half is out of the water. If an uneven number of staff are needed to meet the required staff/child ratios, the majority shall be in the water. Staff shall be stationed in pre-assigned areas that will enable them at all times to hear, see, and respond to the children whether in or out of the water. Children shall not enter the water before center staff are stationed in their pre-assigned areas. Center staff shall devote their full attention to supervising the children in their pre-assigned areas of coverage and shall communicate with one another about children moving from one area to another area. As a reminder, the lifeguard does not count in ratio. We discussed that the facility would like to place Ms. Virella as the Administrator. The Preservice Requirements for Administrator form must be completed in order to make this change. A copy was left with you today. 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 kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 11/14/2024 Number Present: 71 Completed Date: 11/14/2024 Age: From 0 To 5 Total Minutes: 435 Time In: 09:00 AM Time Out: 04:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Mary Virella, Early Learning Specialist, during the visit. Monica Houck, Lead Child Care Consultant, accompanied me today. A signed copy of the visit summary was emailed to you. Ms. Virella was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine percent (89%) as of 11/13/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, YWCA of Asheville and Western North Carolina, Inc, is current/active as of 11/13/24. Permit type – Provisional License due to Lead issued 7/12/24. Special Services/Restrictions – 1st shift (daytime care), meets enhanced ratios, meets enhanced space, children under 2.5 years old in rooms with direct exits only. The facility is approved to provide transportation, offers a swimming pool, fields trips, and serves children with special needs. The last annual compliance visit was conducted on 11/16/23. The last fire drill was practiced on 10/31/24. The last lockdown drill was practiced on 11/12/24. The last playground inspection was documented on 10/28/24. The last fire inspection was approved on 7/10/24. The last sanitation inspection was conducted on 2/13/24 with fifteen (15) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. The facility is no longer an approved NC Pre-K site. NC Pre-K was deselected in Regulatory today. The facility is currently under an Administrative Action Provisional License for Lead, issued 7/12/24. The Administrative Action is posted in an area visible to parents and visitors. The program is approved to provide transportation. No children are currently being transported on a regular basis. The facility uses the buses primarily for field trips. I monitored two (2) vehicles today. There are eighty-eight (88) children enrolled. Nine (9) children’s files were monitored today. There are twenty (20) staff. Three (3) new staff files and two (2) existing staff files were monitored today. The facility is currently under an Emergency Operation Plan for a Boil Water Notice. The plan is implemented as approved. Aquatics are unable to be monitored today. The pool is closed for renovations and swimming lessons are currently paused. Monitoring for aquatics may occur during the Routine Unannounced visit. Upon arrival I was greeted by Ms. Virella, Lisa McKnight, Early Learning Coordinator/Administrator, and Alesia Summey, Director of Early Childhood Education, Lesley Webber, Early Learning Specialist. In classroom space 1, children were being fed and soothed by caregivers. In classroom space 2, children were exploring tactile animal cards with the caregiver, interlocking blocks and animal figurines. In classroom space 3, children explored puzzles, books and danced to music with a Volunteer grandparent. In classroom space 6, children engaged in gross motor exploration with plush seesaws, read books with caregivers and participated in routine caregiving activities such as diaper changing. In classroom space 5, children were soothed by teachers as they rolled cars on various surfaces, pretended to care for baby dolls and participated in routine caregiving activities such as diapering. In classroom space 4, children participated in a community art projects using crayons and paper, solved age appropriate puzzles and built small structures with magnatiles. In classroom space 7, children were engaged in a large group meeting with the caregivers, discussing the next steps to prepare for lunch. Children washed hands in small groups and ate lunch brought from home. In classroom space 8, children participated in a large group read aloud and discussion about owls. Interactions were positive and nurturing. Children were actively supervised at all times. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One (1) child with an enrollment date of 8/26/24 did not have documentation to verify the parent was given a summary of the NC Child Care Law. GS 110-102 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Sleep checks for two (2) children were not documented on 11/13/24. .0606(g) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. One (1) child with an enrollment date of 8/26/24 did not have documentation on file that the parent participation plan was discussed with parents on or before the child's first day of attendance. 10A NCAC 09 .0515(a) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. One (1) child with an enrollment date of 7/17/23 has emergency medical care information last updated on 6/29/23. One (1) child with an enrollment date of 11/16/20 has emergency medical care information last updated on 10/20/20. One (1) child with an enrollment date of 1/3/23 has emergency medical care information last updated on 12/10/22. .0802(c) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. One (1) child with an enrollment date of 8/26/24 did not have on file a signed and dated statement by parent that the discipline policy was received and explained at enrollment. .1804(c) The following items were not cited as violations today. Due to the effects of Tropical Storm Helene, additional guidance and time is given to meet compliance for the following items. Please note, monitoring for these items may occur during future visits. If these items remain out of compliance, a violation may be cited: Fire Inspection Fire inspections must be submitted to the Division within one week after the inspection has been conducted. Please note, if the inspection report is handwritten, it must be mailed to the PO box listed below. If the inspection is digitally completed, it can be forwarded to me via email. Children's Records- Operational Policy The operational policies must be reviewed with all families by the first day of enrollment. A copy of the operational policies must be given to the parent and an acknowledgement of this review must be obtained and placed in the child's file by the first day of enrollment. One (1) child's file was missing the policy signature page that included the acknowledgment for receipt of the operational policies. We discussed to have all paperwork required by the first day of enrollment on file before the child attends and is being cared for in the classroom Health and Safety Training All Health and Safety training topics must be completed within the first year of employment and every five years after. To achieve compliance, the one staff hired 10/13/23 must complete all Health and Safety training topics and the one staff hired 11/9/23 must complete the topic of Precautions in Transporting Children. We discussed that the one (1) staff hired 10/13/23 is part time. Plan to work with this staff member to create a schedule that ensure Health and Safety trainings are completed within the first year of employment and every five years after. The following items were cited as a violations during the visit today. Technical Assistance for achieving compliance as follows: Safe Sleep The staff member completed the sleep chart during the visit today. In your letter of compliance, include a statement that indicates how you will ensure sleep checks are documented on the sleep charts every fifteen minutes, according to the safe sleep policy. Children's Records- Summary of NC Child Care Law, Discipline Policy and Parent Participation Plan: The required records for children must be on file to ensure safety for children and provide information for staff in case of emergency. Lisa McKnight, Early Learning Coordinator, stated she was unaware that the emergency medical care information for children needed to be updated as changes occur and at least annually for each child. Ms. McKnight also stated she was aware that the one child with an enrollment date of 8/26/24 was missing the signed and dated statement/acknowledgment for the summary of the NC Child Care law, the discipline policy, and the parent participation plan. It is recommended to audit all child files for accuracy and completion. We discussed to have all paperwork required by the first day of enrollment on file before the child attends and is being cared for in the classroom. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/28/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall PO Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: The facility was closed due to Tropical Storm Helene from 9/26/24 to 10/28/24. The facility was unable to conduct the planned lockdown drill for September due to the closure. A lockdown drill was conducted on 11/12/24. Additional guidance was given today regarding the additional time needed to conduct the drill. Please continue to conduct safety drills every three months. We discussed aquatics staff requirements. Staff who are left alone with children or who are counted in ratio during the swim lessons need a staff file, including a DCDEE Criminal Background Check qualifying letter. We discussed existing teaching staff can accompany the children to count in ratio, however, according to the aquatics rule below, at least half of the staff required to meet ratio for swimming must be in the pool. 10A NCAC 09 .1403 ACTIVITIES INVOLVING WATER IN CHILD CARE CENTERS (e) The following staff/child ratios shall be maintained whenever children participate in aquatic activities: Age of Children Ratio Staff/Children 3 to 4 Years 1/8 4 to 5 Years 1/10 5 Years and Older 1/13 Notwithstanding the staff/child ratios, at no time shall there be fewer than two staff members supervising the aquatic activity. (f) Children shall be adequately supervised by center staff at all times while participating in aquatic activities. For purposes of this Rule, "Adequate supervision" means that half of the center staff needed to meet the staff/child ratios in Paragraph (e) of this Rule is in the water and the other half is out of the water. If an uneven number of staff are needed to meet the required staff/child ratios, the majority shall be in the water. Staff shall be stationed in pre-assigned areas that will enable them at all times to hear, see, and respond to the children whether in or out of the water. Children shall not enter the water before center staff are stationed in their pre-assigned areas. Center staff shall devote their full attention to supervising the children in their pre-assigned areas of coverage and shall communicate with one another about children moving from one area to another area. As a reminder, the lifeguard does not count in ratio. We discussed that the facility would like to place Ms. Virella as the Administrator. The Preservice Requirements for Administrator form must be completed in order to make this change. A copy was left with you today. 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 kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0508 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 8/13/2024 Number Present: 69 Completed Date: 8/13/2024 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: ERS Announced/Unannounced: Announced The purpose of today’s announced visit was to review the results of your Environment Rating Scale (ERS) conducted on 4/30/24, 5/7/24, 5/15/24. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Mary Virella, during the visit. A signed copy of the visit summary was emailed to you. Ms. Virella and Alesia Summey, Director of Early Learning, were present and available to ask and answer questions throughout the visit today. ERS summaries were reviewed today and items scoring less than a three could constitute a violation of child care requirements and therefore were monitored. These items are noted below: ECERS-R assessment – 5/15/24 Total score – 5.68 Item 10 Indicator: 3.3 (see pages: 24-25 in the ECERS-R) Score: 2 pts Assessor Comments: This indicator requires that eating surfaces are cleaned with soapy water, and then sprayed with a sanitizing solution that is allowed to air dry on the surface for at least 2 minutes. The table was not cleaned or sanitized before or after a child ate breakfast. Before lunch, the three tables were cleaned and sanitized as needed. After lunch, two of the tables were cleaned and sanitized. Please refer to the NC Additional Notes for more information. This is a potential violation of the following requirement: 15A NCAC 18A .2822 TOYS, EQUIPMENT AND FURNITURE (a) Toys, equipment, and furniture provided by a child care center shall be kept clean and in good repair. In rooms designated for children who are not toilet trained, toys and other mouth-contact surfaces that are used by children shall be cleaned and then sanitized after each use and when visibly dirty. Toys and other mouth-contact surfaces shall be cleaned and sanitized as follows: (1) the items shall be scrubbed in warm, soapy water, using a brush to reach into any crevices; (2) the items shall be rinsed in clean water; (3) the items shall be submerged in a sanitizing solution for at least two minutes or in accordance with the instructions on the label of the sanitizing solution; and (4) the items shall be air dried. Observations today: One instance of table cleaning was observed today in classroom space 2. The tables were cleaned with soapy water, sprayed with sanitizing solution, and left to dry for two minutes prior to drying the tables. In classroom space 7, the tables appeared wet with sanitizing solution while children were outdoors playing. Item 22 Indicator: 3.2 (see pages: 26-27 in the ECERS-R) Score: 2 pts Assessor Comments: The children slept with soft toys from the reading area. Since these toys could be used by all of the children during center play, this does not meet sanitary requirements for nap time. During the transition to rest time six cots were stepped or laid on by other children. Although one child's sheet was changed, the other children were not provided with clean bedding prior to rest time. This is a potential violation of the following requirement: 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (c) Beds, cots, and mats shall be assigned and labeled for use by an individual child and equipped with individual linens. Observations today: You stated today that children now bring soft toys from home or choose a toy from the center that stays with the same child throughout the week or until visibly soiled. Soft toys used for rest time are not longer shared. Additionally, you shared that staff wait to place the cots down until children are ready to rest to limit possibility of contaminating clean sheets. Item 13 Indicator: 3.1 (see pages: 30-31 in the ECERS-R) Score: 2 pts Assessor Comments: This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The teachers and staff members washed their hands as needed. The children washed their hands 55% of the time when needed. Several children did not wash their hands upon arrival or after returning to the classroom from the gross motor room before they handled classroom materials. There were many instances when children used play dough or sand and did not wash their hands afterwards. This is a potential violation of the following requirement: 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. Observations today: Two instances of handwashing occurred when children can indoors from outside in classroom spaces 9 and 2. In classroom space 9, children we directed to wash hands at two (2) handwashing sinks prior to choosing a free-choice center. Continue to work with the children on either leaving the faucet on for the next child or using a paper towel to turn off the water. In classroom space 2, children were guided to sit on the rug to wait for their turn to wash hands. Children in this age group struggled to sit for an extended period of time. We discussed the use of transition toys, toys that children are allowed to touch while waiting to wash hands. Item 14 Indicator: 3.1 (see pages: 32-33 in the ECERS-R) Score: 2 pts Assessor Comments: There were no safety concerns outdoors. Indoors, a teacher sprayed a table with sanitizer as a child sat on the floor next to the table. The mist from the sanitizer is a potential eye/lung irritant for young children. This is a potential violation of the following requirement: 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Observations today: In classroom space 2, children were redirected back to toys away from tables as they were being cleaned. Item 27 Indicator: 3.1 (see pages: 54-55 in the ECERS-R) Score: 1 pt Assessor Comments: The teacher reported that children watched "Polar Express" which does not meet the requirements of this indicator because it shows frightening and/or violent content. Indicator: 3.3 (see pages: 54-55 in the ECERS-R) Score: 1 pt Assessor Comments: The teacher reported that the children watched a movie that lasted 50 minutes. This is a potential violation of the following requirement: 10A NCAC 09 .0510 ACTIVITY AREAS (d) When preschool children three years old and older are in care the following shall apply: (2) when screen time is provided on any electronic media device with a visual display, it shall be: (A) offered to stimulate a developmental domain in accordance with the North Carolina Foundations for Early Learning and Development as referenced in Rule .0508 of this Section; (B) limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and (C) documented on a cumulative log or the activity plan that shall be available for review by the Division. (f) Screen time, including television, videos, video games, and computer usage, shall be prohibited for children under three years of age. Observations today: We reviewed the requirements of screen time for children ages 3 and up. Screen time must be limited to thirty (30) minutes per day. We discussed splitting movies for special occasions into two (2) or more viewing sessions on different days to ensure this requirement is met. ECERS-R assessment – 5/7/24 Total score – 5.39 Item 10 Indicator: 3.3 (see pages: 24-25 in the ECERS-R) Score: 2 pts Assessor Comments: This indicator requires that eating surfaces are cleaned with soapy water, and then sprayed with a sanitizing solution that is allowed to air dry on the surface for at least 2 minutes. After breakfast the tables were cleaned with soapy water; however, they were not sprayed with sanitizer. Before lunch the tables were cleaned and sanitized appropriately. Please refer to the NC Additional Notes for more information. This is a potential violation of the following requirement: 15A NCAC 18A .2822 TOYS, EQUIPMENT AND FURNITURE (a) Toys, equipment, and furniture provided by a child care center shall be kept clean and in good repair. In rooms designated for children who are not toilet trained, toys and other mouth-contact surfaces that are used by children shall be cleaned and then sanitized after each use and when visibly dirty. Toys and other mouth-contact surfaces shall be cleaned and sanitized as follows: (1) the items shall be scrubbed in warm, soapy water, using a brush to reach into any crevices; (2) the items shall be rinsed in clean water; (3) the items shall be submerged in a sanitizing solution for at least two minutes or in accordance with the instructions on the label of the sanitizing solution; and (4) the items shall be air dried. Observations today: One instance of table cleaning was observed today in classroom space 2. The tables were cleaned with soapy water, sprayed with sanitizing solution, and left to dry for two minutes prior to drying the tables. In classroom space 7, the tables appeared wet with sanitizing solution while children were outdoors playing. Item 11 Indicator: 3.2 (see pages: 26-27 in the ECERS-R) Score: 2 pts. Assessor Comments: A cot by the drawer with musical instruments was 17 inches from a cot near the light table. Although there was a shelf between the cots, the shelf did not extend to the full length of the cots to allow for closer spacing. Two cots on either side of the wooden bench in the reading area were 15 inches apart, rather than at least 18 inches. The bench between the cots did not extend the full length of the cots to allow for closer spacing. This is a potential violation of the following requirement: 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (e) When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children. Observations today: We discussed reaching out to Environmental Health or Child Care Health Consultants for guidance on appropriate partitions that can be used to separate mats during rest time. Item 34 Indicator: 3.3 (see pages: 63 in the ECERS-R) Score: 2 pts. Assessor Comments: The children play indoors daily, meeting a part of the indicator's requirements. On the day of the observation, the teacher stated that the ground was wet and there were big puddles, and when this occurs they go outside in the afternoon after the water subsides and play for 40 minutes. Wet ground and puddles do not pose a health or safety concern for children who are dressed for the condition. Therefore, children do not play outdoors each day for 1 hour when the weather allows. This is a potential violation for the following requirement: 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS Program Operating Hours: All programs Ages of Children: Under 2 years Minimum Daily Outdoor Time: 30 minutes Program Operating Hours: Less than 5 hours Ages of Children: 0-12 years Minimum Daily Outdoor Time: 30 minutes Program Operating Hours: 5 hours or more Ages of Children: 2-12 years Minimum Daily Outdoor Time: 60 minutes (c) When children are in care and weather conditions permit, there shall be outdoor time, either as part of a small group, a whole group, or individual activity, for no less than the following durations: Observations today: You clarified that children are permitted to play outside in all weather conditions except for heavy rains. You clarified that if the time requirements are not met in the morning, children go outside in the afternoon to meet the one (1) hour time requirement. ITERS-R assessment- 4/30/24 Total Score: 5.17 Item 6 Indicator: 3.4 (see pages: 18-19 in the ITERS-R) Score: 2 pts. Assessor Comments: Two arrivals occurred the morning of the assessment. During the first arrival, the parent talked to the teachers about the child's morning. However, information about the child's health or safety was not shared during the second arrival. This is not a potential violation of Child Care requirements. Observations today: You stated today that teachers and parents discuss information about the children at drop off as regular practice. Item 7 Indicator: 3.1 (see pages: 20-21 in the ITERS-R) Score: 1 pts. Assessor Comments: As the observation began, four children were seated at the tables for breakfast. Water was not offered to these four children between breakfast and lunch time. This is not a potential violation of child care requirements. Please see the guidance in rule below: 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (e) Drinking water shall be freely available to children of all ages. Drinking fountains or individual drinking utensils shall be provided. When a private water supply is used, it must be tested by and meet the requirements of the Commission for Public Health as set forth in 15A NCAC 18A .2800. Observations today: A water jug was present in the classroom. You stated that children are able to access water when they request it. Indicator: 3.4 (see pages 20-21 in the ITERS-R) Assessor Comments: Towards the end of breakfast, as some children continued to eat and drink, a teacher engaged in play with a group of children in the book area while the other teacher pushed the meal cart out of the classroom door. Because the teachers engaged in other activities away from the tables as some children ate and drank, credit could not be earned. This is a potential violation of the following Child Care requirement: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (5) staff must be able to see and hear children aged birth to five years old while the children are eating. Observations today: Two (2) staff were present in classroom space 2 as lunch was being served. Children played with magnatiles on the rug and were called one by one to wash hands. After washing hands, the child sat at the table and was served lunch. One (1) staff prepared plates facing the door with their back turned to the children eating. One (1) staff helped children wash hands, and was positioned to face the children eating. A child needed assistance with self care. The staff member assisting children with washing hands picked up the child and brought them into the diaper changing area to assist. The staff member preparing plates had their back turned to the children when this occurred. Indicator: 3.5 (see pages 20-21 in the ITERS-R) Assessor Comments: The teacher reported that a child enrolled is allergic to eggs. It was further reported that another child is allergic to pineapples and an additional child is allergic to peanuts. Proper substitutions were reported to be made and this information was posted in the classroom. Also, the teacher confirmed that a fourth child enrolled in the group has a peanut allergy and proper substitutions were reported to be made. However, this information was not included on the allergy list posted in the classroom. This is a potential violation of the following Child Care requirement: 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. Observations today: You stated that the second child allergic to peanuts had left the facility prior to the assessment and was no longer enrolled in the classroom during the assessment. The allergy list was reviewed today. You confirmed the allergy list is accurate and up to date. Item 8 Indicator: 3.2 (see pages: 22-23 in the ITERS-R) Score: 2 pts. Assessor Comments: There were several cots spaced between 21 inches to 33 inches apart, rather than at least 36 inches apart. Also, during the transition to nap, many children lay or stepped on two cots in the block area. The bedding on these cots was not replaced before rest time. This is a potential violation of the following child care requirements: 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (e) When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children. 10A NCAC 09 .0806 TOILETING, CLOTHING AND LINENS (c) A supply of clean linens must be on hand so that linens can be changed whenever they become soiled or wet. Observations today: The facility is currently under a provisional license for lead hazards. In classroom space 2, lead was found in the window sill of the classroom. Currently, all the shelves in the classrooms have been moved against wall with the contaminated window sill to prevent children from mouthing the surface. You stated this prevention plan has been approved by Environmental Health. However, this arrangement removes shelves as a potential barrier for mats during nap time. Classroom space 2 was observed during nap time. Three (3) cots were measured at nine (9), twelve (12) and fifteen (15) inches from other cots. Item 9 Indicator: 3.2 (see pages: 26-27 in the ITERS-R) Score: 2 pts. Assessor Comments: All eight children present wore diapers. Diaper changes occurred within the required 2 hour time frame for four children. The observed span of time during which a check or change did not occur for the remaining four children was 2 hours 17 minutes to 2 hours 26 minutes. This is not a violation of child care requirements. Please see the guidance in rule below: 10A NCAC 09 .0806 TOILETING, CLOTHING AND LINENS (a) Diapers shall be changed whenever they become soiled or wet and not on a shift basis. Observations today: You stated today that diapers are checked and changed every one and a half (1.5) hours or when soiled- whichever comes first. Item 10 Indicator: 3.1 (see pages: 26-27 in the ITERS-R) Score: 2 pts. Assessor Comments: Although five mouthed toys were removed, there were several additional mouthed items that were not removed before being used by other children. This is a potential violation of the following child care rule: 15A NCAC 18A .2822 TOYS, EQUIPMENT AND FURNITURE (a) Toys, equipment, and furniture provided by a child care center shall be kept clean and in good repair. In rooms designated for children who are not toilet trained, toys and other mouth-contact surfaces that are used by children shall be cleaned and then sanitized after each use and when visibly dirty. Toys and other mouth-contact surfaces shall be cleaned and sanitized as follows: (1) the items shall be scrubbed in warm, soapy water, using a brush to reach into any crevices; (2) the items shall be rinsed in clean water; (3) the items shall be submerged in a sanitizing solution for at least two minutes or in accordance with the instructions on the label of the sanitizing solution; and (4) the items shall be air dried. Indicator: 3.2 (see pages: 26-27 in the ITERS-R) This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The children's hands were washed as needed. The teachers and staff members washed their hands 30% of the time. A teacher or staff member did not wash their hands upon arrival or reentry to the classroom prior to touching classrooms materials. The teachers and a staff member did not wash their hands after outdoor play or after several instances of removing mouthed toys. This is a potential violation of the following Child Care requirements: 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. Observations today: Two instances of handwashing occurred when children can indoors from outside in classroom spaces 9 and 2. In classroom space 9, children we directed to wash hands at two (2) handwashing sinks prior to choosing a free-choice center. Continue to work with the children on either leaving the faucet on for the next child or using a paper towel to turn off the water. In classroom space 2, children were guided to sit on the rug to wait for their turn to wash hands. Children in this age group struggled to sit for an extended period of time. We discussed the use of transition toys, toys that children are allowed to touch while waiting to wash hands. These toys must then be removed and properly sanitized before being used again. Item 29 Indicator: 3.1 (see pages: 50 in the ITERS-R) Score: 2 pts. Assessor Comments: The concern regarding the diapering routines for four of the eight children, as noted in item 9, applies here as well. Observations today: See item 9. The following violations were cited during the visit today: Violation Number Comment Rule 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. In classroom space 2, three (3) cots measured nine (9), twelve (12) and fifteen (15) inches apart from other cots. 15A NCAC 18A .2821(e) Technical Assistance provided as follows: Item #614 We discussed possible solutions to the temporary space limitations present in this classroom. We discussed reconfiguring the layout to allow for eighteen (18) inches of space between mats. We discussed reaching out to Environmental Health or Child Care Health Consultants for ideas on acceptable partitions. 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (e) When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children. 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 8/27/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation provided as follows: We discussed the supervision requirements while children are eating. Staff must be able to see and hear children while they are eating. If backs are turned to the children, they cannot see them. In classroom space 2, both caregivers had their backs turned to children for a very short period of time while children were eating. We discussed positioning the staff member preparing plates for the children. In your other classrooms, staff perform this task at a table, facing the children who are eating, which allows them to look up to see the children periodically as they prepare and serve plates. This allows for constant supervision to occur while children are eating. Plan to enact a similar routine in classroom space 2. We discussed the table and cart could be moved slightly away from the wall to allow for the staff preparing plates to see the children eating. We discussed that you would like to reopen classroom space 5 as a mixed age classroom. Please see the following rules we discussed today regarding age grouping: 10A NCAC 09 .0713 STAFF/CHILD RATIOS FOR CENTERS (3) a child two years of age and older may be placed with children under one year of age when a physician certifies that the developmental age of the child makes this placement appropriate; (5) except as provided in Subparagraphs (2) and (3) of this Paragraph, children under one year of age shall be kept separate from children two years of age and over; You stated that you would like to move forward with completing the Rated License Reassessment process. The Rated License Reassessment packet and the Staff Information Sheet is included in the email containing this visit summary. Please complete the attached forms and return to me when you are ready to move forward with your Rated License Reassessment. The facility currently operates on a Provisional License due to lead. We discussed that changes cannot occur to your license until this Provisional is lifted. Program Standards: We discussed that you will elect to use the scored received from the ECERS assessment on 5/15/24 and 5/7/24 and the ITERS assessment on 4/30/24 toward your Rated License Reassessment. Your facility currently meets reduced ratios and enhanced space requirements. Education Points: We discussed that your current licensed is calculated with 7 points in education standards. Ensure all staff have their education evaluated by WORKS and their most up-to-date WORKS letter is on file. Plan to review sections .2819, .2820, and .2821 to see what is needed to achieve seven points in education standards. Quality Point: We discussed you are currently meeting your quality point through staff benefits package and infrastructure of parent involvement. A quality point form is attached to the email containing this visit summary. Plan to review the current quality point options in section .2829 of the Chapter 9 Child Care Rules. A Rated License Assessment visit will need to be conducted prior to the Rated License being processed. This visit can be announced. Once the Rated License Reassessment application is received and reviewed, we can discuss possible dates for this visit to occur. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0510 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 8/13/2024 Number Present: 69 Completed Date: 8/13/2024 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: ERS Announced/Unannounced: Announced The purpose of today’s announced visit was to review the results of your Environment Rating Scale (ERS) conducted on 4/30/24, 5/7/24, 5/15/24. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Mary Virella, during the visit. A signed copy of the visit summary was emailed to you. Ms. Virella and Alesia Summey, Director of Early Learning, were present and available to ask and answer questions throughout the visit today. ERS summaries were reviewed today and items scoring less than a three could constitute a violation of child care requirements and therefore were monitored. These items are noted below: ECERS-R assessment – 5/15/24 Total score – 5.68 Item 10 Indicator: 3.3 (see pages: 24-25 in the ECERS-R) Score: 2 pts Assessor Comments: This indicator requires that eating surfaces are cleaned with soapy water, and then sprayed with a sanitizing solution that is allowed to air dry on the surface for at least 2 minutes. The table was not cleaned or sanitized before or after a child ate breakfast. Before lunch, the three tables were cleaned and sanitized as needed. After lunch, two of the tables were cleaned and sanitized. Please refer to the NC Additional Notes for more information. This is a potential violation of the following requirement: 15A NCAC 18A .2822 TOYS, EQUIPMENT AND FURNITURE (a) Toys, equipment, and furniture provided by a child care center shall be kept clean and in good repair. In rooms designated for children who are not toilet trained, toys and other mouth-contact surfaces that are used by children shall be cleaned and then sanitized after each use and when visibly dirty. Toys and other mouth-contact surfaces shall be cleaned and sanitized as follows: (1) the items shall be scrubbed in warm, soapy water, using a brush to reach into any crevices; (2) the items shall be rinsed in clean water; (3) the items shall be submerged in a sanitizing solution for at least two minutes or in accordance with the instructions on the label of the sanitizing solution; and (4) the items shall be air dried. Observations today: One instance of table cleaning was observed today in classroom space 2. The tables were cleaned with soapy water, sprayed with sanitizing solution, and left to dry for two minutes prior to drying the tables. In classroom space 7, the tables appeared wet with sanitizing solution while children were outdoors playing. Item 22 Indicator: 3.2 (see pages: 26-27 in the ECERS-R) Score: 2 pts Assessor Comments: The children slept with soft toys from the reading area. Since these toys could be used by all of the children during center play, this does not meet sanitary requirements for nap time. During the transition to rest time six cots were stepped or laid on by other children. Although one child's sheet was changed, the other children were not provided with clean bedding prior to rest time. This is a potential violation of the following requirement: 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (c) Beds, cots, and mats shall be assigned and labeled for use by an individual child and equipped with individual linens. Observations today: You stated today that children now bring soft toys from home or choose a toy from the center that stays with the same child throughout the week or until visibly soiled. Soft toys used for rest time are not longer shared. Additionally, you shared that staff wait to place the cots down until children are ready to rest to limit possibility of contaminating clean sheets. Item 13 Indicator: 3.1 (see pages: 30-31 in the ECERS-R) Score: 2 pts Assessor Comments: This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The teachers and staff members washed their hands as needed. The children washed their hands 55% of the time when needed. Several children did not wash their hands upon arrival or after returning to the classroom from the gross motor room before they handled classroom materials. There were many instances when children used play dough or sand and did not wash their hands afterwards. This is a potential violation of the following requirement: 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. Observations today: Two instances of handwashing occurred when children can indoors from outside in classroom spaces 9 and 2. In classroom space 9, children we directed to wash hands at two (2) handwashing sinks prior to choosing a free-choice center. Continue to work with the children on either leaving the faucet on for the next child or using a paper towel to turn off the water. In classroom space 2, children were guided to sit on the rug to wait for their turn to wash hands. Children in this age group struggled to sit for an extended period of time. We discussed the use of transition toys, toys that children are allowed to touch while waiting to wash hands. Item 14 Indicator: 3.1 (see pages: 32-33 in the ECERS-R) Score: 2 pts Assessor Comments: There were no safety concerns outdoors. Indoors, a teacher sprayed a table with sanitizer as a child sat on the floor next to the table. The mist from the sanitizer is a potential eye/lung irritant for young children. This is a potential violation of the following requirement: 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Observations today: In classroom space 2, children were redirected back to toys away from tables as they were being cleaned. Item 27 Indicator: 3.1 (see pages: 54-55 in the ECERS-R) Score: 1 pt Assessor Comments: The teacher reported that children watched "Polar Express" which does not meet the requirements of this indicator because it shows frightening and/or violent content. Indicator: 3.3 (see pages: 54-55 in the ECERS-R) Score: 1 pt Assessor Comments: The teacher reported that the children watched a movie that lasted 50 minutes. This is a potential violation of the following requirement: 10A NCAC 09 .0510 ACTIVITY AREAS (d) When preschool children three years old and older are in care the following shall apply: (2) when screen time is provided on any electronic media device with a visual display, it shall be: (A) offered to stimulate a developmental domain in accordance with the North Carolina Foundations for Early Learning and Development as referenced in Rule .0508 of this Section; (B) limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and (C) documented on a cumulative log or the activity plan that shall be available for review by the Division. (f) Screen time, including television, videos, video games, and computer usage, shall be prohibited for children under three years of age. Observations today: We reviewed the requirements of screen time for children ages 3 and up. Screen time must be limited to thirty (30) minutes per day. We discussed splitting movies for special occasions into two (2) or more viewing sessions on different days to ensure this requirement is met. ECERS-R assessment – 5/7/24 Total score – 5.39 Item 10 Indicator: 3.3 (see pages: 24-25 in the ECERS-R) Score: 2 pts Assessor Comments: This indicator requires that eating surfaces are cleaned with soapy water, and then sprayed with a sanitizing solution that is allowed to air dry on the surface for at least 2 minutes. After breakfast the tables were cleaned with soapy water; however, they were not sprayed with sanitizer. Before lunch the tables were cleaned and sanitized appropriately. Please refer to the NC Additional Notes for more information. This is a potential violation of the following requirement: 15A NCAC 18A .2822 TOYS, EQUIPMENT AND FURNITURE (a) Toys, equipment, and furniture provided by a child care center shall be kept clean and in good repair. In rooms designated for children who are not toilet trained, toys and other mouth-contact surfaces that are used by children shall be cleaned and then sanitized after each use and when visibly dirty. Toys and other mouth-contact surfaces shall be cleaned and sanitized as follows: (1) the items shall be scrubbed in warm, soapy water, using a brush to reach into any crevices; (2) the items shall be rinsed in clean water; (3) the items shall be submerged in a sanitizing solution for at least two minutes or in accordance with the instructions on the label of the sanitizing solution; and (4) the items shall be air dried. Observations today: One instance of table cleaning was observed today in classroom space 2. The tables were cleaned with soapy water, sprayed with sanitizing solution, and left to dry for two minutes prior to drying the tables. In classroom space 7, the tables appeared wet with sanitizing solution while children were outdoors playing. Item 11 Indicator: 3.2 (see pages: 26-27 in the ECERS-R) Score: 2 pts. Assessor Comments: A cot by the drawer with musical instruments was 17 inches from a cot near the light table. Although there was a shelf between the cots, the shelf did not extend to the full length of the cots to allow for closer spacing. Two cots on either side of the wooden bench in the reading area were 15 inches apart, rather than at least 18 inches. The bench between the cots did not extend the full length of the cots to allow for closer spacing. This is a potential violation of the following requirement: 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (e) When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children. Observations today: We discussed reaching out to Environmental Health or Child Care Health Consultants for guidance on appropriate partitions that can be used to separate mats during rest time. Item 34 Indicator: 3.3 (see pages: 63 in the ECERS-R) Score: 2 pts. Assessor Comments: The children play indoors daily, meeting a part of the indicator's requirements. On the day of the observation, the teacher stated that the ground was wet and there were big puddles, and when this occurs they go outside in the afternoon after the water subsides and play for 40 minutes. Wet ground and puddles do not pose a health or safety concern for children who are dressed for the condition. Therefore, children do not play outdoors each day for 1 hour when the weather allows. This is a potential violation for the following requirement: 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS Program Operating Hours: All programs Ages of Children: Under 2 years Minimum Daily Outdoor Time: 30 minutes Program Operating Hours: Less than 5 hours Ages of Children: 0-12 years Minimum Daily Outdoor Time: 30 minutes Program Operating Hours: 5 hours or more Ages of Children: 2-12 years Minimum Daily Outdoor Time: 60 minutes (c) When children are in care and weather conditions permit, there shall be outdoor time, either as part of a small group, a whole group, or individual activity, for no less than the following durations: Observations today: You clarified that children are permitted to play outside in all weather conditions except for heavy rains. You clarified that if the time requirements are not met in the morning, children go outside in the afternoon to meet the one (1) hour time requirement. ITERS-R assessment- 4/30/24 Total Score: 5.17 Item 6 Indicator: 3.4 (see pages: 18-19 in the ITERS-R) Score: 2 pts. Assessor Comments: Two arrivals occurred the morning of the assessment. During the first arrival, the parent talked to the teachers about the child's morning. However, information about the child's health or safety was not shared during the second arrival. This is not a potential violation of Child Care requirements. Observations today: You stated today that teachers and parents discuss information about the children at drop off as regular practice. Item 7 Indicator: 3.1 (see pages: 20-21 in the ITERS-R) Score: 1 pts. Assessor Comments: As the observation began, four children were seated at the tables for breakfast. Water was not offered to these four children between breakfast and lunch time. This is not a potential violation of child care requirements. Please see the guidance in rule below: 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (e) Drinking water shall be freely available to children of all ages. Drinking fountains or individual drinking utensils shall be provided. When a private water supply is used, it must be tested by and meet the requirements of the Commission for Public Health as set forth in 15A NCAC 18A .2800. Observations today: A water jug was present in the classroom. You stated that children are able to access water when they request it. Indicator: 3.4 (see pages 20-21 in the ITERS-R) Assessor Comments: Towards the end of breakfast, as some children continued to eat and drink, a teacher engaged in play with a group of children in the book area while the other teacher pushed the meal cart out of the classroom door. Because the teachers engaged in other activities away from the tables as some children ate and drank, credit could not be earned. This is a potential violation of the following Child Care requirement: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (5) staff must be able to see and hear children aged birth to five years old while the children are eating. Observations today: Two (2) staff were present in classroom space 2 as lunch was being served. Children played with magnatiles on the rug and were called one by one to wash hands. After washing hands, the child sat at the table and was served lunch. One (1) staff prepared plates facing the door with their back turned to the children eating. One (1) staff helped children wash hands, and was positioned to face the children eating. A child needed assistance with self care. The staff member assisting children with washing hands picked up the child and brought them into the diaper changing area to assist. The staff member preparing plates had their back turned to the children when this occurred. Indicator: 3.5 (see pages 20-21 in the ITERS-R) Assessor Comments: The teacher reported that a child enrolled is allergic to eggs. It was further reported that another child is allergic to pineapples and an additional child is allergic to peanuts. Proper substitutions were reported to be made and this information was posted in the classroom. Also, the teacher confirmed that a fourth child enrolled in the group has a peanut allergy and proper substitutions were reported to be made. However, this information was not included on the allergy list posted in the classroom. This is a potential violation of the following Child Care requirement: 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. Observations today: You stated that the second child allergic to peanuts had left the facility prior to the assessment and was no longer enrolled in the classroom during the assessment. The allergy list was reviewed today. You confirmed the allergy list is accurate and up to date. Item 8 Indicator: 3.2 (see pages: 22-23 in the ITERS-R) Score: 2 pts. Assessor Comments: There were several cots spaced between 21 inches to 33 inches apart, rather than at least 36 inches apart. Also, during the transition to nap, many children lay or stepped on two cots in the block area. The bedding on these cots was not replaced before rest time. This is a potential violation of the following child care requirements: 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (e) When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children. 10A NCAC 09 .0806 TOILETING, CLOTHING AND LINENS (c) A supply of clean linens must be on hand so that linens can be changed whenever they become soiled or wet. Observations today: The facility is currently under a provisional license for lead hazards. In classroom space 2, lead was found in the window sill of the classroom. Currently, all the shelves in the classrooms have been moved against wall with the contaminated window sill to prevent children from mouthing the surface. You stated this prevention plan has been approved by Environmental Health. However, this arrangement removes shelves as a potential barrier for mats during nap time. Classroom space 2 was observed during nap time. Three (3) cots were measured at nine (9), twelve (12) and fifteen (15) inches from other cots. Item 9 Indicator: 3.2 (see pages: 26-27 in the ITERS-R) Score: 2 pts. Assessor Comments: All eight children present wore diapers. Diaper changes occurred within the required 2 hour time frame for four children. The observed span of time during which a check or change did not occur for the remaining four children was 2 hours 17 minutes to 2 hours 26 minutes. This is not a violation of child care requirements. Please see the guidance in rule below: 10A NCAC 09 .0806 TOILETING, CLOTHING AND LINENS (a) Diapers shall be changed whenever they become soiled or wet and not on a shift basis. Observations today: You stated today that diapers are checked and changed every one and a half (1.5) hours or when soiled- whichever comes first. Item 10 Indicator: 3.1 (see pages: 26-27 in the ITERS-R) Score: 2 pts. Assessor Comments: Although five mouthed toys were removed, there were several additional mouthed items that were not removed before being used by other children. This is a potential violation of the following child care rule: 15A NCAC 18A .2822 TOYS, EQUIPMENT AND FURNITURE (a) Toys, equipment, and furniture provided by a child care center shall be kept clean and in good repair. In rooms designated for children who are not toilet trained, toys and other mouth-contact surfaces that are used by children shall be cleaned and then sanitized after each use and when visibly dirty. Toys and other mouth-contact surfaces shall be cleaned and sanitized as follows: (1) the items shall be scrubbed in warm, soapy water, using a brush to reach into any crevices; (2) the items shall be rinsed in clean water; (3) the items shall be submerged in a sanitizing solution for at least two minutes or in accordance with the instructions on the label of the sanitizing solution; and (4) the items shall be air dried. Indicator: 3.2 (see pages: 26-27 in the ITERS-R) This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The children's hands were washed as needed. The teachers and staff members washed their hands 30% of the time. A teacher or staff member did not wash their hands upon arrival or reentry to the classroom prior to touching classrooms materials. The teachers and a staff member did not wash their hands after outdoor play or after several instances of removing mouthed toys. This is a potential violation of the following Child Care requirements: 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. Observations today: Two instances of handwashing occurred when children can indoors from outside in classroom spaces 9 and 2. In classroom space 9, children we directed to wash hands at two (2) handwashing sinks prior to choosing a free-choice center. Continue to work with the children on either leaving the faucet on for the next child or using a paper towel to turn off the water. In classroom space 2, children were guided to sit on the rug to wait for their turn to wash hands. Children in this age group struggled to sit for an extended period of time. We discussed the use of transition toys, toys that children are allowed to touch while waiting to wash hands. These toys must then be removed and properly sanitized before being used again. Item 29 Indicator: 3.1 (see pages: 50 in the ITERS-R) Score: 2 pts. Assessor Comments: The concern regarding the diapering routines for four of the eight children, as noted in item 9, applies here as well. Observations today: See item 9. The following violations were cited during the visit today: Violation Number Comment Rule 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. In classroom space 2, three (3) cots measured nine (9), twelve (12) and fifteen (15) inches apart from other cots. 15A NCAC 18A .2821(e) Technical Assistance provided as follows: Item #614 We discussed possible solutions to the temporary space limitations present in this classroom. We discussed reconfiguring the layout to allow for eighteen (18) inches of space between mats. We discussed reaching out to Environmental Health or Child Care Health Consultants for ideas on acceptable partitions. 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (e) When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children. 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 8/27/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation provided as follows: We discussed the supervision requirements while children are eating. Staff must be able to see and hear children while they are eating. If backs are turned to the children, they cannot see them. In classroom space 2, both caregivers had their backs turned to children for a very short period of time while children were eating. We discussed positioning the staff member preparing plates for the children. In your other classrooms, staff perform this task at a table, facing the children who are eating, which allows them to look up to see the children periodically as they prepare and serve plates. This allows for constant supervision to occur while children are eating. Plan to enact a similar routine in classroom space 2. We discussed the table and cart could be moved slightly away from the wall to allow for the staff preparing plates to see the children eating. We discussed that you would like to reopen classroom space 5 as a mixed age classroom. Please see the following rules we discussed today regarding age grouping: 10A NCAC 09 .0713 STAFF/CHILD RATIOS FOR CENTERS (3) a child two years of age and older may be placed with children under one year of age when a physician certifies that the developmental age of the child makes this placement appropriate; (5) except as provided in Subparagraphs (2) and (3) of this Paragraph, children under one year of age shall be kept separate from children two years of age and over; You stated that you would like to move forward with completing the Rated License Reassessment process. The Rated License Reassessment packet and the Staff Information Sheet is included in the email containing this visit summary. Please complete the attached forms and return to me when you are ready to move forward with your Rated License Reassessment. The facility currently operates on a Provisional License due to lead. We discussed that changes cannot occur to your license until this Provisional is lifted. Program Standards: We discussed that you will elect to use the scored received from the ECERS assessment on 5/15/24 and 5/7/24 and the ITERS assessment on 4/30/24 toward your Rated License Reassessment. Your facility currently meets reduced ratios and enhanced space requirements. Education Points: We discussed that your current licensed is calculated with 7 points in education standards. Ensure all staff have their education evaluated by WORKS and their most up-to-date WORKS letter is on file. Plan to review sections .2819, .2820, and .2821 to see what is needed to achieve seven points in education standards. Quality Point: We discussed you are currently meeting your quality point through staff benefits package and infrastructure of parent involvement. A quality point form is attached to the email containing this visit summary. Plan to review the current quality point options in section .2829 of the Chapter 9 Child Care Rules. A Rated License Assessment visit will need to be conducted prior to the Rated License being processed. This visit can be announced. Once the Rated License Reassessment application is received and reviewed, we can discuss possible dates for this visit to occur. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0713 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 8/13/2024 Number Present: 69 Completed Date: 8/13/2024 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: ERS Announced/Unannounced: Announced The purpose of today’s announced visit was to review the results of your Environment Rating Scale (ERS) conducted on 4/30/24, 5/7/24, 5/15/24. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Mary Virella, during the visit. A signed copy of the visit summary was emailed to you. Ms. Virella and Alesia Summey, Director of Early Learning, were present and available to ask and answer questions throughout the visit today. ERS summaries were reviewed today and items scoring less than a three could constitute a violation of child care requirements and therefore were monitored. These items are noted below: ECERS-R assessment – 5/15/24 Total score – 5.68 Item 10 Indicator: 3.3 (see pages: 24-25 in the ECERS-R) Score: 2 pts Assessor Comments: This indicator requires that eating surfaces are cleaned with soapy water, and then sprayed with a sanitizing solution that is allowed to air dry on the surface for at least 2 minutes. The table was not cleaned or sanitized before or after a child ate breakfast. Before lunch, the three tables were cleaned and sanitized as needed. After lunch, two of the tables were cleaned and sanitized. Please refer to the NC Additional Notes for more information. This is a potential violation of the following requirement: 15A NCAC 18A .2822 TOYS, EQUIPMENT AND FURNITURE (a) Toys, equipment, and furniture provided by a child care center shall be kept clean and in good repair. In rooms designated for children who are not toilet trained, toys and other mouth-contact surfaces that are used by children shall be cleaned and then sanitized after each use and when visibly dirty. Toys and other mouth-contact surfaces shall be cleaned and sanitized as follows: (1) the items shall be scrubbed in warm, soapy water, using a brush to reach into any crevices; (2) the items shall be rinsed in clean water; (3) the items shall be submerged in a sanitizing solution for at least two minutes or in accordance with the instructions on the label of the sanitizing solution; and (4) the items shall be air dried. Observations today: One instance of table cleaning was observed today in classroom space 2. The tables were cleaned with soapy water, sprayed with sanitizing solution, and left to dry for two minutes prior to drying the tables. In classroom space 7, the tables appeared wet with sanitizing solution while children were outdoors playing. Item 22 Indicator: 3.2 (see pages: 26-27 in the ECERS-R) Score: 2 pts Assessor Comments: The children slept with soft toys from the reading area. Since these toys could be used by all of the children during center play, this does not meet sanitary requirements for nap time. During the transition to rest time six cots were stepped or laid on by other children. Although one child's sheet was changed, the other children were not provided with clean bedding prior to rest time. This is a potential violation of the following requirement: 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (c) Beds, cots, and mats shall be assigned and labeled for use by an individual child and equipped with individual linens. Observations today: You stated today that children now bring soft toys from home or choose a toy from the center that stays with the same child throughout the week or until visibly soiled. Soft toys used for rest time are not longer shared. Additionally, you shared that staff wait to place the cots down until children are ready to rest to limit possibility of contaminating clean sheets. Item 13 Indicator: 3.1 (see pages: 30-31 in the ECERS-R) Score: 2 pts Assessor Comments: This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The teachers and staff members washed their hands as needed. The children washed their hands 55% of the time when needed. Several children did not wash their hands upon arrival or after returning to the classroom from the gross motor room before they handled classroom materials. There were many instances when children used play dough or sand and did not wash their hands afterwards. This is a potential violation of the following requirement: 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. Observations today: Two instances of handwashing occurred when children can indoors from outside in classroom spaces 9 and 2. In classroom space 9, children we directed to wash hands at two (2) handwashing sinks prior to choosing a free-choice center. Continue to work with the children on either leaving the faucet on for the next child or using a paper towel to turn off the water. In classroom space 2, children were guided to sit on the rug to wait for their turn to wash hands. Children in this age group struggled to sit for an extended period of time. We discussed the use of transition toys, toys that children are allowed to touch while waiting to wash hands. Item 14 Indicator: 3.1 (see pages: 32-33 in the ECERS-R) Score: 2 pts Assessor Comments: There were no safety concerns outdoors. Indoors, a teacher sprayed a table with sanitizer as a child sat on the floor next to the table. The mist from the sanitizer is a potential eye/lung irritant for young children. This is a potential violation of the following requirement: 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Observations today: In classroom space 2, children were redirected back to toys away from tables as they were being cleaned. Item 27 Indicator: 3.1 (see pages: 54-55 in the ECERS-R) Score: 1 pt Assessor Comments: The teacher reported that children watched "Polar Express" which does not meet the requirements of this indicator because it shows frightening and/or violent content. Indicator: 3.3 (see pages: 54-55 in the ECERS-R) Score: 1 pt Assessor Comments: The teacher reported that the children watched a movie that lasted 50 minutes. This is a potential violation of the following requirement: 10A NCAC 09 .0510 ACTIVITY AREAS (d) When preschool children three years old and older are in care the following shall apply: (2) when screen time is provided on any electronic media device with a visual display, it shall be: (A) offered to stimulate a developmental domain in accordance with the North Carolina Foundations for Early Learning and Development as referenced in Rule .0508 of this Section; (B) limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and (C) documented on a cumulative log or the activity plan that shall be available for review by the Division. (f) Screen time, including television, videos, video games, and computer usage, shall be prohibited for children under three years of age. Observations today: We reviewed the requirements of screen time for children ages 3 and up. Screen time must be limited to thirty (30) minutes per day. We discussed splitting movies for special occasions into two (2) or more viewing sessions on different days to ensure this requirement is met. ECERS-R assessment – 5/7/24 Total score – 5.39 Item 10 Indicator: 3.3 (see pages: 24-25 in the ECERS-R) Score: 2 pts Assessor Comments: This indicator requires that eating surfaces are cleaned with soapy water, and then sprayed with a sanitizing solution that is allowed to air dry on the surface for at least 2 minutes. After breakfast the tables were cleaned with soapy water; however, they were not sprayed with sanitizer. Before lunch the tables were cleaned and sanitized appropriately. Please refer to the NC Additional Notes for more information. This is a potential violation of the following requirement: 15A NCAC 18A .2822 TOYS, EQUIPMENT AND FURNITURE (a) Toys, equipment, and furniture provided by a child care center shall be kept clean and in good repair. In rooms designated for children who are not toilet trained, toys and other mouth-contact surfaces that are used by children shall be cleaned and then sanitized after each use and when visibly dirty. Toys and other mouth-contact surfaces shall be cleaned and sanitized as follows: (1) the items shall be scrubbed in warm, soapy water, using a brush to reach into any crevices; (2) the items shall be rinsed in clean water; (3) the items shall be submerged in a sanitizing solution for at least two minutes or in accordance with the instructions on the label of the sanitizing solution; and (4) the items shall be air dried. Observations today: One instance of table cleaning was observed today in classroom space 2. The tables were cleaned with soapy water, sprayed with sanitizing solution, and left to dry for two minutes prior to drying the tables. In classroom space 7, the tables appeared wet with sanitizing solution while children were outdoors playing. Item 11 Indicator: 3.2 (see pages: 26-27 in the ECERS-R) Score: 2 pts. Assessor Comments: A cot by the drawer with musical instruments was 17 inches from a cot near the light table. Although there was a shelf between the cots, the shelf did not extend to the full length of the cots to allow for closer spacing. Two cots on either side of the wooden bench in the reading area were 15 inches apart, rather than at least 18 inches. The bench between the cots did not extend the full length of the cots to allow for closer spacing. This is a potential violation of the following requirement: 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (e) When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children. Observations today: We discussed reaching out to Environmental Health or Child Care Health Consultants for guidance on appropriate partitions that can be used to separate mats during rest time. Item 34 Indicator: 3.3 (see pages: 63 in the ECERS-R) Score: 2 pts. Assessor Comments: The children play indoors daily, meeting a part of the indicator's requirements. On the day of the observation, the teacher stated that the ground was wet and there were big puddles, and when this occurs they go outside in the afternoon after the water subsides and play for 40 minutes. Wet ground and puddles do not pose a health or safety concern for children who are dressed for the condition. Therefore, children do not play outdoors each day for 1 hour when the weather allows. This is a potential violation for the following requirement: 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS Program Operating Hours: All programs Ages of Children: Under 2 years Minimum Daily Outdoor Time: 30 minutes Program Operating Hours: Less than 5 hours Ages of Children: 0-12 years Minimum Daily Outdoor Time: 30 minutes Program Operating Hours: 5 hours or more Ages of Children: 2-12 years Minimum Daily Outdoor Time: 60 minutes (c) When children are in care and weather conditions permit, there shall be outdoor time, either as part of a small group, a whole group, or individual activity, for no less than the following durations: Observations today: You clarified that children are permitted to play outside in all weather conditions except for heavy rains. You clarified that if the time requirements are not met in the morning, children go outside in the afternoon to meet the one (1) hour time requirement. ITERS-R assessment- 4/30/24 Total Score: 5.17 Item 6 Indicator: 3.4 (see pages: 18-19 in the ITERS-R) Score: 2 pts. Assessor Comments: Two arrivals occurred the morning of the assessment. During the first arrival, the parent talked to the teachers about the child's morning. However, information about the child's health or safety was not shared during the second arrival. This is not a potential violation of Child Care requirements. Observations today: You stated today that teachers and parents discuss information about the children at drop off as regular practice. Item 7 Indicator: 3.1 (see pages: 20-21 in the ITERS-R) Score: 1 pts. Assessor Comments: As the observation began, four children were seated at the tables for breakfast. Water was not offered to these four children between breakfast and lunch time. This is not a potential violation of child care requirements. Please see the guidance in rule below: 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (e) Drinking water shall be freely available to children of all ages. Drinking fountains or individual drinking utensils shall be provided. When a private water supply is used, it must be tested by and meet the requirements of the Commission for Public Health as set forth in 15A NCAC 18A .2800. Observations today: A water jug was present in the classroom. You stated that children are able to access water when they request it. Indicator: 3.4 (see pages 20-21 in the ITERS-R) Assessor Comments: Towards the end of breakfast, as some children continued to eat and drink, a teacher engaged in play with a group of children in the book area while the other teacher pushed the meal cart out of the classroom door. Because the teachers engaged in other activities away from the tables as some children ate and drank, credit could not be earned. This is a potential violation of the following Child Care requirement: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (5) staff must be able to see and hear children aged birth to five years old while the children are eating. Observations today: Two (2) staff were present in classroom space 2 as lunch was being served. Children played with magnatiles on the rug and were called one by one to wash hands. After washing hands, the child sat at the table and was served lunch. One (1) staff prepared plates facing the door with their back turned to the children eating. One (1) staff helped children wash hands, and was positioned to face the children eating. A child needed assistance with self care. The staff member assisting children with washing hands picked up the child and brought them into the diaper changing area to assist. The staff member preparing plates had their back turned to the children when this occurred. Indicator: 3.5 (see pages 20-21 in the ITERS-R) Assessor Comments: The teacher reported that a child enrolled is allergic to eggs. It was further reported that another child is allergic to pineapples and an additional child is allergic to peanuts. Proper substitutions were reported to be made and this information was posted in the classroom. Also, the teacher confirmed that a fourth child enrolled in the group has a peanut allergy and proper substitutions were reported to be made. However, this information was not included on the allergy list posted in the classroom. This is a potential violation of the following Child Care requirement: 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. Observations today: You stated that the second child allergic to peanuts had left the facility prior to the assessment and was no longer enrolled in the classroom during the assessment. The allergy list was reviewed today. You confirmed the allergy list is accurate and up to date. Item 8 Indicator: 3.2 (see pages: 22-23 in the ITERS-R) Score: 2 pts. Assessor Comments: There were several cots spaced between 21 inches to 33 inches apart, rather than at least 36 inches apart. Also, during the transition to nap, many children lay or stepped on two cots in the block area. The bedding on these cots was not replaced before rest time. This is a potential violation of the following child care requirements: 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (e) When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children. 10A NCAC 09 .0806 TOILETING, CLOTHING AND LINENS (c) A supply of clean linens must be on hand so that linens can be changed whenever they become soiled or wet. Observations today: The facility is currently under a provisional license for lead hazards. In classroom space 2, lead was found in the window sill of the classroom. Currently, all the shelves in the classrooms have been moved against wall with the contaminated window sill to prevent children from mouthing the surface. You stated this prevention plan has been approved by Environmental Health. However, this arrangement removes shelves as a potential barrier for mats during nap time. Classroom space 2 was observed during nap time. Three (3) cots were measured at nine (9), twelve (12) and fifteen (15) inches from other cots. Item 9 Indicator: 3.2 (see pages: 26-27 in the ITERS-R) Score: 2 pts. Assessor Comments: All eight children present wore diapers. Diaper changes occurred within the required 2 hour time frame for four children. The observed span of time during which a check or change did not occur for the remaining four children was 2 hours 17 minutes to 2 hours 26 minutes. This is not a violation of child care requirements. Please see the guidance in rule below: 10A NCAC 09 .0806 TOILETING, CLOTHING AND LINENS (a) Diapers shall be changed whenever they become soiled or wet and not on a shift basis. Observations today: You stated today that diapers are checked and changed every one and a half (1.5) hours or when soiled- whichever comes first. Item 10 Indicator: 3.1 (see pages: 26-27 in the ITERS-R) Score: 2 pts. Assessor Comments: Although five mouthed toys were removed, there were several additional mouthed items that were not removed before being used by other children. This is a potential violation of the following child care rule: 15A NCAC 18A .2822 TOYS, EQUIPMENT AND FURNITURE (a) Toys, equipment, and furniture provided by a child care center shall be kept clean and in good repair. In rooms designated for children who are not toilet trained, toys and other mouth-contact surfaces that are used by children shall be cleaned and then sanitized after each use and when visibly dirty. Toys and other mouth-contact surfaces shall be cleaned and sanitized as follows: (1) the items shall be scrubbed in warm, soapy water, using a brush to reach into any crevices; (2) the items shall be rinsed in clean water; (3) the items shall be submerged in a sanitizing solution for at least two minutes or in accordance with the instructions on the label of the sanitizing solution; and (4) the items shall be air dried. Indicator: 3.2 (see pages: 26-27 in the ITERS-R) This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The children's hands were washed as needed. The teachers and staff members washed their hands 30% of the time. A teacher or staff member did not wash their hands upon arrival or reentry to the classroom prior to touching classrooms materials. The teachers and a staff member did not wash their hands after outdoor play or after several instances of removing mouthed toys. This is a potential violation of the following Child Care requirements: 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. Observations today: Two instances of handwashing occurred when children can indoors from outside in classroom spaces 9 and 2. In classroom space 9, children we directed to wash hands at two (2) handwashing sinks prior to choosing a free-choice center. Continue to work with the children on either leaving the faucet on for the next child or using a paper towel to turn off the water. In classroom space 2, children were guided to sit on the rug to wait for their turn to wash hands. Children in this age group struggled to sit for an extended period of time. We discussed the use of transition toys, toys that children are allowed to touch while waiting to wash hands. These toys must then be removed and properly sanitized before being used again. Item 29 Indicator: 3.1 (see pages: 50 in the ITERS-R) Score: 2 pts. Assessor Comments: The concern regarding the diapering routines for four of the eight children, as noted in item 9, applies here as well. Observations today: See item 9. The following violations were cited during the visit today: Violation Number Comment Rule 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. In classroom space 2, three (3) cots measured nine (9), twelve (12) and fifteen (15) inches apart from other cots. 15A NCAC 18A .2821(e) Technical Assistance provided as follows: Item #614 We discussed possible solutions to the temporary space limitations present in this classroom. We discussed reconfiguring the layout to allow for eighteen (18) inches of space between mats. We discussed reaching out to Environmental Health or Child Care Health Consultants for ideas on acceptable partitions. 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (e) When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children. 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 8/27/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation provided as follows: We discussed the supervision requirements while children are eating. Staff must be able to see and hear children while they are eating. If backs are turned to the children, they cannot see them. In classroom space 2, both caregivers had their backs turned to children for a very short period of time while children were eating. We discussed positioning the staff member preparing plates for the children. In your other classrooms, staff perform this task at a table, facing the children who are eating, which allows them to look up to see the children periodically as they prepare and serve plates. This allows for constant supervision to occur while children are eating. Plan to enact a similar routine in classroom space 2. We discussed the table and cart could be moved slightly away from the wall to allow for the staff preparing plates to see the children eating. We discussed that you would like to reopen classroom space 5 as a mixed age classroom. Please see the following rules we discussed today regarding age grouping: 10A NCAC 09 .0713 STAFF/CHILD RATIOS FOR CENTERS (3) a child two years of age and older may be placed with children under one year of age when a physician certifies that the developmental age of the child makes this placement appropriate; (5) except as provided in Subparagraphs (2) and (3) of this Paragraph, children under one year of age shall be kept separate from children two years of age and over; You stated that you would like to move forward with completing the Rated License Reassessment process. The Rated License Reassessment packet and the Staff Information Sheet is included in the email containing this visit summary. Please complete the attached forms and return to me when you are ready to move forward with your Rated License Reassessment. The facility currently operates on a Provisional License due to lead. We discussed that changes cannot occur to your license until this Provisional is lifted. Program Standards: We discussed that you will elect to use the scored received from the ECERS assessment on 5/15/24 and 5/7/24 and the ITERS assessment on 4/30/24 toward your Rated License Reassessment. Your facility currently meets reduced ratios and enhanced space requirements. Education Points: We discussed that your current licensed is calculated with 7 points in education standards. Ensure all staff have their education evaluated by WORKS and their most up-to-date WORKS letter is on file. Plan to review sections .2819, .2820, and .2821 to see what is needed to achieve seven points in education standards. Quality Point: We discussed you are currently meeting your quality point through staff benefits package and infrastructure of parent involvement. A quality point form is attached to the email containing this visit summary. Plan to review the current quality point options in section .2829 of the Chapter 9 Child Care Rules. A Rated License Assessment visit will need to be conducted prior to the Rated License being processed. This visit can be announced. Once the Rated License Reassessment application is received and reviewed, we can discuss possible dates for this visit to occur. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0806 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 8/13/2024 Number Present: 69 Completed Date: 8/13/2024 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: ERS Announced/Unannounced: Announced The purpose of today’s announced visit was to review the results of your Environment Rating Scale (ERS) conducted on 4/30/24, 5/7/24, 5/15/24. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Mary Virella, during the visit. A signed copy of the visit summary was emailed to you. Ms. Virella and Alesia Summey, Director of Early Learning, were present and available to ask and answer questions throughout the visit today. ERS summaries were reviewed today and items scoring less than a three could constitute a violation of child care requirements and therefore were monitored. These items are noted below: ECERS-R assessment – 5/15/24 Total score – 5.68 Item 10 Indicator: 3.3 (see pages: 24-25 in the ECERS-R) Score: 2 pts Assessor Comments: This indicator requires that eating surfaces are cleaned with soapy water, and then sprayed with a sanitizing solution that is allowed to air dry on the surface for at least 2 minutes. The table was not cleaned or sanitized before or after a child ate breakfast. Before lunch, the three tables were cleaned and sanitized as needed. After lunch, two of the tables were cleaned and sanitized. Please refer to the NC Additional Notes for more information. This is a potential violation of the following requirement: 15A NCAC 18A .2822 TOYS, EQUIPMENT AND FURNITURE (a) Toys, equipment, and furniture provided by a child care center shall be kept clean and in good repair. In rooms designated for children who are not toilet trained, toys and other mouth-contact surfaces that are used by children shall be cleaned and then sanitized after each use and when visibly dirty. Toys and other mouth-contact surfaces shall be cleaned and sanitized as follows: (1) the items shall be scrubbed in warm, soapy water, using a brush to reach into any crevices; (2) the items shall be rinsed in clean water; (3) the items shall be submerged in a sanitizing solution for at least two minutes or in accordance with the instructions on the label of the sanitizing solution; and (4) the items shall be air dried. Observations today: One instance of table cleaning was observed today in classroom space 2. The tables were cleaned with soapy water, sprayed with sanitizing solution, and left to dry for two minutes prior to drying the tables. In classroom space 7, the tables appeared wet with sanitizing solution while children were outdoors playing. Item 22 Indicator: 3.2 (see pages: 26-27 in the ECERS-R) Score: 2 pts Assessor Comments: The children slept with soft toys from the reading area. Since these toys could be used by all of the children during center play, this does not meet sanitary requirements for nap time. During the transition to rest time six cots were stepped or laid on by other children. Although one child's sheet was changed, the other children were not provided with clean bedding prior to rest time. This is a potential violation of the following requirement: 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (c) Beds, cots, and mats shall be assigned and labeled for use by an individual child and equipped with individual linens. Observations today: You stated today that children now bring soft toys from home or choose a toy from the center that stays with the same child throughout the week or until visibly soiled. Soft toys used for rest time are not longer shared. Additionally, you shared that staff wait to place the cots down until children are ready to rest to limit possibility of contaminating clean sheets. Item 13 Indicator: 3.1 (see pages: 30-31 in the ECERS-R) Score: 2 pts Assessor Comments: This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The teachers and staff members washed their hands as needed. The children washed their hands 55% of the time when needed. Several children did not wash their hands upon arrival or after returning to the classroom from the gross motor room before they handled classroom materials. There were many instances when children used play dough or sand and did not wash their hands afterwards. This is a potential violation of the following requirement: 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. Observations today: Two instances of handwashing occurred when children can indoors from outside in classroom spaces 9 and 2. In classroom space 9, children we directed to wash hands at two (2) handwashing sinks prior to choosing a free-choice center. Continue to work with the children on either leaving the faucet on for the next child or using a paper towel to turn off the water. In classroom space 2, children were guided to sit on the rug to wait for their turn to wash hands. Children in this age group struggled to sit for an extended period of time. We discussed the use of transition toys, toys that children are allowed to touch while waiting to wash hands. Item 14 Indicator: 3.1 (see pages: 32-33 in the ECERS-R) Score: 2 pts Assessor Comments: There were no safety concerns outdoors. Indoors, a teacher sprayed a table with sanitizer as a child sat on the floor next to the table. The mist from the sanitizer is a potential eye/lung irritant for young children. This is a potential violation of the following requirement: 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Observations today: In classroom space 2, children were redirected back to toys away from tables as they were being cleaned. Item 27 Indicator: 3.1 (see pages: 54-55 in the ECERS-R) Score: 1 pt Assessor Comments: The teacher reported that children watched "Polar Express" which does not meet the requirements of this indicator because it shows frightening and/or violent content. Indicator: 3.3 (see pages: 54-55 in the ECERS-R) Score: 1 pt Assessor Comments: The teacher reported that the children watched a movie that lasted 50 minutes. This is a potential violation of the following requirement: 10A NCAC 09 .0510 ACTIVITY AREAS (d) When preschool children three years old and older are in care the following shall apply: (2) when screen time is provided on any electronic media device with a visual display, it shall be: (A) offered to stimulate a developmental domain in accordance with the North Carolina Foundations for Early Learning and Development as referenced in Rule .0508 of this Section; (B) limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and (C) documented on a cumulative log or the activity plan that shall be available for review by the Division. (f) Screen time, including television, videos, video games, and computer usage, shall be prohibited for children under three years of age. Observations today: We reviewed the requirements of screen time for children ages 3 and up. Screen time must be limited to thirty (30) minutes per day. We discussed splitting movies for special occasions into two (2) or more viewing sessions on different days to ensure this requirement is met. ECERS-R assessment – 5/7/24 Total score – 5.39 Item 10 Indicator: 3.3 (see pages: 24-25 in the ECERS-R) Score: 2 pts Assessor Comments: This indicator requires that eating surfaces are cleaned with soapy water, and then sprayed with a sanitizing solution that is allowed to air dry on the surface for at least 2 minutes. After breakfast the tables were cleaned with soapy water; however, they were not sprayed with sanitizer. Before lunch the tables were cleaned and sanitized appropriately. Please refer to the NC Additional Notes for more information. This is a potential violation of the following requirement: 15A NCAC 18A .2822 TOYS, EQUIPMENT AND FURNITURE (a) Toys, equipment, and furniture provided by a child care center shall be kept clean and in good repair. In rooms designated for children who are not toilet trained, toys and other mouth-contact surfaces that are used by children shall be cleaned and then sanitized after each use and when visibly dirty. Toys and other mouth-contact surfaces shall be cleaned and sanitized as follows: (1) the items shall be scrubbed in warm, soapy water, using a brush to reach into any crevices; (2) the items shall be rinsed in clean water; (3) the items shall be submerged in a sanitizing solution for at least two minutes or in accordance with the instructions on the label of the sanitizing solution; and (4) the items shall be air dried. Observations today: One instance of table cleaning was observed today in classroom space 2. The tables were cleaned with soapy water, sprayed with sanitizing solution, and left to dry for two minutes prior to drying the tables. In classroom space 7, the tables appeared wet with sanitizing solution while children were outdoors playing. Item 11 Indicator: 3.2 (see pages: 26-27 in the ECERS-R) Score: 2 pts. Assessor Comments: A cot by the drawer with musical instruments was 17 inches from a cot near the light table. Although there was a shelf between the cots, the shelf did not extend to the full length of the cots to allow for closer spacing. Two cots on either side of the wooden bench in the reading area were 15 inches apart, rather than at least 18 inches. The bench between the cots did not extend the full length of the cots to allow for closer spacing. This is a potential violation of the following requirement: 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (e) When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children. Observations today: We discussed reaching out to Environmental Health or Child Care Health Consultants for guidance on appropriate partitions that can be used to separate mats during rest time. Item 34 Indicator: 3.3 (see pages: 63 in the ECERS-R) Score: 2 pts. Assessor Comments: The children play indoors daily, meeting a part of the indicator's requirements. On the day of the observation, the teacher stated that the ground was wet and there were big puddles, and when this occurs they go outside in the afternoon after the water subsides and play for 40 minutes. Wet ground and puddles do not pose a health or safety concern for children who are dressed for the condition. Therefore, children do not play outdoors each day for 1 hour when the weather allows. This is a potential violation for the following requirement: 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS Program Operating Hours: All programs Ages of Children: Under 2 years Minimum Daily Outdoor Time: 30 minutes Program Operating Hours: Less than 5 hours Ages of Children: 0-12 years Minimum Daily Outdoor Time: 30 minutes Program Operating Hours: 5 hours or more Ages of Children: 2-12 years Minimum Daily Outdoor Time: 60 minutes (c) When children are in care and weather conditions permit, there shall be outdoor time, either as part of a small group, a whole group, or individual activity, for no less than the following durations: Observations today: You clarified that children are permitted to play outside in all weather conditions except for heavy rains. You clarified that if the time requirements are not met in the morning, children go outside in the afternoon to meet the one (1) hour time requirement. ITERS-R assessment- 4/30/24 Total Score: 5.17 Item 6 Indicator: 3.4 (see pages: 18-19 in the ITERS-R) Score: 2 pts. Assessor Comments: Two arrivals occurred the morning of the assessment. During the first arrival, the parent talked to the teachers about the child's morning. However, information about the child's health or safety was not shared during the second arrival. This is not a potential violation of Child Care requirements. Observations today: You stated today that teachers and parents discuss information about the children at drop off as regular practice. Item 7 Indicator: 3.1 (see pages: 20-21 in the ITERS-R) Score: 1 pts. Assessor Comments: As the observation began, four children were seated at the tables for breakfast. Water was not offered to these four children between breakfast and lunch time. This is not a potential violation of child care requirements. Please see the guidance in rule below: 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (e) Drinking water shall be freely available to children of all ages. Drinking fountains or individual drinking utensils shall be provided. When a private water supply is used, it must be tested by and meet the requirements of the Commission for Public Health as set forth in 15A NCAC 18A .2800. Observations today: A water jug was present in the classroom. You stated that children are able to access water when they request it. Indicator: 3.4 (see pages 20-21 in the ITERS-R) Assessor Comments: Towards the end of breakfast, as some children continued to eat and drink, a teacher engaged in play with a group of children in the book area while the other teacher pushed the meal cart out of the classroom door. Because the teachers engaged in other activities away from the tables as some children ate and drank, credit could not be earned. This is a potential violation of the following Child Care requirement: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (5) staff must be able to see and hear children aged birth to five years old while the children are eating. Observations today: Two (2) staff were present in classroom space 2 as lunch was being served. Children played with magnatiles on the rug and were called one by one to wash hands. After washing hands, the child sat at the table and was served lunch. One (1) staff prepared plates facing the door with their back turned to the children eating. One (1) staff helped children wash hands, and was positioned to face the children eating. A child needed assistance with self care. The staff member assisting children with washing hands picked up the child and brought them into the diaper changing area to assist. The staff member preparing plates had their back turned to the children when this occurred. Indicator: 3.5 (see pages 20-21 in the ITERS-R) Assessor Comments: The teacher reported that a child enrolled is allergic to eggs. It was further reported that another child is allergic to pineapples and an additional child is allergic to peanuts. Proper substitutions were reported to be made and this information was posted in the classroom. Also, the teacher confirmed that a fourth child enrolled in the group has a peanut allergy and proper substitutions were reported to be made. However, this information was not included on the allergy list posted in the classroom. This is a potential violation of the following Child Care requirement: 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. Observations today: You stated that the second child allergic to peanuts had left the facility prior to the assessment and was no longer enrolled in the classroom during the assessment. The allergy list was reviewed today. You confirmed the allergy list is accurate and up to date. Item 8 Indicator: 3.2 (see pages: 22-23 in the ITERS-R) Score: 2 pts. Assessor Comments: There were several cots spaced between 21 inches to 33 inches apart, rather than at least 36 inches apart. Also, during the transition to nap, many children lay or stepped on two cots in the block area. The bedding on these cots was not replaced before rest time. This is a potential violation of the following child care requirements: 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (e) When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children. 10A NCAC 09 .0806 TOILETING, CLOTHING AND LINENS (c) A supply of clean linens must be on hand so that linens can be changed whenever they become soiled or wet. Observations today: The facility is currently under a provisional license for lead hazards. In classroom space 2, lead was found in the window sill of the classroom. Currently, all the shelves in the classrooms have been moved against wall with the contaminated window sill to prevent children from mouthing the surface. You stated this prevention plan has been approved by Environmental Health. However, this arrangement removes shelves as a potential barrier for mats during nap time. Classroom space 2 was observed during nap time. Three (3) cots were measured at nine (9), twelve (12) and fifteen (15) inches from other cots. Item 9 Indicator: 3.2 (see pages: 26-27 in the ITERS-R) Score: 2 pts. Assessor Comments: All eight children present wore diapers. Diaper changes occurred within the required 2 hour time frame for four children. The observed span of time during which a check or change did not occur for the remaining four children was 2 hours 17 minutes to 2 hours 26 minutes. This is not a violation of child care requirements. Please see the guidance in rule below: 10A NCAC 09 .0806 TOILETING, CLOTHING AND LINENS (a) Diapers shall be changed whenever they become soiled or wet and not on a shift basis. Observations today: You stated today that diapers are checked and changed every one and a half (1.5) hours or when soiled- whichever comes first. Item 10 Indicator: 3.1 (see pages: 26-27 in the ITERS-R) Score: 2 pts. Assessor Comments: Although five mouthed toys were removed, there were several additional mouthed items that were not removed before being used by other children. This is a potential violation of the following child care rule: 15A NCAC 18A .2822 TOYS, EQUIPMENT AND FURNITURE (a) Toys, equipment, and furniture provided by a child care center shall be kept clean and in good repair. In rooms designated for children who are not toilet trained, toys and other mouth-contact surfaces that are used by children shall be cleaned and then sanitized after each use and when visibly dirty. Toys and other mouth-contact surfaces shall be cleaned and sanitized as follows: (1) the items shall be scrubbed in warm, soapy water, using a brush to reach into any crevices; (2) the items shall be rinsed in clean water; (3) the items shall be submerged in a sanitizing solution for at least two minutes or in accordance with the instructions on the label of the sanitizing solution; and (4) the items shall be air dried. Indicator: 3.2 (see pages: 26-27 in the ITERS-R) This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The children's hands were washed as needed. The teachers and staff members washed their hands 30% of the time. A teacher or staff member did not wash their hands upon arrival or reentry to the classroom prior to touching classrooms materials. The teachers and a staff member did not wash their hands after outdoor play or after several instances of removing mouthed toys. This is a potential violation of the following Child Care requirements: 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. Observations today: Two instances of handwashing occurred when children can indoors from outside in classroom spaces 9 and 2. In classroom space 9, children we directed to wash hands at two (2) handwashing sinks prior to choosing a free-choice center. Continue to work with the children on either leaving the faucet on for the next child or using a paper towel to turn off the water. In classroom space 2, children were guided to sit on the rug to wait for their turn to wash hands. Children in this age group struggled to sit for an extended period of time. We discussed the use of transition toys, toys that children are allowed to touch while waiting to wash hands. These toys must then be removed and properly sanitized before being used again. Item 29 Indicator: 3.1 (see pages: 50 in the ITERS-R) Score: 2 pts. Assessor Comments: The concern regarding the diapering routines for four of the eight children, as noted in item 9, applies here as well. Observations today: See item 9. The following violations were cited during the visit today: Violation Number Comment Rule 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. In classroom space 2, three (3) cots measured nine (9), twelve (12) and fifteen (15) inches apart from other cots. 15A NCAC 18A .2821(e) Technical Assistance provided as follows: Item #614 We discussed possible solutions to the temporary space limitations present in this classroom. We discussed reconfiguring the layout to allow for eighteen (18) inches of space between mats. We discussed reaching out to Environmental Health or Child Care Health Consultants for ideas on acceptable partitions. 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (e) When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children. 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 8/27/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation provided as follows: We discussed the supervision requirements while children are eating. Staff must be able to see and hear children while they are eating. If backs are turned to the children, they cannot see them. In classroom space 2, both caregivers had their backs turned to children for a very short period of time while children were eating. We discussed positioning the staff member preparing plates for the children. In your other classrooms, staff perform this task at a table, facing the children who are eating, which allows them to look up to see the children periodically as they prepare and serve plates. This allows for constant supervision to occur while children are eating. Plan to enact a similar routine in classroom space 2. We discussed the table and cart could be moved slightly away from the wall to allow for the staff preparing plates to see the children eating. We discussed that you would like to reopen classroom space 5 as a mixed age classroom. Please see the following rules we discussed today regarding age grouping: 10A NCAC 09 .0713 STAFF/CHILD RATIOS FOR CENTERS (3) a child two years of age and older may be placed with children under one year of age when a physician certifies that the developmental age of the child makes this placement appropriate; (5) except as provided in Subparagraphs (2) and (3) of this Paragraph, children under one year of age shall be kept separate from children two years of age and over; You stated that you would like to move forward with completing the Rated License Reassessment process. The Rated License Reassessment packet and the Staff Information Sheet is included in the email containing this visit summary. Please complete the attached forms and return to me when you are ready to move forward with your Rated License Reassessment. The facility currently operates on a Provisional License due to lead. We discussed that changes cannot occur to your license until this Provisional is lifted. Program Standards: We discussed that you will elect to use the scored received from the ECERS assessment on 5/15/24 and 5/7/24 and the ITERS assessment on 4/30/24 toward your Rated License Reassessment. Your facility currently meets reduced ratios and enhanced space requirements. Education Points: We discussed that your current licensed is calculated with 7 points in education standards. Ensure all staff have their education evaluated by WORKS and their most up-to-date WORKS letter is on file. Plan to review sections .2819, .2820, and .2821 to see what is needed to achieve seven points in education standards. Quality Point: We discussed you are currently meeting your quality point through staff benefits package and infrastructure of parent involvement. A quality point form is attached to the email containing this visit summary. Plan to review the current quality point options in section .2829 of the Chapter 9 Child Care Rules. A Rated License Assessment visit will need to be conducted prior to the Rated License being processed. This visit can be announced. Once the Rated License Reassessment application is received and reviewed, we can discuss possible dates for this visit to occur. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0901 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 8/13/2024 Number Present: 69 Completed Date: 8/13/2024 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: ERS Announced/Unannounced: Announced The purpose of today’s announced visit was to review the results of your Environment Rating Scale (ERS) conducted on 4/30/24, 5/7/24, 5/15/24. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Mary Virella, during the visit. A signed copy of the visit summary was emailed to you. Ms. Virella and Alesia Summey, Director of Early Learning, were present and available to ask and answer questions throughout the visit today. ERS summaries were reviewed today and items scoring less than a three could constitute a violation of child care requirements and therefore were monitored. These items are noted below: ECERS-R assessment – 5/15/24 Total score – 5.68 Item 10 Indicator: 3.3 (see pages: 24-25 in the ECERS-R) Score: 2 pts Assessor Comments: This indicator requires that eating surfaces are cleaned with soapy water, and then sprayed with a sanitizing solution that is allowed to air dry on the surface for at least 2 minutes. The table was not cleaned or sanitized before or after a child ate breakfast. Before lunch, the three tables were cleaned and sanitized as needed. After lunch, two of the tables were cleaned and sanitized. Please refer to the NC Additional Notes for more information. This is a potential violation of the following requirement: 15A NCAC 18A .2822 TOYS, EQUIPMENT AND FURNITURE (a) Toys, equipment, and furniture provided by a child care center shall be kept clean and in good repair. In rooms designated for children who are not toilet trained, toys and other mouth-contact surfaces that are used by children shall be cleaned and then sanitized after each use and when visibly dirty. Toys and other mouth-contact surfaces shall be cleaned and sanitized as follows: (1) the items shall be scrubbed in warm, soapy water, using a brush to reach into any crevices; (2) the items shall be rinsed in clean water; (3) the items shall be submerged in a sanitizing solution for at least two minutes or in accordance with the instructions on the label of the sanitizing solution; and (4) the items shall be air dried. Observations today: One instance of table cleaning was observed today in classroom space 2. The tables were cleaned with soapy water, sprayed with sanitizing solution, and left to dry for two minutes prior to drying the tables. In classroom space 7, the tables appeared wet with sanitizing solution while children were outdoors playing. Item 22 Indicator: 3.2 (see pages: 26-27 in the ECERS-R) Score: 2 pts Assessor Comments: The children slept with soft toys from the reading area. Since these toys could be used by all of the children during center play, this does not meet sanitary requirements for nap time. During the transition to rest time six cots were stepped or laid on by other children. Although one child's sheet was changed, the other children were not provided with clean bedding prior to rest time. This is a potential violation of the following requirement: 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (c) Beds, cots, and mats shall be assigned and labeled for use by an individual child and equipped with individual linens. Observations today: You stated today that children now bring soft toys from home or choose a toy from the center that stays with the same child throughout the week or until visibly soiled. Soft toys used for rest time are not longer shared. Additionally, you shared that staff wait to place the cots down until children are ready to rest to limit possibility of contaminating clean sheets. Item 13 Indicator: 3.1 (see pages: 30-31 in the ECERS-R) Score: 2 pts Assessor Comments: This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The teachers and staff members washed their hands as needed. The children washed their hands 55% of the time when needed. Several children did not wash their hands upon arrival or after returning to the classroom from the gross motor room before they handled classroom materials. There were many instances when children used play dough or sand and did not wash their hands afterwards. This is a potential violation of the following requirement: 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. Observations today: Two instances of handwashing occurred when children can indoors from outside in classroom spaces 9 and 2. In classroom space 9, children we directed to wash hands at two (2) handwashing sinks prior to choosing a free-choice center. Continue to work with the children on either leaving the faucet on for the next child or using a paper towel to turn off the water. In classroom space 2, children were guided to sit on the rug to wait for their turn to wash hands. Children in this age group struggled to sit for an extended period of time. We discussed the use of transition toys, toys that children are allowed to touch while waiting to wash hands. Item 14 Indicator: 3.1 (see pages: 32-33 in the ECERS-R) Score: 2 pts Assessor Comments: There were no safety concerns outdoors. Indoors, a teacher sprayed a table with sanitizer as a child sat on the floor next to the table. The mist from the sanitizer is a potential eye/lung irritant for young children. This is a potential violation of the following requirement: 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Observations today: In classroom space 2, children were redirected back to toys away from tables as they were being cleaned. Item 27 Indicator: 3.1 (see pages: 54-55 in the ECERS-R) Score: 1 pt Assessor Comments: The teacher reported that children watched "Polar Express" which does not meet the requirements of this indicator because it shows frightening and/or violent content. Indicator: 3.3 (see pages: 54-55 in the ECERS-R) Score: 1 pt Assessor Comments: The teacher reported that the children watched a movie that lasted 50 minutes. This is a potential violation of the following requirement: 10A NCAC 09 .0510 ACTIVITY AREAS (d) When preschool children three years old and older are in care the following shall apply: (2) when screen time is provided on any electronic media device with a visual display, it shall be: (A) offered to stimulate a developmental domain in accordance with the North Carolina Foundations for Early Learning and Development as referenced in Rule .0508 of this Section; (B) limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and (C) documented on a cumulative log or the activity plan that shall be available for review by the Division. (f) Screen time, including television, videos, video games, and computer usage, shall be prohibited for children under three years of age. Observations today: We reviewed the requirements of screen time for children ages 3 and up. Screen time must be limited to thirty (30) minutes per day. We discussed splitting movies for special occasions into two (2) or more viewing sessions on different days to ensure this requirement is met. ECERS-R assessment – 5/7/24 Total score – 5.39 Item 10 Indicator: 3.3 (see pages: 24-25 in the ECERS-R) Score: 2 pts Assessor Comments: This indicator requires that eating surfaces are cleaned with soapy water, and then sprayed with a sanitizing solution that is allowed to air dry on the surface for at least 2 minutes. After breakfast the tables were cleaned with soapy water; however, they were not sprayed with sanitizer. Before lunch the tables were cleaned and sanitized appropriately. Please refer to the NC Additional Notes for more information. This is a potential violation of the following requirement: 15A NCAC 18A .2822 TOYS, EQUIPMENT AND FURNITURE (a) Toys, equipment, and furniture provided by a child care center shall be kept clean and in good repair. In rooms designated for children who are not toilet trained, toys and other mouth-contact surfaces that are used by children shall be cleaned and then sanitized after each use and when visibly dirty. Toys and other mouth-contact surfaces shall be cleaned and sanitized as follows: (1) the items shall be scrubbed in warm, soapy water, using a brush to reach into any crevices; (2) the items shall be rinsed in clean water; (3) the items shall be submerged in a sanitizing solution for at least two minutes or in accordance with the instructions on the label of the sanitizing solution; and (4) the items shall be air dried. Observations today: One instance of table cleaning was observed today in classroom space 2. The tables were cleaned with soapy water, sprayed with sanitizing solution, and left to dry for two minutes prior to drying the tables. In classroom space 7, the tables appeared wet with sanitizing solution while children were outdoors playing. Item 11 Indicator: 3.2 (see pages: 26-27 in the ECERS-R) Score: 2 pts. Assessor Comments: A cot by the drawer with musical instruments was 17 inches from a cot near the light table. Although there was a shelf between the cots, the shelf did not extend to the full length of the cots to allow for closer spacing. Two cots on either side of the wooden bench in the reading area were 15 inches apart, rather than at least 18 inches. The bench between the cots did not extend the full length of the cots to allow for closer spacing. This is a potential violation of the following requirement: 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (e) When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children. Observations today: We discussed reaching out to Environmental Health or Child Care Health Consultants for guidance on appropriate partitions that can be used to separate mats during rest time. Item 34 Indicator: 3.3 (see pages: 63 in the ECERS-R) Score: 2 pts. Assessor Comments: The children play indoors daily, meeting a part of the indicator's requirements. On the day of the observation, the teacher stated that the ground was wet and there were big puddles, and when this occurs they go outside in the afternoon after the water subsides and play for 40 minutes. Wet ground and puddles do not pose a health or safety concern for children who are dressed for the condition. Therefore, children do not play outdoors each day for 1 hour when the weather allows. This is a potential violation for the following requirement: 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS Program Operating Hours: All programs Ages of Children: Under 2 years Minimum Daily Outdoor Time: 30 minutes Program Operating Hours: Less than 5 hours Ages of Children: 0-12 years Minimum Daily Outdoor Time: 30 minutes Program Operating Hours: 5 hours or more Ages of Children: 2-12 years Minimum Daily Outdoor Time: 60 minutes (c) When children are in care and weather conditions permit, there shall be outdoor time, either as part of a small group, a whole group, or individual activity, for no less than the following durations: Observations today: You clarified that children are permitted to play outside in all weather conditions except for heavy rains. You clarified that if the time requirements are not met in the morning, children go outside in the afternoon to meet the one (1) hour time requirement. ITERS-R assessment- 4/30/24 Total Score: 5.17 Item 6 Indicator: 3.4 (see pages: 18-19 in the ITERS-R) Score: 2 pts. Assessor Comments: Two arrivals occurred the morning of the assessment. During the first arrival, the parent talked to the teachers about the child's morning. However, information about the child's health or safety was not shared during the second arrival. This is not a potential violation of Child Care requirements. Observations today: You stated today that teachers and parents discuss information about the children at drop off as regular practice. Item 7 Indicator: 3.1 (see pages: 20-21 in the ITERS-R) Score: 1 pts. Assessor Comments: As the observation began, four children were seated at the tables for breakfast. Water was not offered to these four children between breakfast and lunch time. This is not a potential violation of child care requirements. Please see the guidance in rule below: 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (e) Drinking water shall be freely available to children of all ages. Drinking fountains or individual drinking utensils shall be provided. When a private water supply is used, it must be tested by and meet the requirements of the Commission for Public Health as set forth in 15A NCAC 18A .2800. Observations today: A water jug was present in the classroom. You stated that children are able to access water when they request it. Indicator: 3.4 (see pages 20-21 in the ITERS-R) Assessor Comments: Towards the end of breakfast, as some children continued to eat and drink, a teacher engaged in play with a group of children in the book area while the other teacher pushed the meal cart out of the classroom door. Because the teachers engaged in other activities away from the tables as some children ate and drank, credit could not be earned. This is a potential violation of the following Child Care requirement: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (5) staff must be able to see and hear children aged birth to five years old while the children are eating. Observations today: Two (2) staff were present in classroom space 2 as lunch was being served. Children played with magnatiles on the rug and were called one by one to wash hands. After washing hands, the child sat at the table and was served lunch. One (1) staff prepared plates facing the door with their back turned to the children eating. One (1) staff helped children wash hands, and was positioned to face the children eating. A child needed assistance with self care. The staff member assisting children with washing hands picked up the child and brought them into the diaper changing area to assist. The staff member preparing plates had their back turned to the children when this occurred. Indicator: 3.5 (see pages 20-21 in the ITERS-R) Assessor Comments: The teacher reported that a child enrolled is allergic to eggs. It was further reported that another child is allergic to pineapples and an additional child is allergic to peanuts. Proper substitutions were reported to be made and this information was posted in the classroom. Also, the teacher confirmed that a fourth child enrolled in the group has a peanut allergy and proper substitutions were reported to be made. However, this information was not included on the allergy list posted in the classroom. This is a potential violation of the following Child Care requirement: 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. Observations today: You stated that the second child allergic to peanuts had left the facility prior to the assessment and was no longer enrolled in the classroom during the assessment. The allergy list was reviewed today. You confirmed the allergy list is accurate and up to date. Item 8 Indicator: 3.2 (see pages: 22-23 in the ITERS-R) Score: 2 pts. Assessor Comments: There were several cots spaced between 21 inches to 33 inches apart, rather than at least 36 inches apart. Also, during the transition to nap, many children lay or stepped on two cots in the block area. The bedding on these cots was not replaced before rest time. This is a potential violation of the following child care requirements: 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (e) When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children. 10A NCAC 09 .0806 TOILETING, CLOTHING AND LINENS (c) A supply of clean linens must be on hand so that linens can be changed whenever they become soiled or wet. Observations today: The facility is currently under a provisional license for lead hazards. In classroom space 2, lead was found in the window sill of the classroom. Currently, all the shelves in the classrooms have been moved against wall with the contaminated window sill to prevent children from mouthing the surface. You stated this prevention plan has been approved by Environmental Health. However, this arrangement removes shelves as a potential barrier for mats during nap time. Classroom space 2 was observed during nap time. Three (3) cots were measured at nine (9), twelve (12) and fifteen (15) inches from other cots. Item 9 Indicator: 3.2 (see pages: 26-27 in the ITERS-R) Score: 2 pts. Assessor Comments: All eight children present wore diapers. Diaper changes occurred within the required 2 hour time frame for four children. The observed span of time during which a check or change did not occur for the remaining four children was 2 hours 17 minutes to 2 hours 26 minutes. This is not a violation of child care requirements. Please see the guidance in rule below: 10A NCAC 09 .0806 TOILETING, CLOTHING AND LINENS (a) Diapers shall be changed whenever they become soiled or wet and not on a shift basis. Observations today: You stated today that diapers are checked and changed every one and a half (1.5) hours or when soiled- whichever comes first. Item 10 Indicator: 3.1 (see pages: 26-27 in the ITERS-R) Score: 2 pts. Assessor Comments: Although five mouthed toys were removed, there were several additional mouthed items that were not removed before being used by other children. This is a potential violation of the following child care rule: 15A NCAC 18A .2822 TOYS, EQUIPMENT AND FURNITURE (a) Toys, equipment, and furniture provided by a child care center shall be kept clean and in good repair. In rooms designated for children who are not toilet trained, toys and other mouth-contact surfaces that are used by children shall be cleaned and then sanitized after each use and when visibly dirty. Toys and other mouth-contact surfaces shall be cleaned and sanitized as follows: (1) the items shall be scrubbed in warm, soapy water, using a brush to reach into any crevices; (2) the items shall be rinsed in clean water; (3) the items shall be submerged in a sanitizing solution for at least two minutes or in accordance with the instructions on the label of the sanitizing solution; and (4) the items shall be air dried. Indicator: 3.2 (see pages: 26-27 in the ITERS-R) This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The children's hands were washed as needed. The teachers and staff members washed their hands 30% of the time. A teacher or staff member did not wash their hands upon arrival or reentry to the classroom prior to touching classrooms materials. The teachers and a staff member did not wash their hands after outdoor play or after several instances of removing mouthed toys. This is a potential violation of the following Child Care requirements: 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. Observations today: Two instances of handwashing occurred when children can indoors from outside in classroom spaces 9 and 2. In classroom space 9, children we directed to wash hands at two (2) handwashing sinks prior to choosing a free-choice center. Continue to work with the children on either leaving the faucet on for the next child or using a paper towel to turn off the water. In classroom space 2, children were guided to sit on the rug to wait for their turn to wash hands. Children in this age group struggled to sit for an extended period of time. We discussed the use of transition toys, toys that children are allowed to touch while waiting to wash hands. These toys must then be removed and properly sanitized before being used again. Item 29 Indicator: 3.1 (see pages: 50 in the ITERS-R) Score: 2 pts. Assessor Comments: The concern regarding the diapering routines for four of the eight children, as noted in item 9, applies here as well. Observations today: See item 9. The following violations were cited during the visit today: Violation Number Comment Rule 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. In classroom space 2, three (3) cots measured nine (9), twelve (12) and fifteen (15) inches apart from other cots. 15A NCAC 18A .2821(e) Technical Assistance provided as follows: Item #614 We discussed possible solutions to the temporary space limitations present in this classroom. We discussed reconfiguring the layout to allow for eighteen (18) inches of space between mats. We discussed reaching out to Environmental Health or Child Care Health Consultants for ideas on acceptable partitions. 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (e) When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children. 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 8/27/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation provided as follows: We discussed the supervision requirements while children are eating. Staff must be able to see and hear children while they are eating. If backs are turned to the children, they cannot see them. In classroom space 2, both caregivers had their backs turned to children for a very short period of time while children were eating. We discussed positioning the staff member preparing plates for the children. In your other classrooms, staff perform this task at a table, facing the children who are eating, which allows them to look up to see the children periodically as they prepare and serve plates. This allows for constant supervision to occur while children are eating. Plan to enact a similar routine in classroom space 2. We discussed the table and cart could be moved slightly away from the wall to allow for the staff preparing plates to see the children eating. We discussed that you would like to reopen classroom space 5 as a mixed age classroom. Please see the following rules we discussed today regarding age grouping: 10A NCAC 09 .0713 STAFF/CHILD RATIOS FOR CENTERS (3) a child two years of age and older may be placed with children under one year of age when a physician certifies that the developmental age of the child makes this placement appropriate; (5) except as provided in Subparagraphs (2) and (3) of this Paragraph, children under one year of age shall be kept separate from children two years of age and over; You stated that you would like to move forward with completing the Rated License Reassessment process. The Rated License Reassessment packet and the Staff Information Sheet is included in the email containing this visit summary. Please complete the attached forms and return to me when you are ready to move forward with your Rated License Reassessment. The facility currently operates on a Provisional License due to lead. We discussed that changes cannot occur to your license until this Provisional is lifted. Program Standards: We discussed that you will elect to use the scored received from the ECERS assessment on 5/15/24 and 5/7/24 and the ITERS assessment on 4/30/24 toward your Rated License Reassessment. Your facility currently meets reduced ratios and enhanced space requirements. Education Points: We discussed that your current licensed is calculated with 7 points in education standards. Ensure all staff have their education evaluated by WORKS and their most up-to-date WORKS letter is on file. Plan to review sections .2819, .2820, and .2821 to see what is needed to achieve seven points in education standards. Quality Point: We discussed you are currently meeting your quality point through staff benefits package and infrastructure of parent involvement. A quality point form is attached to the email containing this visit summary. Plan to review the current quality point options in section .2829 of the Chapter 9 Child Care Rules. A Rated License Assessment visit will need to be conducted prior to the Rated License being processed. This visit can be announced. Once the Rated License Reassessment application is received and reviewed, we can discuss possible dates for this visit to occur. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1801 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 8/13/2024 Number Present: 69 Completed Date: 8/13/2024 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: ERS Announced/Unannounced: Announced The purpose of today’s announced visit was to review the results of your Environment Rating Scale (ERS) conducted on 4/30/24, 5/7/24, 5/15/24. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Mary Virella, during the visit. A signed copy of the visit summary was emailed to you. Ms. Virella and Alesia Summey, Director of Early Learning, were present and available to ask and answer questions throughout the visit today. ERS summaries were reviewed today and items scoring less than a three could constitute a violation of child care requirements and therefore were monitored. These items are noted below: ECERS-R assessment – 5/15/24 Total score – 5.68 Item 10 Indicator: 3.3 (see pages: 24-25 in the ECERS-R) Score: 2 pts Assessor Comments: This indicator requires that eating surfaces are cleaned with soapy water, and then sprayed with a sanitizing solution that is allowed to air dry on the surface for at least 2 minutes. The table was not cleaned or sanitized before or after a child ate breakfast. Before lunch, the three tables were cleaned and sanitized as needed. After lunch, two of the tables were cleaned and sanitized. Please refer to the NC Additional Notes for more information. This is a potential violation of the following requirement: 15A NCAC 18A .2822 TOYS, EQUIPMENT AND FURNITURE (a) Toys, equipment, and furniture provided by a child care center shall be kept clean and in good repair. In rooms designated for children who are not toilet trained, toys and other mouth-contact surfaces that are used by children shall be cleaned and then sanitized after each use and when visibly dirty. Toys and other mouth-contact surfaces shall be cleaned and sanitized as follows: (1) the items shall be scrubbed in warm, soapy water, using a brush to reach into any crevices; (2) the items shall be rinsed in clean water; (3) the items shall be submerged in a sanitizing solution for at least two minutes or in accordance with the instructions on the label of the sanitizing solution; and (4) the items shall be air dried. Observations today: One instance of table cleaning was observed today in classroom space 2. The tables were cleaned with soapy water, sprayed with sanitizing solution, and left to dry for two minutes prior to drying the tables. In classroom space 7, the tables appeared wet with sanitizing solution while children were outdoors playing. Item 22 Indicator: 3.2 (see pages: 26-27 in the ECERS-R) Score: 2 pts Assessor Comments: The children slept with soft toys from the reading area. Since these toys could be used by all of the children during center play, this does not meet sanitary requirements for nap time. During the transition to rest time six cots were stepped or laid on by other children. Although one child's sheet was changed, the other children were not provided with clean bedding prior to rest time. This is a potential violation of the following requirement: 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (c) Beds, cots, and mats shall be assigned and labeled for use by an individual child and equipped with individual linens. Observations today: You stated today that children now bring soft toys from home or choose a toy from the center that stays with the same child throughout the week or until visibly soiled. Soft toys used for rest time are not longer shared. Additionally, you shared that staff wait to place the cots down until children are ready to rest to limit possibility of contaminating clean sheets. Item 13 Indicator: 3.1 (see pages: 30-31 in the ECERS-R) Score: 2 pts Assessor Comments: This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The teachers and staff members washed their hands as needed. The children washed their hands 55% of the time when needed. Several children did not wash their hands upon arrival or after returning to the classroom from the gross motor room before they handled classroom materials. There were many instances when children used play dough or sand and did not wash their hands afterwards. This is a potential violation of the following requirement: 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. Observations today: Two instances of handwashing occurred when children can indoors from outside in classroom spaces 9 and 2. In classroom space 9, children we directed to wash hands at two (2) handwashing sinks prior to choosing a free-choice center. Continue to work with the children on either leaving the faucet on for the next child or using a paper towel to turn off the water. In classroom space 2, children were guided to sit on the rug to wait for their turn to wash hands. Children in this age group struggled to sit for an extended period of time. We discussed the use of transition toys, toys that children are allowed to touch while waiting to wash hands. Item 14 Indicator: 3.1 (see pages: 32-33 in the ECERS-R) Score: 2 pts Assessor Comments: There were no safety concerns outdoors. Indoors, a teacher sprayed a table with sanitizer as a child sat on the floor next to the table. The mist from the sanitizer is a potential eye/lung irritant for young children. This is a potential violation of the following requirement: 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Observations today: In classroom space 2, children were redirected back to toys away from tables as they were being cleaned. Item 27 Indicator: 3.1 (see pages: 54-55 in the ECERS-R) Score: 1 pt Assessor Comments: The teacher reported that children watched "Polar Express" which does not meet the requirements of this indicator because it shows frightening and/or violent content. Indicator: 3.3 (see pages: 54-55 in the ECERS-R) Score: 1 pt Assessor Comments: The teacher reported that the children watched a movie that lasted 50 minutes. This is a potential violation of the following requirement: 10A NCAC 09 .0510 ACTIVITY AREAS (d) When preschool children three years old and older are in care the following shall apply: (2) when screen time is provided on any electronic media device with a visual display, it shall be: (A) offered to stimulate a developmental domain in accordance with the North Carolina Foundations for Early Learning and Development as referenced in Rule .0508 of this Section; (B) limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and (C) documented on a cumulative log or the activity plan that shall be available for review by the Division. (f) Screen time, including television, videos, video games, and computer usage, shall be prohibited for children under three years of age. Observations today: We reviewed the requirements of screen time for children ages 3 and up. Screen time must be limited to thirty (30) minutes per day. We discussed splitting movies for special occasions into two (2) or more viewing sessions on different days to ensure this requirement is met. ECERS-R assessment – 5/7/24 Total score – 5.39 Item 10 Indicator: 3.3 (see pages: 24-25 in the ECERS-R) Score: 2 pts Assessor Comments: This indicator requires that eating surfaces are cleaned with soapy water, and then sprayed with a sanitizing solution that is allowed to air dry on the surface for at least 2 minutes. After breakfast the tables were cleaned with soapy water; however, they were not sprayed with sanitizer. Before lunch the tables were cleaned and sanitized appropriately. Please refer to the NC Additional Notes for more information. This is a potential violation of the following requirement: 15A NCAC 18A .2822 TOYS, EQUIPMENT AND FURNITURE (a) Toys, equipment, and furniture provided by a child care center shall be kept clean and in good repair. In rooms designated for children who are not toilet trained, toys and other mouth-contact surfaces that are used by children shall be cleaned and then sanitized after each use and when visibly dirty. Toys and other mouth-contact surfaces shall be cleaned and sanitized as follows: (1) the items shall be scrubbed in warm, soapy water, using a brush to reach into any crevices; (2) the items shall be rinsed in clean water; (3) the items shall be submerged in a sanitizing solution for at least two minutes or in accordance with the instructions on the label of the sanitizing solution; and (4) the items shall be air dried. Observations today: One instance of table cleaning was observed today in classroom space 2. The tables were cleaned with soapy water, sprayed with sanitizing solution, and left to dry for two minutes prior to drying the tables. In classroom space 7, the tables appeared wet with sanitizing solution while children were outdoors playing. Item 11 Indicator: 3.2 (see pages: 26-27 in the ECERS-R) Score: 2 pts. Assessor Comments: A cot by the drawer with musical instruments was 17 inches from a cot near the light table. Although there was a shelf between the cots, the shelf did not extend to the full length of the cots to allow for closer spacing. Two cots on either side of the wooden bench in the reading area were 15 inches apart, rather than at least 18 inches. The bench between the cots did not extend the full length of the cots to allow for closer spacing. This is a potential violation of the following requirement: 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (e) When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children. Observations today: We discussed reaching out to Environmental Health or Child Care Health Consultants for guidance on appropriate partitions that can be used to separate mats during rest time. Item 34 Indicator: 3.3 (see pages: 63 in the ECERS-R) Score: 2 pts. Assessor Comments: The children play indoors daily, meeting a part of the indicator's requirements. On the day of the observation, the teacher stated that the ground was wet and there were big puddles, and when this occurs they go outside in the afternoon after the water subsides and play for 40 minutes. Wet ground and puddles do not pose a health or safety concern for children who are dressed for the condition. Therefore, children do not play outdoors each day for 1 hour when the weather allows. This is a potential violation for the following requirement: 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS Program Operating Hours: All programs Ages of Children: Under 2 years Minimum Daily Outdoor Time: 30 minutes Program Operating Hours: Less than 5 hours Ages of Children: 0-12 years Minimum Daily Outdoor Time: 30 minutes Program Operating Hours: 5 hours or more Ages of Children: 2-12 years Minimum Daily Outdoor Time: 60 minutes (c) When children are in care and weather conditions permit, there shall be outdoor time, either as part of a small group, a whole group, or individual activity, for no less than the following durations: Observations today: You clarified that children are permitted to play outside in all weather conditions except for heavy rains. You clarified that if the time requirements are not met in the morning, children go outside in the afternoon to meet the one (1) hour time requirement. ITERS-R assessment- 4/30/24 Total Score: 5.17 Item 6 Indicator: 3.4 (see pages: 18-19 in the ITERS-R) Score: 2 pts. Assessor Comments: Two arrivals occurred the morning of the assessment. During the first arrival, the parent talked to the teachers about the child's morning. However, information about the child's health or safety was not shared during the second arrival. This is not a potential violation of Child Care requirements. Observations today: You stated today that teachers and parents discuss information about the children at drop off as regular practice. Item 7 Indicator: 3.1 (see pages: 20-21 in the ITERS-R) Score: 1 pts. Assessor Comments: As the observation began, four children were seated at the tables for breakfast. Water was not offered to these four children between breakfast and lunch time. This is not a potential violation of child care requirements. Please see the guidance in rule below: 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (e) Drinking water shall be freely available to children of all ages. Drinking fountains or individual drinking utensils shall be provided. When a private water supply is used, it must be tested by and meet the requirements of the Commission for Public Health as set forth in 15A NCAC 18A .2800. Observations today: A water jug was present in the classroom. You stated that children are able to access water when they request it. Indicator: 3.4 (see pages 20-21 in the ITERS-R) Assessor Comments: Towards the end of breakfast, as some children continued to eat and drink, a teacher engaged in play with a group of children in the book area while the other teacher pushed the meal cart out of the classroom door. Because the teachers engaged in other activities away from the tables as some children ate and drank, credit could not be earned. This is a potential violation of the following Child Care requirement: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (5) staff must be able to see and hear children aged birth to five years old while the children are eating. Observations today: Two (2) staff were present in classroom space 2 as lunch was being served. Children played with magnatiles on the rug and were called one by one to wash hands. After washing hands, the child sat at the table and was served lunch. One (1) staff prepared plates facing the door with their back turned to the children eating. One (1) staff helped children wash hands, and was positioned to face the children eating. A child needed assistance with self care. The staff member assisting children with washing hands picked up the child and brought them into the diaper changing area to assist. The staff member preparing plates had their back turned to the children when this occurred. Indicator: 3.5 (see pages 20-21 in the ITERS-R) Assessor Comments: The teacher reported that a child enrolled is allergic to eggs. It was further reported that another child is allergic to pineapples and an additional child is allergic to peanuts. Proper substitutions were reported to be made and this information was posted in the classroom. Also, the teacher confirmed that a fourth child enrolled in the group has a peanut allergy and proper substitutions were reported to be made. However, this information was not included on the allergy list posted in the classroom. This is a potential violation of the following Child Care requirement: 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. Observations today: You stated that the second child allergic to peanuts had left the facility prior to the assessment and was no longer enrolled in the classroom during the assessment. The allergy list was reviewed today. You confirmed the allergy list is accurate and up to date. Item 8 Indicator: 3.2 (see pages: 22-23 in the ITERS-R) Score: 2 pts. Assessor Comments: There were several cots spaced between 21 inches to 33 inches apart, rather than at least 36 inches apart. Also, during the transition to nap, many children lay or stepped on two cots in the block area. The bedding on these cots was not replaced before rest time. This is a potential violation of the following child care requirements: 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (e) When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children. 10A NCAC 09 .0806 TOILETING, CLOTHING AND LINENS (c) A supply of clean linens must be on hand so that linens can be changed whenever they become soiled or wet. Observations today: The facility is currently under a provisional license for lead hazards. In classroom space 2, lead was found in the window sill of the classroom. Currently, all the shelves in the classrooms have been moved against wall with the contaminated window sill to prevent children from mouthing the surface. You stated this prevention plan has been approved by Environmental Health. However, this arrangement removes shelves as a potential barrier for mats during nap time. Classroom space 2 was observed during nap time. Three (3) cots were measured at nine (9), twelve (12) and fifteen (15) inches from other cots. Item 9 Indicator: 3.2 (see pages: 26-27 in the ITERS-R) Score: 2 pts. Assessor Comments: All eight children present wore diapers. Diaper changes occurred within the required 2 hour time frame for four children. The observed span of time during which a check or change did not occur for the remaining four children was 2 hours 17 minutes to 2 hours 26 minutes. This is not a violation of child care requirements. Please see the guidance in rule below: 10A NCAC 09 .0806 TOILETING, CLOTHING AND LINENS (a) Diapers shall be changed whenever they become soiled or wet and not on a shift basis. Observations today: You stated today that diapers are checked and changed every one and a half (1.5) hours or when soiled- whichever comes first. Item 10 Indicator: 3.1 (see pages: 26-27 in the ITERS-R) Score: 2 pts. Assessor Comments: Although five mouthed toys were removed, there were several additional mouthed items that were not removed before being used by other children. This is a potential violation of the following child care rule: 15A NCAC 18A .2822 TOYS, EQUIPMENT AND FURNITURE (a) Toys, equipment, and furniture provided by a child care center shall be kept clean and in good repair. In rooms designated for children who are not toilet trained, toys and other mouth-contact surfaces that are used by children shall be cleaned and then sanitized after each use and when visibly dirty. Toys and other mouth-contact surfaces shall be cleaned and sanitized as follows: (1) the items shall be scrubbed in warm, soapy water, using a brush to reach into any crevices; (2) the items shall be rinsed in clean water; (3) the items shall be submerged in a sanitizing solution for at least two minutes or in accordance with the instructions on the label of the sanitizing solution; and (4) the items shall be air dried. Indicator: 3.2 (see pages: 26-27 in the ITERS-R) This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The children's hands were washed as needed. The teachers and staff members washed their hands 30% of the time. A teacher or staff member did not wash their hands upon arrival or reentry to the classroom prior to touching classrooms materials. The teachers and a staff member did not wash their hands after outdoor play or after several instances of removing mouthed toys. This is a potential violation of the following Child Care requirements: 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. Observations today: Two instances of handwashing occurred when children can indoors from outside in classroom spaces 9 and 2. In classroom space 9, children we directed to wash hands at two (2) handwashing sinks prior to choosing a free-choice center. Continue to work with the children on either leaving the faucet on for the next child or using a paper towel to turn off the water. In classroom space 2, children were guided to sit on the rug to wait for their turn to wash hands. Children in this age group struggled to sit for an extended period of time. We discussed the use of transition toys, toys that children are allowed to touch while waiting to wash hands. These toys must then be removed and properly sanitized before being used again. Item 29 Indicator: 3.1 (see pages: 50 in the ITERS-R) Score: 2 pts. Assessor Comments: The concern regarding the diapering routines for four of the eight children, as noted in item 9, applies here as well. Observations today: See item 9. The following violations were cited during the visit today: Violation Number Comment Rule 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. In classroom space 2, three (3) cots measured nine (9), twelve (12) and fifteen (15) inches apart from other cots. 15A NCAC 18A .2821(e) Technical Assistance provided as follows: Item #614 We discussed possible solutions to the temporary space limitations present in this classroom. We discussed reconfiguring the layout to allow for eighteen (18) inches of space between mats. We discussed reaching out to Environmental Health or Child Care Health Consultants for ideas on acceptable partitions. 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (e) When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children. 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 8/27/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation provided as follows: We discussed the supervision requirements while children are eating. Staff must be able to see and hear children while they are eating. If backs are turned to the children, they cannot see them. In classroom space 2, both caregivers had their backs turned to children for a very short period of time while children were eating. We discussed positioning the staff member preparing plates for the children. In your other classrooms, staff perform this task at a table, facing the children who are eating, which allows them to look up to see the children periodically as they prepare and serve plates. This allows for constant supervision to occur while children are eating. Plan to enact a similar routine in classroom space 2. We discussed the table and cart could be moved slightly away from the wall to allow for the staff preparing plates to see the children eating. We discussed that you would like to reopen classroom space 5 as a mixed age classroom. Please see the following rules we discussed today regarding age grouping: 10A NCAC 09 .0713 STAFF/CHILD RATIOS FOR CENTERS (3) a child two years of age and older may be placed with children under one year of age when a physician certifies that the developmental age of the child makes this placement appropriate; (5) except as provided in Subparagraphs (2) and (3) of this Paragraph, children under one year of age shall be kept separate from children two years of age and over; You stated that you would like to move forward with completing the Rated License Reassessment process. The Rated License Reassessment packet and the Staff Information Sheet is included in the email containing this visit summary. Please complete the attached forms and return to me when you are ready to move forward with your Rated License Reassessment. The facility currently operates on a Provisional License due to lead. We discussed that changes cannot occur to your license until this Provisional is lifted. Program Standards: We discussed that you will elect to use the scored received from the ECERS assessment on 5/15/24 and 5/7/24 and the ITERS assessment on 4/30/24 toward your Rated License Reassessment. Your facility currently meets reduced ratios and enhanced space requirements. Education Points: We discussed that your current licensed is calculated with 7 points in education standards. Ensure all staff have their education evaluated by WORKS and their most up-to-date WORKS letter is on file. Plan to review sections .2819, .2820, and .2821 to see what is needed to achieve seven points in education standards. Quality Point: We discussed you are currently meeting your quality point through staff benefits package and infrastructure of parent involvement. A quality point form is attached to the email containing this visit summary. Plan to review the current quality point options in section .2829 of the Chapter 9 Child Care Rules. A Rated License Assessment visit will need to be conducted prior to the Rated License being processed. This visit can be announced. Once the Rated License Reassessment application is received and reviewed, we can discuss possible dates for this visit to occur. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 8/13/2024 Number Present: 69 Completed Date: 8/13/2024 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: ERS Announced/Unannounced: Announced The purpose of today’s announced visit was to review the results of your Environment Rating Scale (ERS) conducted on 4/30/24, 5/7/24, 5/15/24. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Kaitlyn Marshall, Child Care Consultant and also signed by Mary Virella, during the visit. A signed copy of the visit summary was emailed to you. Ms. Virella and Alesia Summey, Director of Early Learning, were present and available to ask and answer questions throughout the visit today. ERS summaries were reviewed today and items scoring less than a three could constitute a violation of child care requirements and therefore were monitored. These items are noted below: ECERS-R assessment – 5/15/24 Total score – 5.68 Item 10 Indicator: 3.3 (see pages: 24-25 in the ECERS-R) Score: 2 pts Assessor Comments: This indicator requires that eating surfaces are cleaned with soapy water, and then sprayed with a sanitizing solution that is allowed to air dry on the surface for at least 2 minutes. The table was not cleaned or sanitized before or after a child ate breakfast. Before lunch, the three tables were cleaned and sanitized as needed. After lunch, two of the tables were cleaned and sanitized. Please refer to the NC Additional Notes for more information. This is a potential violation of the following requirement: 15A NCAC 18A .2822 TOYS, EQUIPMENT AND FURNITURE (a) Toys, equipment, and furniture provided by a child care center shall be kept clean and in good repair. In rooms designated for children who are not toilet trained, toys and other mouth-contact surfaces that are used by children shall be cleaned and then sanitized after each use and when visibly dirty. Toys and other mouth-contact surfaces shall be cleaned and sanitized as follows: (1) the items shall be scrubbed in warm, soapy water, using a brush to reach into any crevices; (2) the items shall be rinsed in clean water; (3) the items shall be submerged in a sanitizing solution for at least two minutes or in accordance with the instructions on the label of the sanitizing solution; and (4) the items shall be air dried. Observations today: One instance of table cleaning was observed today in classroom space 2. The tables were cleaned with soapy water, sprayed with sanitizing solution, and left to dry for two minutes prior to drying the tables. In classroom space 7, the tables appeared wet with sanitizing solution while children were outdoors playing. Item 22 Indicator: 3.2 (see pages: 26-27 in the ECERS-R) Score: 2 pts Assessor Comments: The children slept with soft toys from the reading area. Since these toys could be used by all of the children during center play, this does not meet sanitary requirements for nap time. During the transition to rest time six cots were stepped or laid on by other children. Although one child's sheet was changed, the other children were not provided with clean bedding prior to rest time. This is a potential violation of the following requirement: 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (c) Beds, cots, and mats shall be assigned and labeled for use by an individual child and equipped with individual linens. Observations today: You stated today that children now bring soft toys from home or choose a toy from the center that stays with the same child throughout the week or until visibly soiled. Soft toys used for rest time are not longer shared. Additionally, you shared that staff wait to place the cots down until children are ready to rest to limit possibility of contaminating clean sheets. Item 13 Indicator: 3.1 (see pages: 30-31 in the ECERS-R) Score: 2 pts Assessor Comments: This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The teachers and staff members washed their hands as needed. The children washed their hands 55% of the time when needed. Several children did not wash their hands upon arrival or after returning to the classroom from the gross motor room before they handled classroom materials. There were many instances when children used play dough or sand and did not wash their hands afterwards. This is a potential violation of the following requirement: 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. Observations today: Two instances of handwashing occurred when children can indoors from outside in classroom spaces 9 and 2. In classroom space 9, children we directed to wash hands at two (2) handwashing sinks prior to choosing a free-choice center. Continue to work with the children on either leaving the faucet on for the next child or using a paper towel to turn off the water. In classroom space 2, children were guided to sit on the rug to wait for their turn to wash hands. Children in this age group struggled to sit for an extended period of time. We discussed the use of transition toys, toys that children are allowed to touch while waiting to wash hands. Item 14 Indicator: 3.1 (see pages: 32-33 in the ECERS-R) Score: 2 pts Assessor Comments: There were no safety concerns outdoors. Indoors, a teacher sprayed a table with sanitizer as a child sat on the floor next to the table. The mist from the sanitizer is a potential eye/lung irritant for young children. This is a potential violation of the following requirement: 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Observations today: In classroom space 2, children were redirected back to toys away from tables as they were being cleaned. Item 27 Indicator: 3.1 (see pages: 54-55 in the ECERS-R) Score: 1 pt Assessor Comments: The teacher reported that children watched "Polar Express" which does not meet the requirements of this indicator because it shows frightening and/or violent content. Indicator: 3.3 (see pages: 54-55 in the ECERS-R) Score: 1 pt Assessor Comments: The teacher reported that the children watched a movie that lasted 50 minutes. This is a potential violation of the following requirement: 10A NCAC 09 .0510 ACTIVITY AREAS (d) When preschool children three years old and older are in care the following shall apply: (2) when screen time is provided on any electronic media device with a visual display, it shall be: (A) offered to stimulate a developmental domain in accordance with the North Carolina Foundations for Early Learning and Development as referenced in Rule .0508 of this Section; (B) limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and (C) documented on a cumulative log or the activity plan that shall be available for review by the Division. (f) Screen time, including television, videos, video games, and computer usage, shall be prohibited for children under three years of age. Observations today: We reviewed the requirements of screen time for children ages 3 and up. Screen time must be limited to thirty (30) minutes per day. We discussed splitting movies for special occasions into two (2) or more viewing sessions on different days to ensure this requirement is met. ECERS-R assessment – 5/7/24 Total score – 5.39 Item 10 Indicator: 3.3 (see pages: 24-25 in the ECERS-R) Score: 2 pts Assessor Comments: This indicator requires that eating surfaces are cleaned with soapy water, and then sprayed with a sanitizing solution that is allowed to air dry on the surface for at least 2 minutes. After breakfast the tables were cleaned with soapy water; however, they were not sprayed with sanitizer. Before lunch the tables were cleaned and sanitized appropriately. Please refer to the NC Additional Notes for more information. This is a potential violation of the following requirement: 15A NCAC 18A .2822 TOYS, EQUIPMENT AND FURNITURE (a) Toys, equipment, and furniture provided by a child care center shall be kept clean and in good repair. In rooms designated for children who are not toilet trained, toys and other mouth-contact surfaces that are used by children shall be cleaned and then sanitized after each use and when visibly dirty. Toys and other mouth-contact surfaces shall be cleaned and sanitized as follows: (1) the items shall be scrubbed in warm, soapy water, using a brush to reach into any crevices; (2) the items shall be rinsed in clean water; (3) the items shall be submerged in a sanitizing solution for at least two minutes or in accordance with the instructions on the label of the sanitizing solution; and (4) the items shall be air dried. Observations today: One instance of table cleaning was observed today in classroom space 2. The tables were cleaned with soapy water, sprayed with sanitizing solution, and left to dry for two minutes prior to drying the tables. In classroom space 7, the tables appeared wet with sanitizing solution while children were outdoors playing. Item 11 Indicator: 3.2 (see pages: 26-27 in the ECERS-R) Score: 2 pts. Assessor Comments: A cot by the drawer with musical instruments was 17 inches from a cot near the light table. Although there was a shelf between the cots, the shelf did not extend to the full length of the cots to allow for closer spacing. Two cots on either side of the wooden bench in the reading area were 15 inches apart, rather than at least 18 inches. The bench between the cots did not extend the full length of the cots to allow for closer spacing. This is a potential violation of the following requirement: 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (e) When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children. Observations today: We discussed reaching out to Environmental Health or Child Care Health Consultants for guidance on appropriate partitions that can be used to separate mats during rest time. Item 34 Indicator: 3.3 (see pages: 63 in the ECERS-R) Score: 2 pts. Assessor Comments: The children play indoors daily, meeting a part of the indicator's requirements. On the day of the observation, the teacher stated that the ground was wet and there were big puddles, and when this occurs they go outside in the afternoon after the water subsides and play for 40 minutes. Wet ground and puddles do not pose a health or safety concern for children who are dressed for the condition. Therefore, children do not play outdoors each day for 1 hour when the weather allows. This is a potential violation for the following requirement: 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS Program Operating Hours: All programs Ages of Children: Under 2 years Minimum Daily Outdoor Time: 30 minutes Program Operating Hours: Less than 5 hours Ages of Children: 0-12 years Minimum Daily Outdoor Time: 30 minutes Program Operating Hours: 5 hours or more Ages of Children: 2-12 years Minimum Daily Outdoor Time: 60 minutes (c) When children are in care and weather conditions permit, there shall be outdoor time, either as part of a small group, a whole group, or individual activity, for no less than the following durations: Observations today: You clarified that children are permitted to play outside in all weather conditions except for heavy rains. You clarified that if the time requirements are not met in the morning, children go outside in the afternoon to meet the one (1) hour time requirement. ITERS-R assessment- 4/30/24 Total Score: 5.17 Item 6 Indicator: 3.4 (see pages: 18-19 in the ITERS-R) Score: 2 pts. Assessor Comments: Two arrivals occurred the morning of the assessment. During the first arrival, the parent talked to the teachers about the child's morning. However, information about the child's health or safety was not shared during the second arrival. This is not a potential violation of Child Care requirements. Observations today: You stated today that teachers and parents discuss information about the children at drop off as regular practice. Item 7 Indicator: 3.1 (see pages: 20-21 in the ITERS-R) Score: 1 pts. Assessor Comments: As the observation began, four children were seated at the tables for breakfast. Water was not offered to these four children between breakfast and lunch time. This is not a potential violation of child care requirements. Please see the guidance in rule below: 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (e) Drinking water shall be freely available to children of all ages. Drinking fountains or individual drinking utensils shall be provided. When a private water supply is used, it must be tested by and meet the requirements of the Commission for Public Health as set forth in 15A NCAC 18A .2800. Observations today: A water jug was present in the classroom. You stated that children are able to access water when they request it. Indicator: 3.4 (see pages 20-21 in the ITERS-R) Assessor Comments: Towards the end of breakfast, as some children continued to eat and drink, a teacher engaged in play with a group of children in the book area while the other teacher pushed the meal cart out of the classroom door. Because the teachers engaged in other activities away from the tables as some children ate and drank, credit could not be earned. This is a potential violation of the following Child Care requirement: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (5) staff must be able to see and hear children aged birth to five years old while the children are eating. Observations today: Two (2) staff were present in classroom space 2 as lunch was being served. Children played with magnatiles on the rug and were called one by one to wash hands. After washing hands, the child sat at the table and was served lunch. One (1) staff prepared plates facing the door with their back turned to the children eating. One (1) staff helped children wash hands, and was positioned to face the children eating. A child needed assistance with self care. The staff member assisting children with washing hands picked up the child and brought them into the diaper changing area to assist. The staff member preparing plates had their back turned to the children when this occurred. Indicator: 3.5 (see pages 20-21 in the ITERS-R) Assessor Comments: The teacher reported that a child enrolled is allergic to eggs. It was further reported that another child is allergic to pineapples and an additional child is allergic to peanuts. Proper substitutions were reported to be made and this information was posted in the classroom. Also, the teacher confirmed that a fourth child enrolled in the group has a peanut allergy and proper substitutions were reported to be made. However, this information was not included on the allergy list posted in the classroom. This is a potential violation of the following Child Care requirement: 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. Observations today: You stated that the second child allergic to peanuts had left the facility prior to the assessment and was no longer enrolled in the classroom during the assessment. The allergy list was reviewed today. You confirmed the allergy list is accurate and up to date. Item 8 Indicator: 3.2 (see pages: 22-23 in the ITERS-R) Score: 2 pts. Assessor Comments: There were several cots spaced between 21 inches to 33 inches apart, rather than at least 36 inches apart. Also, during the transition to nap, many children lay or stepped on two cots in the block area. The bedding on these cots was not replaced before rest time. This is a potential violation of the following child care requirements: 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (e) When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children. 10A NCAC 09 .0806 TOILETING, CLOTHING AND LINENS (c) A supply of clean linens must be on hand so that linens can be changed whenever they become soiled or wet. Observations today: The facility is currently under a provisional license for lead hazards. In classroom space 2, lead was found in the window sill of the classroom. Currently, all the shelves in the classrooms have been moved against wall with the contaminated window sill to prevent children from mouthing the surface. You stated this prevention plan has been approved by Environmental Health. However, this arrangement removes shelves as a potential barrier for mats during nap time. Classroom space 2 was observed during nap time. Three (3) cots were measured at nine (9), twelve (12) and fifteen (15) inches from other cots. Item 9 Indicator: 3.2 (see pages: 26-27 in the ITERS-R) Score: 2 pts. Assessor Comments: All eight children present wore diapers. Diaper changes occurred within the required 2 hour time frame for four children. The observed span of time during which a check or change did not occur for the remaining four children was 2 hours 17 minutes to 2 hours 26 minutes. This is not a violation of child care requirements. Please see the guidance in rule below: 10A NCAC 09 .0806 TOILETING, CLOTHING AND LINENS (a) Diapers shall be changed whenever they become soiled or wet and not on a shift basis. Observations today: You stated today that diapers are checked and changed every one and a half (1.5) hours or when soiled- whichever comes first. Item 10 Indicator: 3.1 (see pages: 26-27 in the ITERS-R) Score: 2 pts. Assessor Comments: Although five mouthed toys were removed, there were several additional mouthed items that were not removed before being used by other children. This is a potential violation of the following child care rule: 15A NCAC 18A .2822 TOYS, EQUIPMENT AND FURNITURE (a) Toys, equipment, and furniture provided by a child care center shall be kept clean and in good repair. In rooms designated for children who are not toilet trained, toys and other mouth-contact surfaces that are used by children shall be cleaned and then sanitized after each use and when visibly dirty. Toys and other mouth-contact surfaces shall be cleaned and sanitized as follows: (1) the items shall be scrubbed in warm, soapy water, using a brush to reach into any crevices; (2) the items shall be rinsed in clean water; (3) the items shall be submerged in a sanitizing solution for at least two minutes or in accordance with the instructions on the label of the sanitizing solution; and (4) the items shall be air dried. Indicator: 3.2 (see pages: 26-27 in the ITERS-R) This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The children's hands were washed as needed. The teachers and staff members washed their hands 30% of the time. A teacher or staff member did not wash their hands upon arrival or reentry to the classroom prior to touching classrooms materials. The teachers and a staff member did not wash their hands after outdoor play or after several instances of removing mouthed toys. This is a potential violation of the following Child Care requirements: 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. Observations today: Two instances of handwashing occurred when children can indoors from outside in classroom spaces 9 and 2. In classroom space 9, children we directed to wash hands at two (2) handwashing sinks prior to choosing a free-choice center. Continue to work with the children on either leaving the faucet on for the next child or using a paper towel to turn off the water. In classroom space 2, children were guided to sit on the rug to wait for their turn to wash hands. Children in this age group struggled to sit for an extended period of time. We discussed the use of transition toys, toys that children are allowed to touch while waiting to wash hands. These toys must then be removed and properly sanitized before being used again. Item 29 Indicator: 3.1 (see pages: 50 in the ITERS-R) Score: 2 pts. Assessor Comments: The concern regarding the diapering routines for four of the eight children, as noted in item 9, applies here as well. Observations today: See item 9. The following violations were cited during the visit today: Violation Number Comment Rule 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. In classroom space 2, three (3) cots measured nine (9), twelve (12) and fifteen (15) inches apart from other cots. 15A NCAC 18A .2821(e) Technical Assistance provided as follows: Item #614 We discussed possible solutions to the temporary space limitations present in this classroom. We discussed reconfiguring the layout to allow for eighteen (18) inches of space between mats. We discussed reaching out to Environmental Health or Child Care Health Consultants for ideas on acceptable partitions. 15A NCAC 18A .2821 BEDS, COTS, MATS, AND LINENS (e) When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children. 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 8/27/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation provided as follows: We discussed the supervision requirements while children are eating. Staff must be able to see and hear children while they are eating. If backs are turned to the children, they cannot see them. In classroom space 2, both caregivers had their backs turned to children for a very short period of time while children were eating. We discussed positioning the staff member preparing plates for the children. In your other classrooms, staff perform this task at a table, facing the children who are eating, which allows them to look up to see the children periodically as they prepare and serve plates. This allows for constant supervision to occur while children are eating. Plan to enact a similar routine in classroom space 2. We discussed the table and cart could be moved slightly away from the wall to allow for the staff preparing plates to see the children eating. We discussed that you would like to reopen classroom space 5 as a mixed age classroom. Please see the following rules we discussed today regarding age grouping: 10A NCAC 09 .0713 STAFF/CHILD RATIOS FOR CENTERS (3) a child two years of age and older may be placed with children under one year of age when a physician certifies that the developmental age of the child makes this placement appropriate; (5) except as provided in Subparagraphs (2) and (3) of this Paragraph, children under one year of age shall be kept separate from children two years of age and over; You stated that you would like to move forward with completing the Rated License Reassessment process. The Rated License Reassessment packet and the Staff Information Sheet is included in the email containing this visit summary. Please complete the attached forms and return to me when you are ready to move forward with your Rated License Reassessment. The facility currently operates on a Provisional License due to lead. We discussed that changes cannot occur to your license until this Provisional is lifted. Program Standards: We discussed that you will elect to use the scored received from the ECERS assessment on 5/15/24 and 5/7/24 and the ITERS assessment on 4/30/24 toward your Rated License Reassessment. Your facility currently meets reduced ratios and enhanced space requirements. Education Points: We discussed that your current licensed is calculated with 7 points in education standards. Ensure all staff have their education evaluated by WORKS and their most up-to-date WORKS letter is on file. Plan to review sections .2819, .2820, and .2821 to see what is needed to achieve seven points in education standards. Quality Point: We discussed you are currently meeting your quality point through staff benefits package and infrastructure of parent involvement. A quality point form is attached to the email containing this visit summary. Plan to review the current quality point options in section .2829 of the Chapter 9 Child Care Rules. A Rated License Assessment visit will need to be conducted prior to the Rated License being processed. This visit can be announced. Once the Rated License Reassessment application is received and reviewed, we can discuss possible dates for this visit to occur. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0604 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 5/29/2024 Number Present: 85 Completed Date: 5/29/2024 Age: From 0 To 5 Total Minutes: 285 Time In: 09:15 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a Routine Unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Mary Virella-Minton, Program Coordinator, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. Virella-Minton was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, CPR / First Aid, special training, CBC qualification, ITS – SIDS, Emergency Medical Care plan, administration of medication, storage of hazardous products, storage of medication, general safety, discipline, adequate / approved space, program records, license posted, and permit restrictions. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight percent (88%) as of 5/28/24. The last fire drill was practiced on 4/26/24. The last emergency drill, lockdown drill, was practiced on 3/28/24. The last fire inspection was approved on 7/5/23. The program’s most recent sanitation inspection was completed on 2/13/24, with fifteen (15) demerits for a superior rating. The Emergency Medical Care Plan was posted and current. There are three (3) new staff. Three (3) new staff files were monitored today. Upon arrival I was greeted by Ms. Virella-Minton. In classroom space 1, one (1) child was napping and six (6) children were freely exploring their environment. One child was engaged in water play withing close proximity to a caregiver. Children explored rattlers and danced to music. In classroom space 2, children were engaged in a large group music and movement activity led by the teacher. Two (2) diaper changes were observed. In classroom space 3, children played outside on the infant/toddler playground. Children were observed climbing, sliding, stepping up on stumps and scooping mulch with dump trucks. Three children fell during the observation. Teachers responded to the children’s needs immediately and called for help to apply ice via walkie talkie. In classroom space 4, children were engaged in a large group music and movement activity with one teacher as the other teacher called children to use the restroom and wash hands. One (1) handwashing was observed. Children from classrooms 7 and 10 were playing outside on the Pre-K playground. Children were observed riding tricycles, playing basketball, and digging in the sandbox. Children explored the surrounding foliage at the fence line, observing plants and insects. In classroom space 9, children were engaged in sand play, built large structures with wooden blocks and animal and transportation figurines, built small structures with magnatiles, and counted and sorted rubber worms by color. Interactions were positive and nurturing. Supervision was adequate. Supervision was observed during meal time in classroom spaces 2, 3, and 4. Teachers were positioned to hear and see the children who were eating. In classroom space 2, five (5) children were eating as others were transitioning to wash hands and go to their cots. One (1) teacher helped children wash hands in the sink located within the eating area of the classroom and the other teacher helped children to their cots. As the teacher assisted the child washing hands, they turned their body so that they were positioned to see the children who remained eating at the tables. We discussed increasing communication with staff to ensure no lapses in supervision during this transition occur. Transportation was unable to be monitored during the Annual Compliance visit on 11/16/23 due to the vehicles not being on site during the visit. Transportation was monitored during the visit today. Currently, no children are being transported on a regular basis. The registration and inspection expire 11/30/24. The insurance expires on 7/1/24. One (1) bus was monitored during the visit today. A first aid kit and fire extinguisher were present on the vehicle. The driver holds a Commercial Drivers License that expires on 8/30/28. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were cited during the visit today: Violation Number Comment Rule 823 Toxic plants were accessible to children. Poison ivy was identified along the back fence line on the Pre-K playground. .0604(l) 853 Incident logs were not completed and maintained as required. An incident that occurred on 3/21/24 was not documented on the incident log. .0802(g)(1-6) 1898 Staff did not complete the health and safety training within one year of employment. One (1) staff, hire date 3/6/23, did not complete the topic of Administration of Medication within one (1) year of hire. .1102(a) 1911 An incident report was not completed and mailed to a Division representative within seven days after the incident when medical treatment was required. On 3/21/24, a four year old child was injured at the facility and received medical attention. The incident report was sent to the Child Care Consultant on 4/1/24. .0802(f) Technical Assistance provided as follows: Item #823 The poison ivy much be removed from areas accessible to children. I observed children exploring and picking leaves near the area in which poison ivy was identified. The Maintenance and Facilities department was contacted during the visit today and stated that they would spray a non-toxic solution on the foliage along the fence line. Supervision near the fence line was increased during the observation to ensure children did not go near the poison ivy. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (l) Toxic plants shall be inaccessible to children. A list of toxic plants may be found on the Division's website. Item #853 The incident that occurred on 3/21/24 was documented on the incident log during the visit today. This was corrected. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website. Item #1898 Staff LD must complete the topic of Administration of Medication immediately. As a reminder, this course must be search for separately in the Moodle. Once logged in, the staff can search “medication 2024” to find the most recent training in this topic. When the training has been completed, plan to place a copy of the staff member’s certificate in their file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. The following persons shall be exempt from this requirement: (1) staff members that do not have caregiving responsibilities for a child or group of children; (2) service providers such as speech therapists, occupational therapists, and physical therapists; and (3) substitute providers who provide services for less than 10 days in a 12-month period. (b) The health and safety training shall include the following topic areas: (1) Prevention and control of infectious diseases, including immunization; (2) Administration of medication, with standards for parental consent; (3) Prevention of and response to emergencies due to food and allergic reactions; (4) Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; (5) Emergency preparedness and response planning for emergencies resulting from a natural disaster, or a man-caused event; (6) Handling and storage of hazardous materials and the appropriate disposal of biocontaminants; (7) Precautions in transporting children, if applicable; (8) Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; (9) CPR and First Aid training as required in Paragraphs (c) and (d) of this Rule; (10) Recognizing and reporting child abuse, child neglect, and child maltreatment; and (11) Prevention of sudden infant death syndrome and use of safe sleeping practices. Item #1911 In your letter of compliance, include a statement that indicates how you will ensure incidents reports are mailed to me within seven (7) days, if the child seeks outside medical attention. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (f) When medical treatment is required by a health care professional, community clinic, or local health department as a result of an incident occurring while the child is in care, a copy of the incident report shall be mailed to a representative of the Division within seven calendar days after the incident. 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 6/12/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that, according to the Staff and Training Worksheet completed on 11/16/23, there are nine (9) staff whose CPR/First Aid certification expires on 6/3/24. The initials of these staff are provided as follows: LC, MC, TC, SN, JP, JP, AR, MVM, LW. Plan to schedule an obtain a CPR/First Aid training for these staff and new hire AS immediately. New hire CS cannot work in the infant room until they receive ITS-SIDS training. The mulch on the infant/toddler playground around the climbing structure measured six (6) to eight (8) inches deep. However, the mulch has become packed down and needs to be raked. On the infant/toddler playground, there is a bush that has grown in the back left corner near the fence line. Children were observed hiding behind the bush, exploring leaves during the observation today. Supervision was adequate as a teacher approached the child behind the bush during the visit. However, this could be a potential supervision issue in the future. It is recommended to either remove the bush or to station a staff in the back left corner at all times to prevent a lapse in supervision. Your facility has been placed in cohort 1. You are currently in your Prep Year which will end 6/30/24. Your reassessment year will be 7/1/24-6/30/25. Prep Year Assessments were requested on 3/22/24. ECERS-R assessments were conducted on 5/7/24 and 5/13/24. An ITERS-R was conducted on 4/30/24. The reports from these assessments have not been received. An ERS visit will need to be conducted if there are scores below 2 points in any assessment. This visit can be announced. We discussed the importance of ensuring all staff have their education evaluated by WORKS. A fire drill must be conducted by 5/31/24. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0802 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 5/29/2024 Number Present: 85 Completed Date: 5/29/2024 Age: From 0 To 5 Total Minutes: 285 Time In: 09:15 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a Routine Unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Mary Virella-Minton, Program Coordinator, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. Virella-Minton was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, CPR / First Aid, special training, CBC qualification, ITS – SIDS, Emergency Medical Care plan, administration of medication, storage of hazardous products, storage of medication, general safety, discipline, adequate / approved space, program records, license posted, and permit restrictions. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight percent (88%) as of 5/28/24. The last fire drill was practiced on 4/26/24. The last emergency drill, lockdown drill, was practiced on 3/28/24. The last fire inspection was approved on 7/5/23. The program’s most recent sanitation inspection was completed on 2/13/24, with fifteen (15) demerits for a superior rating. The Emergency Medical Care Plan was posted and current. There are three (3) new staff. Three (3) new staff files were monitored today. Upon arrival I was greeted by Ms. Virella-Minton. In classroom space 1, one (1) child was napping and six (6) children were freely exploring their environment. One child was engaged in water play withing close proximity to a caregiver. Children explored rattlers and danced to music. In classroom space 2, children were engaged in a large group music and movement activity led by the teacher. Two (2) diaper changes were observed. In classroom space 3, children played outside on the infant/toddler playground. Children were observed climbing, sliding, stepping up on stumps and scooping mulch with dump trucks. Three children fell during the observation. Teachers responded to the children’s needs immediately and called for help to apply ice via walkie talkie. In classroom space 4, children were engaged in a large group music and movement activity with one teacher as the other teacher called children to use the restroom and wash hands. One (1) handwashing was observed. Children from classrooms 7 and 10 were playing outside on the Pre-K playground. Children were observed riding tricycles, playing basketball, and digging in the sandbox. Children explored the surrounding foliage at the fence line, observing plants and insects. In classroom space 9, children were engaged in sand play, built large structures with wooden blocks and animal and transportation figurines, built small structures with magnatiles, and counted and sorted rubber worms by color. Interactions were positive and nurturing. Supervision was adequate. Supervision was observed during meal time in classroom spaces 2, 3, and 4. Teachers were positioned to hear and see the children who were eating. In classroom space 2, five (5) children were eating as others were transitioning to wash hands and go to their cots. One (1) teacher helped children wash hands in the sink located within the eating area of the classroom and the other teacher helped children to their cots. As the teacher assisted the child washing hands, they turned their body so that they were positioned to see the children who remained eating at the tables. We discussed increasing communication with staff to ensure no lapses in supervision during this transition occur. Transportation was unable to be monitored during the Annual Compliance visit on 11/16/23 due to the vehicles not being on site during the visit. Transportation was monitored during the visit today. Currently, no children are being transported on a regular basis. The registration and inspection expire 11/30/24. The insurance expires on 7/1/24. One (1) bus was monitored during the visit today. A first aid kit and fire extinguisher were present on the vehicle. The driver holds a Commercial Drivers License that expires on 8/30/28. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were cited during the visit today: Violation Number Comment Rule 823 Toxic plants were accessible to children. Poison ivy was identified along the back fence line on the Pre-K playground. .0604(l) 853 Incident logs were not completed and maintained as required. An incident that occurred on 3/21/24 was not documented on the incident log. .0802(g)(1-6) 1898 Staff did not complete the health and safety training within one year of employment. One (1) staff, hire date 3/6/23, did not complete the topic of Administration of Medication within one (1) year of hire. .1102(a) 1911 An incident report was not completed and mailed to a Division representative within seven days after the incident when medical treatment was required. On 3/21/24, a four year old child was injured at the facility and received medical attention. The incident report was sent to the Child Care Consultant on 4/1/24. .0802(f) Technical Assistance provided as follows: Item #823 The poison ivy much be removed from areas accessible to children. I observed children exploring and picking leaves near the area in which poison ivy was identified. The Maintenance and Facilities department was contacted during the visit today and stated that they would spray a non-toxic solution on the foliage along the fence line. Supervision near the fence line was increased during the observation to ensure children did not go near the poison ivy. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (l) Toxic plants shall be inaccessible to children. A list of toxic plants may be found on the Division's website. Item #853 The incident that occurred on 3/21/24 was documented on the incident log during the visit today. This was corrected. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website. Item #1898 Staff LD must complete the topic of Administration of Medication immediately. As a reminder, this course must be search for separately in the Moodle. Once logged in, the staff can search “medication 2024” to find the most recent training in this topic. When the training has been completed, plan to place a copy of the staff member’s certificate in their file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. The following persons shall be exempt from this requirement: (1) staff members that do not have caregiving responsibilities for a child or group of children; (2) service providers such as speech therapists, occupational therapists, and physical therapists; and (3) substitute providers who provide services for less than 10 days in a 12-month period. (b) The health and safety training shall include the following topic areas: (1) Prevention and control of infectious diseases, including immunization; (2) Administration of medication, with standards for parental consent; (3) Prevention of and response to emergencies due to food and allergic reactions; (4) Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; (5) Emergency preparedness and response planning for emergencies resulting from a natural disaster, or a man-caused event; (6) Handling and storage of hazardous materials and the appropriate disposal of biocontaminants; (7) Precautions in transporting children, if applicable; (8) Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; (9) CPR and First Aid training as required in Paragraphs (c) and (d) of this Rule; (10) Recognizing and reporting child abuse, child neglect, and child maltreatment; and (11) Prevention of sudden infant death syndrome and use of safe sleeping practices. Item #1911 In your letter of compliance, include a statement that indicates how you will ensure incidents reports are mailed to me within seven (7) days, if the child seeks outside medical attention. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (f) When medical treatment is required by a health care professional, community clinic, or local health department as a result of an incident occurring while the child is in care, a copy of the incident report shall be mailed to a representative of the Division within seven calendar days after the incident. 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 6/12/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that, according to the Staff and Training Worksheet completed on 11/16/23, there are nine (9) staff whose CPR/First Aid certification expires on 6/3/24. The initials of these staff are provided as follows: LC, MC, TC, SN, JP, JP, AR, MVM, LW. Plan to schedule an obtain a CPR/First Aid training for these staff and new hire AS immediately. New hire CS cannot work in the infant room until they receive ITS-SIDS training. The mulch on the infant/toddler playground around the climbing structure measured six (6) to eight (8) inches deep. However, the mulch has become packed down and needs to be raked. On the infant/toddler playground, there is a bush that has grown in the back left corner near the fence line. Children were observed hiding behind the bush, exploring leaves during the observation today. Supervision was adequate as a teacher approached the child behind the bush during the visit. However, this could be a potential supervision issue in the future. It is recommended to either remove the bush or to station a staff in the back left corner at all times to prevent a lapse in supervision. Your facility has been placed in cohort 1. You are currently in your Prep Year which will end 6/30/24. Your reassessment year will be 7/1/24-6/30/25. Prep Year Assessments were requested on 3/22/24. ECERS-R assessments were conducted on 5/7/24 and 5/13/24. An ITERS-R was conducted on 4/30/24. The reports from these assessments have not been received. An ERS visit will need to be conducted if there are scores below 2 points in any assessment. This visit can be announced. We discussed the importance of ensuring all staff have their education evaluated by WORKS. A fire drill must be conducted by 5/31/24. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 5/29/2024 Number Present: 85 Completed Date: 5/29/2024 Age: From 0 To 5 Total Minutes: 285 Time In: 09:15 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a Routine Unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Mary Virella-Minton, Program Coordinator, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. Virella-Minton was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, CPR / First Aid, special training, CBC qualification, ITS – SIDS, Emergency Medical Care plan, administration of medication, storage of hazardous products, storage of medication, general safety, discipline, adequate / approved space, program records, license posted, and permit restrictions. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight percent (88%) as of 5/28/24. The last fire drill was practiced on 4/26/24. The last emergency drill, lockdown drill, was practiced on 3/28/24. The last fire inspection was approved on 7/5/23. The program’s most recent sanitation inspection was completed on 2/13/24, with fifteen (15) demerits for a superior rating. The Emergency Medical Care Plan was posted and current. There are three (3) new staff. Three (3) new staff files were monitored today. Upon arrival I was greeted by Ms. Virella-Minton. In classroom space 1, one (1) child was napping and six (6) children were freely exploring their environment. One child was engaged in water play withing close proximity to a caregiver. Children explored rattlers and danced to music. In classroom space 2, children were engaged in a large group music and movement activity led by the teacher. Two (2) diaper changes were observed. In classroom space 3, children played outside on the infant/toddler playground. Children were observed climbing, sliding, stepping up on stumps and scooping mulch with dump trucks. Three children fell during the observation. Teachers responded to the children’s needs immediately and called for help to apply ice via walkie talkie. In classroom space 4, children were engaged in a large group music and movement activity with one teacher as the other teacher called children to use the restroom and wash hands. One (1) handwashing was observed. Children from classrooms 7 and 10 were playing outside on the Pre-K playground. Children were observed riding tricycles, playing basketball, and digging in the sandbox. Children explored the surrounding foliage at the fence line, observing plants and insects. In classroom space 9, children were engaged in sand play, built large structures with wooden blocks and animal and transportation figurines, built small structures with magnatiles, and counted and sorted rubber worms by color. Interactions were positive and nurturing. Supervision was adequate. Supervision was observed during meal time in classroom spaces 2, 3, and 4. Teachers were positioned to hear and see the children who were eating. In classroom space 2, five (5) children were eating as others were transitioning to wash hands and go to their cots. One (1) teacher helped children wash hands in the sink located within the eating area of the classroom and the other teacher helped children to their cots. As the teacher assisted the child washing hands, they turned their body so that they were positioned to see the children who remained eating at the tables. We discussed increasing communication with staff to ensure no lapses in supervision during this transition occur. Transportation was unable to be monitored during the Annual Compliance visit on 11/16/23 due to the vehicles not being on site during the visit. Transportation was monitored during the visit today. Currently, no children are being transported on a regular basis. The registration and inspection expire 11/30/24. The insurance expires on 7/1/24. One (1) bus was monitored during the visit today. A first aid kit and fire extinguisher were present on the vehicle. The driver holds a Commercial Drivers License that expires on 8/30/28. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were cited during the visit today: Violation Number Comment Rule 823 Toxic plants were accessible to children. Poison ivy was identified along the back fence line on the Pre-K playground. .0604(l) 853 Incident logs were not completed and maintained as required. An incident that occurred on 3/21/24 was not documented on the incident log. .0802(g)(1-6) 1898 Staff did not complete the health and safety training within one year of employment. One (1) staff, hire date 3/6/23, did not complete the topic of Administration of Medication within one (1) year of hire. .1102(a) 1911 An incident report was not completed and mailed to a Division representative within seven days after the incident when medical treatment was required. On 3/21/24, a four year old child was injured at the facility and received medical attention. The incident report was sent to the Child Care Consultant on 4/1/24. .0802(f) Technical Assistance provided as follows: Item #823 The poison ivy much be removed from areas accessible to children. I observed children exploring and picking leaves near the area in which poison ivy was identified. The Maintenance and Facilities department was contacted during the visit today and stated that they would spray a non-toxic solution on the foliage along the fence line. Supervision near the fence line was increased during the observation to ensure children did not go near the poison ivy. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (l) Toxic plants shall be inaccessible to children. A list of toxic plants may be found on the Division's website. Item #853 The incident that occurred on 3/21/24 was documented on the incident log during the visit today. This was corrected. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website. Item #1898 Staff LD must complete the topic of Administration of Medication immediately. As a reminder, this course must be search for separately in the Moodle. Once logged in, the staff can search “medication 2024” to find the most recent training in this topic. When the training has been completed, plan to place a copy of the staff member’s certificate in their file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. The following persons shall be exempt from this requirement: (1) staff members that do not have caregiving responsibilities for a child or group of children; (2) service providers such as speech therapists, occupational therapists, and physical therapists; and (3) substitute providers who provide services for less than 10 days in a 12-month period. (b) The health and safety training shall include the following topic areas: (1) Prevention and control of infectious diseases, including immunization; (2) Administration of medication, with standards for parental consent; (3) Prevention of and response to emergencies due to food and allergic reactions; (4) Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; (5) Emergency preparedness and response planning for emergencies resulting from a natural disaster, or a man-caused event; (6) Handling and storage of hazardous materials and the appropriate disposal of biocontaminants; (7) Precautions in transporting children, if applicable; (8) Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; (9) CPR and First Aid training as required in Paragraphs (c) and (d) of this Rule; (10) Recognizing and reporting child abuse, child neglect, and child maltreatment; and (11) Prevention of sudden infant death syndrome and use of safe sleeping practices. Item #1911 In your letter of compliance, include a statement that indicates how you will ensure incidents reports are mailed to me within seven (7) days, if the child seeks outside medical attention. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (f) When medical treatment is required by a health care professional, community clinic, or local health department as a result of an incident occurring while the child is in care, a copy of the incident report shall be mailed to a representative of the Division within seven calendar days after the incident. 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 6/12/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that, according to the Staff and Training Worksheet completed on 11/16/23, there are nine (9) staff whose CPR/First Aid certification expires on 6/3/24. The initials of these staff are provided as follows: LC, MC, TC, SN, JP, JP, AR, MVM, LW. Plan to schedule an obtain a CPR/First Aid training for these staff and new hire AS immediately. New hire CS cannot work in the infant room until they receive ITS-SIDS training. The mulch on the infant/toddler playground around the climbing structure measured six (6) to eight (8) inches deep. However, the mulch has become packed down and needs to be raked. On the infant/toddler playground, there is a bush that has grown in the back left corner near the fence line. Children were observed hiding behind the bush, exploring leaves during the observation today. Supervision was adequate as a teacher approached the child behind the bush during the visit. However, this could be a potential supervision issue in the future. It is recommended to either remove the bush or to station a staff in the back left corner at all times to prevent a lapse in supervision. Your facility has been placed in cohort 1. You are currently in your Prep Year which will end 6/30/24. Your reassessment year will be 7/1/24-6/30/25. Prep Year Assessments were requested on 3/22/24. ECERS-R assessments were conducted on 5/7/24 and 5/13/24. An ITERS-R was conducted on 4/30/24. The reports from these assessments have not been received. An ERS visit will need to be conducted if there are scores below 2 points in any assessment. This visit can be announced. We discussed the importance of ensuring all staff have their education evaluated by WORKS. A fire drill must be conducted by 5/31/24. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 5/29/2024 Number Present: 85 Completed Date: 5/29/2024 Age: From 0 To 5 Total Minutes: 285 Time In: 09:15 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a Routine Unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Mary Virella-Minton, Program Coordinator, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. Virella-Minton was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, CPR / First Aid, special training, CBC qualification, ITS – SIDS, Emergency Medical Care plan, administration of medication, storage of hazardous products, storage of medication, general safety, discipline, adequate / approved space, program records, license posted, and permit restrictions. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight percent (88%) as of 5/28/24. The last fire drill was practiced on 4/26/24. The last emergency drill, lockdown drill, was practiced on 3/28/24. The last fire inspection was approved on 7/5/23. The program’s most recent sanitation inspection was completed on 2/13/24, with fifteen (15) demerits for a superior rating. The Emergency Medical Care Plan was posted and current. There are three (3) new staff. Three (3) new staff files were monitored today. Upon arrival I was greeted by Ms. Virella-Minton. In classroom space 1, one (1) child was napping and six (6) children were freely exploring their environment. One child was engaged in water play withing close proximity to a caregiver. Children explored rattlers and danced to music. In classroom space 2, children were engaged in a large group music and movement activity led by the teacher. Two (2) diaper changes were observed. In classroom space 3, children played outside on the infant/toddler playground. Children were observed climbing, sliding, stepping up on stumps and scooping mulch with dump trucks. Three children fell during the observation. Teachers responded to the children’s needs immediately and called for help to apply ice via walkie talkie. In classroom space 4, children were engaged in a large group music and movement activity with one teacher as the other teacher called children to use the restroom and wash hands. One (1) handwashing was observed. Children from classrooms 7 and 10 were playing outside on the Pre-K playground. Children were observed riding tricycles, playing basketball, and digging in the sandbox. Children explored the surrounding foliage at the fence line, observing plants and insects. In classroom space 9, children were engaged in sand play, built large structures with wooden blocks and animal and transportation figurines, built small structures with magnatiles, and counted and sorted rubber worms by color. Interactions were positive and nurturing. Supervision was adequate. Supervision was observed during meal time in classroom spaces 2, 3, and 4. Teachers were positioned to hear and see the children who were eating. In classroom space 2, five (5) children were eating as others were transitioning to wash hands and go to their cots. One (1) teacher helped children wash hands in the sink located within the eating area of the classroom and the other teacher helped children to their cots. As the teacher assisted the child washing hands, they turned their body so that they were positioned to see the children who remained eating at the tables. We discussed increasing communication with staff to ensure no lapses in supervision during this transition occur. Transportation was unable to be monitored during the Annual Compliance visit on 11/16/23 due to the vehicles not being on site during the visit. Transportation was monitored during the visit today. Currently, no children are being transported on a regular basis. The registration and inspection expire 11/30/24. The insurance expires on 7/1/24. One (1) bus was monitored during the visit today. A first aid kit and fire extinguisher were present on the vehicle. The driver holds a Commercial Drivers License that expires on 8/30/28. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were cited during the visit today: Violation Number Comment Rule 823 Toxic plants were accessible to children. Poison ivy was identified along the back fence line on the Pre-K playground. .0604(l) 853 Incident logs were not completed and maintained as required. An incident that occurred on 3/21/24 was not documented on the incident log. .0802(g)(1-6) 1898 Staff did not complete the health and safety training within one year of employment. One (1) staff, hire date 3/6/23, did not complete the topic of Administration of Medication within one (1) year of hire. .1102(a) 1911 An incident report was not completed and mailed to a Division representative within seven days after the incident when medical treatment was required. On 3/21/24, a four year old child was injured at the facility and received medical attention. The incident report was sent to the Child Care Consultant on 4/1/24. .0802(f) Technical Assistance provided as follows: Item #823 The poison ivy much be removed from areas accessible to children. I observed children exploring and picking leaves near the area in which poison ivy was identified. The Maintenance and Facilities department was contacted during the visit today and stated that they would spray a non-toxic solution on the foliage along the fence line. Supervision near the fence line was increased during the observation to ensure children did not go near the poison ivy. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (l) Toxic plants shall be inaccessible to children. A list of toxic plants may be found on the Division's website. Item #853 The incident that occurred on 3/21/24 was documented on the incident log during the visit today. This was corrected. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website. Item #1898 Staff LD must complete the topic of Administration of Medication immediately. As a reminder, this course must be search for separately in the Moodle. Once logged in, the staff can search “medication 2024” to find the most recent training in this topic. When the training has been completed, plan to place a copy of the staff member’s certificate in their file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. The following persons shall be exempt from this requirement: (1) staff members that do not have caregiving responsibilities for a child or group of children; (2) service providers such as speech therapists, occupational therapists, and physical therapists; and (3) substitute providers who provide services for less than 10 days in a 12-month period. (b) The health and safety training shall include the following topic areas: (1) Prevention and control of infectious diseases, including immunization; (2) Administration of medication, with standards for parental consent; (3) Prevention of and response to emergencies due to food and allergic reactions; (4) Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; (5) Emergency preparedness and response planning for emergencies resulting from a natural disaster, or a man-caused event; (6) Handling and storage of hazardous materials and the appropriate disposal of biocontaminants; (7) Precautions in transporting children, if applicable; (8) Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; (9) CPR and First Aid training as required in Paragraphs (c) and (d) of this Rule; (10) Recognizing and reporting child abuse, child neglect, and child maltreatment; and (11) Prevention of sudden infant death syndrome and use of safe sleeping practices. Item #1911 In your letter of compliance, include a statement that indicates how you will ensure incidents reports are mailed to me within seven (7) days, if the child seeks outside medical attention. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (f) When medical treatment is required by a health care professional, community clinic, or local health department as a result of an incident occurring while the child is in care, a copy of the incident report shall be mailed to a representative of the Division within seven calendar days after the incident. 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 6/12/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that, according to the Staff and Training Worksheet completed on 11/16/23, there are nine (9) staff whose CPR/First Aid certification expires on 6/3/24. The initials of these staff are provided as follows: LC, MC, TC, SN, JP, JP, AR, MVM, LW. Plan to schedule an obtain a CPR/First Aid training for these staff and new hire AS immediately. New hire CS cannot work in the infant room until they receive ITS-SIDS training. The mulch on the infant/toddler playground around the climbing structure measured six (6) to eight (8) inches deep. However, the mulch has become packed down and needs to be raked. On the infant/toddler playground, there is a bush that has grown in the back left corner near the fence line. Children were observed hiding behind the bush, exploring leaves during the observation today. Supervision was adequate as a teacher approached the child behind the bush during the visit. However, this could be a potential supervision issue in the future. It is recommended to either remove the bush or to station a staff in the back left corner at all times to prevent a lapse in supervision. Your facility has been placed in cohort 1. You are currently in your Prep Year which will end 6/30/24. Your reassessment year will be 7/1/24-6/30/25. Prep Year Assessments were requested on 3/22/24. ECERS-R assessments were conducted on 5/7/24 and 5/13/24. An ITERS-R was conducted on 4/30/24. The reports from these assessments have not been received. An ERS visit will need to be conducted if there are scores below 2 points in any assessment. This visit can be announced. We discussed the importance of ensuring all staff have their education evaluated by WORKS. A fire drill must be conducted by 5/31/24. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0901 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: 0424-311L Visit Date: 5/2/2024 Number Present: 96 Completed Date: 5/2/2024 Age: From 0 To 5 Total Minutes: 120 Time In: 02:45 PM Time Out: 04:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to investigate a complaint received by the Division of Child Development and Early Education (DCDEE) on 4/22/24 and sent to Kaitlyn Marshall, Child Care Consultant, on 4/22/24. The reported concern is regarding supervision and safe environment. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Mary Virella-Minton, Program Coordinator, during the visit. Alesia Summey, Director of Early Learning Program, was present for the review of the visit summary. A signed copy of the visit summary was emailed to you. Ms. Virella-Minton was present and available to ask and answer questions throughout the visit today. Applicable child care requirements were monitored today including supervision, staff/child ratio, permit restrictions, approved space and capacity, and safe environment. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight percent (88%) as of 5/2/24. The facility operates on a five (5) star license issued 2/15/21. Restrictions include 1st shift (daytime care), meets enhanced space, meets enhanced ratios, children under 2.5 years old in rooms with direct exits only. Per report, at approximately 2:55pm on 4/16/24, a one year old child who is allergic to eggs, accidentally ate a muffin containing eggs. The child was administered an Epipen and 911 was called. Ms. Virella-Minton informed me of the incident via phone call on 4/17/24. Upon arrival I was greeted by Ms. Virella-Minton. I observed the children in classroom space 2. There were eleven (11) children with three (3) caregivers present. Children had just finished eating snack and were preparing to go outside to play. Allergies were posted in the classroom on a bulletin board in the play area of the classroom. Interactions were positive and nurturing. Supervision was adequate. I spoke with Ms. Virella-Minton as well as the caregivers involved in the incident. According to staff reports, a staff member was seated next to the child as they were eating. Another caregiver was assisting children who were washing hands in a sink located in the eating area. A parent arrived to pick up a child. The teacher who was sitting next to the child assisted the parent at pick up. When the caregiver returned to the seat next to the child, they noticed the child had crumbs on their mouth similar to the muffin containing eggs that other children were eating. The additional caregiver remained in the eating area throughout the incident. Medical action was taken according to the facility’s emergency medical care plan. As the medical emergency was being addressed, the other caregiver supervised the group of children. Caregivers have moved children with similar allergies to one table, isolated from children who eat the food provided by the facility. An incident report was received on 4/19/24. Video footage of the incident was not available for review. Due to statements from the caregiver and administrative staff that staff members were located in the eating area at the time of the event, the supervision concern is unsubstantiated. Due to the action taken by staff to ensure emergency medical treatment was provided according to procedures and the actions taken by staff to prevent the incident from recurring, the concerns regarding safe environment are unsubstantiated. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 508 Special diet or food allergy information was not posted where they can be seen in food preparation and eating areas. The list of food allergies was posted in the play area of classroom space 2. The list of food allergies was not posted in the eating area of the classroom. .0901(g) Technical Assistance provided as follows: Item #508 The list of food allergies was posted in the play area of classroom space 2. The list of food allergies was not posted in the eating area of the classroom. The list of food allergies was moved into the eating area of the classroom. This was corrected. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. Consultation is provided as follows: We discussed the supervision rule regarding children who are eating. We discussed that, in the future, one caregiver should remain at the tables until all children are finished eating snack while one caregiver is up assisting parents and other children. Please see the rule reference below for additional guidance: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (5) staff must be able to see and hear children aged birth to five years old while the children are eating. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1801 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: 0424-311L Visit Date: 5/2/2024 Number Present: 96 Completed Date: 5/2/2024 Age: From 0 To 5 Total Minutes: 120 Time In: 02:45 PM Time Out: 04:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to investigate a complaint received by the Division of Child Development and Early Education (DCDEE) on 4/22/24 and sent to Kaitlyn Marshall, Child Care Consultant, on 4/22/24. The reported concern is regarding supervision and safe environment. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Mary Virella-Minton, Program Coordinator, during the visit. Alesia Summey, Director of Early Learning Program, was present for the review of the visit summary. A signed copy of the visit summary was emailed to you. Ms. Virella-Minton was present and available to ask and answer questions throughout the visit today. Applicable child care requirements were monitored today including supervision, staff/child ratio, permit restrictions, approved space and capacity, and safe environment. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight percent (88%) as of 5/2/24. The facility operates on a five (5) star license issued 2/15/21. Restrictions include 1st shift (daytime care), meets enhanced space, meets enhanced ratios, children under 2.5 years old in rooms with direct exits only. Per report, at approximately 2:55pm on 4/16/24, a one year old child who is allergic to eggs, accidentally ate a muffin containing eggs. The child was administered an Epipen and 911 was called. Ms. Virella-Minton informed me of the incident via phone call on 4/17/24. Upon arrival I was greeted by Ms. Virella-Minton. I observed the children in classroom space 2. There were eleven (11) children with three (3) caregivers present. Children had just finished eating snack and were preparing to go outside to play. Allergies were posted in the classroom on a bulletin board in the play area of the classroom. Interactions were positive and nurturing. Supervision was adequate. I spoke with Ms. Virella-Minton as well as the caregivers involved in the incident. According to staff reports, a staff member was seated next to the child as they were eating. Another caregiver was assisting children who were washing hands in a sink located in the eating area. A parent arrived to pick up a child. The teacher who was sitting next to the child assisted the parent at pick up. When the caregiver returned to the seat next to the child, they noticed the child had crumbs on their mouth similar to the muffin containing eggs that other children were eating. The additional caregiver remained in the eating area throughout the incident. Medical action was taken according to the facility’s emergency medical care plan. As the medical emergency was being addressed, the other caregiver supervised the group of children. Caregivers have moved children with similar allergies to one table, isolated from children who eat the food provided by the facility. An incident report was received on 4/19/24. Video footage of the incident was not available for review. Due to statements from the caregiver and administrative staff that staff members were located in the eating area at the time of the event, the supervision concern is unsubstantiated. Due to the action taken by staff to ensure emergency medical treatment was provided according to procedures and the actions taken by staff to prevent the incident from recurring, the concerns regarding safe environment are unsubstantiated. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 508 Special diet or food allergy information was not posted where they can be seen in food preparation and eating areas. The list of food allergies was posted in the play area of classroom space 2. The list of food allergies was not posted in the eating area of the classroom. .0901(g) Technical Assistance provided as follows: Item #508 The list of food allergies was posted in the play area of classroom space 2. The list of food allergies was not posted in the eating area of the classroom. The list of food allergies was moved into the eating area of the classroom. This was corrected. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Children's special diets or food allergies shall be posted where they can be seen in the food preparation area and in the child's eating area. Consultation is provided as follows: We discussed the supervision rule regarding children who are eating. We discussed that, in the future, one caregiver should remain at the tables until all children are finished eating snack while one caregiver is up assisting parents and other children. Please see the rule reference below for additional guidance: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (5) staff must be able to see and hear children aged birth to five years old while the children are eating. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 12/20/2023 Number Present: 56 Completed Date: 12/20/2023 Age: From 0 To 5 Total Minutes: 120 Time In: 01:00 PM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Unannounced Visit Follow-Up Announced/Unannounced: Unannounced The purpose of today’s visit was to follow-up on compliance for violations issued during the Annual Compliance visit on 11/15/23. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Lisa McKnight, Program Coordinator, during the visit. An electronic signed copy of the visit summary was emailed to you. Limited monitoring was conducted today including staff records and children records. The center’s compliance history was reviewed with the operator. The program’s compliance history was include the eighty-seven percent (87%) as of 12/20/23. The following violations were cited as repeat violations on 12/5/23: #1768, #1769, #1897. The following violations are in compliance today: #1768: The one (1) NC Pre-K child received a hearing screening on 12/8/23. The screening has been placed in the child’s file. Compliance was verified during the visit today. #1897: The two (2) staff completed the Recognizing and Responding to Suspicions of Child Maltreatment training. The training certificates were placed in the staff member’s file. Compliance was verified during the visit today. One (1) violation remains out of compliance and was cited as a repeat violation during the visit today: Violation Number Comment Rule 1769 The health assessment did not include a dental screening. One (1) NC Pre-K child's health assessment did not include a dental screening. .3005 (a)(5) 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 1/3/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation provided as follows: During the visit today, a walkthrough was conducted in classroom space 6. There is partition wall that reduces visibility to the classroom bathroom. You stated that you would like to have part of the wall removed so that teachers can have a clear line of sight to the bathroom for adequate supervision. Plan to reach out to Environmental Health prior to construction beginning to ensure there would be no lead hazards caused by this project. You stated that while the building was constructed in the 1950’s, the wall was added recently, in approximately the last ten (10) years. During the visit today, you informed me that you would like to expand the fencing on the playground for two year old children outside of classroom space 3. You would like to expand the fence to include the building doors leading to the playground. Additionally, you would like to replace the gate with a push-bar gate that can only be accessed from inside the playground for added security. You stated that you would like to update the gates for all of the playground to this style of push-bar gate. You state that this would not change means of egress for any classrooms. A visit may need to be made to remeasure both spaces once the work is complete. This can be an announced visit. Continue to keep in communication with me about any changes to the floor plan that you are planning. To avoid repeat violations, plan to keep in communication about compliance with open violations. As a reminder, if an extension is needed, a request containing the item #, reason for the extension, and requested extension date is needed. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 12/5/2023 Number Present: 68 Completed Date: 12/5/2023 Age: From 0 To 5 Total Minutes: 85 Time In: 10:05 AM Time Out: 11:30 AM Time In: Time Out: List to Use: Center Type Of Visit: Annual Compliance Follow-Up Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an Unannounced Follow-up visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Lisa McKnight, Program Coordinator, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. McKnight was present and available to ask and answer questions throughout the visit today. Limited monitoring was conducted today including staff files and children’s files. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 12/5/23. The annual compliance visit was conducted on 11/16/23. An “other” visit was conducted on 11/17/23 to complete the monitoring of staff files as part of the Annual Compliance process. The following violations have been corrected: Item #811- The bottle of disinfectant was moved to a location inaccessible to children during the visit on 11/16/23. This was corrected during the visit. Item #1033- In a compliance letter received on 12/4/23, you stated the one (1) staff completed the TB test on 11/22/23. Compliance was verified today. Item #1041- The staff member had a Criminal Background Check completed after the date of employment. In a letter of compliance received on 12/4/23, you stated that the program would require Criminal Background Check qualifying letters to be on file prior to employment, moving forward. Compliance was verified today. Item #1048- In a letter of compliance received on 12/4/23, you stated the staff member received First Aid/CPR training on 11/21/23. Compliance was verified today. Item #1049- In a letter of compliance received on 12/4/23, you stated the staff member received First Aid/CPR training on 11/21/23. Compliance was verified today. The following items have been granted an extension: Item #1032- An extension was granted to 12/8/23 due to a delay in paperwork at the doctors’ offices. The following items were not in compliance: Item #1768: One (1) NC Pre-K child did not have a hearing screening as part of their medical report. You stated the screenings would be on file by 12/22/23. Item #1769: One (1) NC Pre-K child did not have a dental screening as part of their medical report. You stated the screenings would be on file prior to 12/22/23. Item #1897: Three (3) support staff had not completed Recognizing and Responding to Suspicions of Child Maltreatment training. The letter of compliance did not include a statement of compliance for this item. 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 repeat violations were cited during the visit today: Violation Number Comment Rule 1768 The health assessment did not include a hearing screening. One (1) NC Pre-K child's health assessment did not include a hearing screening. .3005 (a)(4) 1769 The health assessment did not include a dental screening. One (1) NC Pre-K child's health assessment did not include a dental screening. .3005 (a)(5) 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. Two (2) support staff did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. .1102(g) Technical Assistance provided as follows: Item #1768 and 1769 The one (1) NC Pre-K child must have a hearing screening on file. The one (1) NC Pre-K child must have a dental screening on file. 10A NCAC 09 .3005 CHILD HEALTH ASSESSMENTS (a) A health assessment shall be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment shall include the following: (4) hearing screening; and (5) dental screening. Item #1897 Two (2) staff must complete Recognizing and Responding to Suspicions of Child Maltreatment Training. 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 12/19/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed requesting extensions for violations cited. When requesting an extension please provide the item #, the date you are requesting the extension to, and the reason an extension is needed. Please submit requests for extensions as soon as you know an extension will be needed to prevent further follow-up visits. You shared your compliance checklist for classrooms today that you are planning to implement. You also shared that you will utilize an electronic calendar that automatically generates reminder emails when trainings and documents are due. We discussed that an Administrative Action will not be recommended at this time. Please continue to reach out for support and technical assistance as needed, to maintain compliance with Child Care Rules. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .3005 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 12/5/2023 Number Present: 68 Completed Date: 12/5/2023 Age: From 0 To 5 Total Minutes: 85 Time In: 10:05 AM Time Out: 11:30 AM Time In: Time Out: List to Use: Center Type Of Visit: Annual Compliance Follow-Up Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an Unannounced Follow-up visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Lisa McKnight, Program Coordinator, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. McKnight was present and available to ask and answer questions throughout the visit today. Limited monitoring was conducted today including staff files and children’s files. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 12/5/23. The annual compliance visit was conducted on 11/16/23. An “other” visit was conducted on 11/17/23 to complete the monitoring of staff files as part of the Annual Compliance process. The following violations have been corrected: Item #811- The bottle of disinfectant was moved to a location inaccessible to children during the visit on 11/16/23. This was corrected during the visit. Item #1033- In a compliance letter received on 12/4/23, you stated the one (1) staff completed the TB test on 11/22/23. Compliance was verified today. Item #1041- The staff member had a Criminal Background Check completed after the date of employment. In a letter of compliance received on 12/4/23, you stated that the program would require Criminal Background Check qualifying letters to be on file prior to employment, moving forward. Compliance was verified today. Item #1048- In a letter of compliance received on 12/4/23, you stated the staff member received First Aid/CPR training on 11/21/23. Compliance was verified today. Item #1049- In a letter of compliance received on 12/4/23, you stated the staff member received First Aid/CPR training on 11/21/23. Compliance was verified today. The following items have been granted an extension: Item #1032- An extension was granted to 12/8/23 due to a delay in paperwork at the doctors’ offices. The following items were not in compliance: Item #1768: One (1) NC Pre-K child did not have a hearing screening as part of their medical report. You stated the screenings would be on file by 12/22/23. Item #1769: One (1) NC Pre-K child did not have a dental screening as part of their medical report. You stated the screenings would be on file prior to 12/22/23. Item #1897: Three (3) support staff had not completed Recognizing and Responding to Suspicions of Child Maltreatment training. The letter of compliance did not include a statement of compliance for this item. 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 repeat violations were cited during the visit today: Violation Number Comment Rule 1768 The health assessment did not include a hearing screening. One (1) NC Pre-K child's health assessment did not include a hearing screening. .3005 (a)(4) 1769 The health assessment did not include a dental screening. One (1) NC Pre-K child's health assessment did not include a dental screening. .3005 (a)(5) 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. Two (2) support staff did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. .1102(g) Technical Assistance provided as follows: Item #1768 and 1769 The one (1) NC Pre-K child must have a hearing screening on file. The one (1) NC Pre-K child must have a dental screening on file. 10A NCAC 09 .3005 CHILD HEALTH ASSESSMENTS (a) A health assessment shall be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment shall include the following: (4) hearing screening; and (5) dental screening. Item #1897 Two (2) staff must complete Recognizing and Responding to Suspicions of Child Maltreatment Training. 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 12/19/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed requesting extensions for violations cited. When requesting an extension please provide the item #, the date you are requesting the extension to, and the reason an extension is needed. Please submit requests for extensions as soon as you know an extension will be needed to prevent further follow-up visits. You shared your compliance checklist for classrooms today that you are planning to implement. You also shared that you will utilize an electronic calendar that automatically generates reminder emails when trainings and documents are due. We discussed that an Administrative Action will not be recommended at this time. Please continue to reach out for support and technical assistance as needed, to maintain compliance with Child Care Rules. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 12/5/2023 Number Present: 68 Completed Date: 12/5/2023 Age: From 0 To 5 Total Minutes: 85 Time In: 10:05 AM Time Out: 11:30 AM Time In: Time Out: List to Use: Center Type Of Visit: Annual Compliance Follow-Up Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an Unannounced Follow-up visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Lisa McKnight, Program Coordinator, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. McKnight was present and available to ask and answer questions throughout the visit today. Limited monitoring was conducted today including staff files and children’s files. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 12/5/23. The annual compliance visit was conducted on 11/16/23. An “other” visit was conducted on 11/17/23 to complete the monitoring of staff files as part of the Annual Compliance process. The following violations have been corrected: Item #811- The bottle of disinfectant was moved to a location inaccessible to children during the visit on 11/16/23. This was corrected during the visit. Item #1033- In a compliance letter received on 12/4/23, you stated the one (1) staff completed the TB test on 11/22/23. Compliance was verified today. Item #1041- The staff member had a Criminal Background Check completed after the date of employment. In a letter of compliance received on 12/4/23, you stated that the program would require Criminal Background Check qualifying letters to be on file prior to employment, moving forward. Compliance was verified today. Item #1048- In a letter of compliance received on 12/4/23, you stated the staff member received First Aid/CPR training on 11/21/23. Compliance was verified today. Item #1049- In a letter of compliance received on 12/4/23, you stated the staff member received First Aid/CPR training on 11/21/23. Compliance was verified today. The following items have been granted an extension: Item #1032- An extension was granted to 12/8/23 due to a delay in paperwork at the doctors’ offices. The following items were not in compliance: Item #1768: One (1) NC Pre-K child did not have a hearing screening as part of their medical report. You stated the screenings would be on file by 12/22/23. Item #1769: One (1) NC Pre-K child did not have a dental screening as part of their medical report. You stated the screenings would be on file prior to 12/22/23. Item #1897: Three (3) support staff had not completed Recognizing and Responding to Suspicions of Child Maltreatment training. The letter of compliance did not include a statement of compliance for this item. 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 repeat violations were cited during the visit today: Violation Number Comment Rule 1768 The health assessment did not include a hearing screening. One (1) NC Pre-K child's health assessment did not include a hearing screening. .3005 (a)(4) 1769 The health assessment did not include a dental screening. One (1) NC Pre-K child's health assessment did not include a dental screening. .3005 (a)(5) 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. Two (2) support staff did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. .1102(g) Technical Assistance provided as follows: Item #1768 and 1769 The one (1) NC Pre-K child must have a hearing screening on file. The one (1) NC Pre-K child must have a dental screening on file. 10A NCAC 09 .3005 CHILD HEALTH ASSESSMENTS (a) A health assessment shall be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment shall include the following: (4) hearing screening; and (5) dental screening. Item #1897 Two (2) staff must complete Recognizing and Responding to Suspicions of Child Maltreatment Training. 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 12/19/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall P.O. Box 19531 Asheville, NC 28815 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed requesting extensions for violations cited. When requesting an extension please provide the item #, the date you are requesting the extension to, and the reason an extension is needed. Please submit requests for extensions as soon as you know an extension will be needed to prevent further follow-up visits. You shared your compliance checklist for classrooms today that you are planning to implement. You also shared that you will utilize an electronic calendar that automatically generates reminder emails when trainings and documents are due. We discussed that an Administrative Action will not be recommended at this time. Please continue to reach out for support and technical assistance as needed, to maintain compliance with Child Care Rules. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 11/16/2023 Number Present: 69 Completed Date: 11/16/2023 Age: From 0 To 5 Total Minutes: 405 Time In: 09:15 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Lisa McKnight, Program Coordinator, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. McKnight was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. Due to time constraints, monitoring of staff files was not completed today. A follow-up visit will be conducted to review existing staff files. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and will be emailed to you upon completion of the follow-up visit. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight (88%) percent as of 11/13/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, YWCA of Asheville and Western North Carolina, Inc., is current/active as of 11/13/23. Permit type – Five (5) star license issued 2/15/21. Special Services/Restrictions – 1st shift (daytime care), meets enhanced ratios, meets enhanced space, children under 2.5 years old in rooms with direct exits only. This facility meets requirements to provide transportation and NC Pre-K. This facility offers a swimming pool, field trips, and serves children with special needs. The last annual compliance visit was conducted on 12/2/22. The last fire drill was practiced on 10/30/23. The last shelter-in-place drill was practiced on 912/23. The last playground inspection was documented on 10/30/23. The last fire inspection was approved on 7/5/23. The last sanitation inspection was conducted on 9/12/23 with fourteen (14) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. The approved formative assessment tool is Teaching Strategies Gold. The center’s Emergency Preparedness and Response plan was updated on 9/12/23. There are seventy-eight (78) children enrolled, including eighteen (18) NC Pre-K children. Eight (8) children’s files were monitored today, including two (2) NC Pre-K children’s files. There are twenty-six (26) staff. Five (5) new staff files were monitored today. Existing staff files will be monitored during the return visit. Upon arrival I was greeted by Dr. Ameris Lavendar, Chief Program Officer, and Lisa McKnight, Program Coordinator. Ms. McKnight accompanied me on the walkthrough of the indoor and outdoor spaces. In classroom space 1, children explored their environment by crawling, cruising and pulling up on furniture. Children were fed by caregivers and explored magnifying glasses. In classroom space 2, children were played outdoors, pushed toys, threw balls and ran down a path. In classroom space 3, children sang and danced to music and built long chains with plastic connectors. I observed a diaper change in which all steps were followed according to sanitation requirements. In classroom space 4, children played outside, climbed on structures and explored acorns with the caregiver. In classroom space 10, children in the NC Pre-K classroom built small houses with magnatiles, prepared pretend food in the dramatic play kitchen, read books, put together Mr. Potato Head, and practice writing their names with teacher and peer support. In classroom space 7, children used rolling pins and cookie cutters to explore clay, prepared pretend food in the dramatic play kitchen, and explored a set of toy horses with riders. Interactions were positive and nurturing. Children were soothed and redirected as needed. Supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. You stated the transportation is only used for field trips. Transportation was not able to be monitored today due to the vehicle needing repairs off site. Transportation will be monitored during the Routine Unannounced visit which will occur in approximately four (4) to six (6) months. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. The NC Pre-K Program Site Monitoring Tool was reviewed today and was completed on 10/27/23 by Lisa McKnight and Millad Nooraei. The classroom operates from 8:30 a.m. to 3:00 p.m. The following violations were documented during today’s visit: Violation Number Comment Rule 811 Potentially hazardous items including but not limited to power tools, nails, chemicals, propane stoves, lawn mowers, gasoline, or kerosene were not stored in locked areas, removed from the premises, or made inaccessible to children. In classroom space 2, one (1) spray bottle of disinfectant was placed in a location accessible to children. .0604(a) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Two (2) staff received a medical report after the date of employment. Five (5) support staff did not have a medical report 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. Two (2) staff received a TB test or screening after the first day of work. One (1) support staff did not have a TB test or screening on file. Please refer to your staff and training worksheet for additional information. .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. One staff, hire date 10/12/23, received the Criminal Background Check qualifying letter on 10/13/23. G.S. 110-90.2(b) 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, hire date 3/6/23, does not have a First Aid certificate on file. .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, hire date 3/6/23, did not have a CPR certificate on file. .1102(d) 1768 The health assessment did not include a hearing screening. One (1) child's file did not include a hearing screening. .3005 (a)(4) 1769 The health assessment did not include a dental screening. One (1) child's file did not include a dental screening. .3005 (a)(5) 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. Three (3) support staff did not complete Recognizing and Responding to Suspicions to Child Maltreatment Training. Please refer to the staff and training worksheet for additional information. .1102(g) Technical assistance was provided as follows: Item #811 The bottle of sanitizing spray in classroom space 2 was moved to a location five (5) feet high during the visit. The closet containing cleaners and an aerosol can was locked during the visit. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (a) In child care centers, potentially hazardous items, including power tools, nails, chemicals, propane stoves, lawn mowers, and gasoline or kerosene, whether or not intended for use by children, shall be stored in locked areas, removed from the premises, or otherwise inaccessible to children. Item #1768 The one (1) NC Pre-K child must have a hearing screening on file. 10A NCAC 09 .3005 CHILD HEALTH ASSESSMENTS (a) A health assessment shall be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment shall include the following: (4) hearing screening; Item # 1769 The one (1) NC Pre-K child must have a dental screening on file. 10A NCAC 09 .3005 CHILD HEALTH ASSESSMENTS (a) A health assessment shall be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment shall include the following: (5) dental screening. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/30/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall 2 Pinehurst Ct. Asheville, NC 28805 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed the Prevention of Shaken Baby Syndrome and Abusive Head Trauma Policy and the Discipline policy requirements. Both of these forms require the child’s date of enrollment to be on the acknowledgement. Plan to update your policy acknowledgement form to include the date of the child’s enrollment. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Your facility has been placed in cohort 1. You are currently in your prep year which ends 6/30/24. Your reassessment year is 7/1/24-6/30/25. We discussed the importance of ensuring all staff are registered for a WORKS account and submit their transcripts to have their education evaluated by WORKS. We discussed the Prep Year Assessment. Information about this option was provided to you in the email containing this Visit Summary. Please note that the Prep Year assessment is only available until 6/30/24. If you would like to move forward with this opportunity, please complete send the Rated License Assessment Request Review form to me. A copy of this form is attached to the email containing this Visit Summary. Please plan to visit https://ncrlap.org/ for more information regarding Rated License and Environment Rating Scale. We discussed Education Points. On your current license, you have seven (7) points in education standards. We discussed the education requirements needed to maintain these points during your Rated License reassessment for Administrator, Teacher and Lead Teacher. We discussed the Quality Point option. You stated that you will be able to maintain your current Quality Point option during the Rated License reassessment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192 or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0604 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 11/16/2023 Number Present: 69 Completed Date: 11/16/2023 Age: From 0 To 5 Total Minutes: 405 Time In: 09:15 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Lisa McKnight, Program Coordinator, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. McKnight was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. Due to time constraints, monitoring of staff files was not completed today. A follow-up visit will be conducted to review existing staff files. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and will be emailed to you upon completion of the follow-up visit. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight (88%) percent as of 11/13/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, YWCA of Asheville and Western North Carolina, Inc., is current/active as of 11/13/23. Permit type – Five (5) star license issued 2/15/21. Special Services/Restrictions – 1st shift (daytime care), meets enhanced ratios, meets enhanced space, children under 2.5 years old in rooms with direct exits only. This facility meets requirements to provide transportation and NC Pre-K. This facility offers a swimming pool, field trips, and serves children with special needs. The last annual compliance visit was conducted on 12/2/22. The last fire drill was practiced on 10/30/23. The last shelter-in-place drill was practiced on 912/23. The last playground inspection was documented on 10/30/23. The last fire inspection was approved on 7/5/23. The last sanitation inspection was conducted on 9/12/23 with fourteen (14) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. The approved formative assessment tool is Teaching Strategies Gold. The center’s Emergency Preparedness and Response plan was updated on 9/12/23. There are seventy-eight (78) children enrolled, including eighteen (18) NC Pre-K children. Eight (8) children’s files were monitored today, including two (2) NC Pre-K children’s files. There are twenty-six (26) staff. Five (5) new staff files were monitored today. Existing staff files will be monitored during the return visit. Upon arrival I was greeted by Dr. Ameris Lavendar, Chief Program Officer, and Lisa McKnight, Program Coordinator. Ms. McKnight accompanied me on the walkthrough of the indoor and outdoor spaces. In classroom space 1, children explored their environment by crawling, cruising and pulling up on furniture. Children were fed by caregivers and explored magnifying glasses. In classroom space 2, children were played outdoors, pushed toys, threw balls and ran down a path. In classroom space 3, children sang and danced to music and built long chains with plastic connectors. I observed a diaper change in which all steps were followed according to sanitation requirements. In classroom space 4, children played outside, climbed on structures and explored acorns with the caregiver. In classroom space 10, children in the NC Pre-K classroom built small houses with magnatiles, prepared pretend food in the dramatic play kitchen, read books, put together Mr. Potato Head, and practice writing their names with teacher and peer support. In classroom space 7, children used rolling pins and cookie cutters to explore clay, prepared pretend food in the dramatic play kitchen, and explored a set of toy horses with riders. Interactions were positive and nurturing. Children were soothed and redirected as needed. Supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. You stated the transportation is only used for field trips. Transportation was not able to be monitored today due to the vehicle needing repairs off site. Transportation will be monitored during the Routine Unannounced visit which will occur in approximately four (4) to six (6) months. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. The NC Pre-K Program Site Monitoring Tool was reviewed today and was completed on 10/27/23 by Lisa McKnight and Millad Nooraei. The classroom operates from 8:30 a.m. to 3:00 p.m. The following violations were documented during today’s visit: Violation Number Comment Rule 811 Potentially hazardous items including but not limited to power tools, nails, chemicals, propane stoves, lawn mowers, gasoline, or kerosene were not stored in locked areas, removed from the premises, or made inaccessible to children. In classroom space 2, one (1) spray bottle of disinfectant was placed in a location accessible to children. .0604(a) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Two (2) staff received a medical report after the date of employment. Five (5) support staff did not have a medical report 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. Two (2) staff received a TB test or screening after the first day of work. One (1) support staff did not have a TB test or screening on file. Please refer to your staff and training worksheet for additional information. .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. One staff, hire date 10/12/23, received the Criminal Background Check qualifying letter on 10/13/23. G.S. 110-90.2(b) 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, hire date 3/6/23, does not have a First Aid certificate on file. .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, hire date 3/6/23, did not have a CPR certificate on file. .1102(d) 1768 The health assessment did not include a hearing screening. One (1) child's file did not include a hearing screening. .3005 (a)(4) 1769 The health assessment did not include a dental screening. One (1) child's file did not include a dental screening. .3005 (a)(5) 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. Three (3) support staff did not complete Recognizing and Responding to Suspicions to Child Maltreatment Training. Please refer to the staff and training worksheet for additional information. .1102(g) Technical assistance was provided as follows: Item #811 The bottle of sanitizing spray in classroom space 2 was moved to a location five (5) feet high during the visit. The closet containing cleaners and an aerosol can was locked during the visit. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (a) In child care centers, potentially hazardous items, including power tools, nails, chemicals, propane stoves, lawn mowers, and gasoline or kerosene, whether or not intended for use by children, shall be stored in locked areas, removed from the premises, or otherwise inaccessible to children. Item #1768 The one (1) NC Pre-K child must have a hearing screening on file. 10A NCAC 09 .3005 CHILD HEALTH ASSESSMENTS (a) A health assessment shall be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment shall include the following: (4) hearing screening; Item # 1769 The one (1) NC Pre-K child must have a dental screening on file. 10A NCAC 09 .3005 CHILD HEALTH ASSESSMENTS (a) A health assessment shall be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment shall include the following: (5) dental screening. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/30/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall 2 Pinehurst Ct. Asheville, NC 28805 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed the Prevention of Shaken Baby Syndrome and Abusive Head Trauma Policy and the Discipline policy requirements. Both of these forms require the child’s date of enrollment to be on the acknowledgement. Plan to update your policy acknowledgement form to include the date of the child’s enrollment. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Your facility has been placed in cohort 1. You are currently in your prep year which ends 6/30/24. Your reassessment year is 7/1/24-6/30/25. We discussed the importance of ensuring all staff are registered for a WORKS account and submit their transcripts to have their education evaluated by WORKS. We discussed the Prep Year Assessment. Information about this option was provided to you in the email containing this Visit Summary. Please note that the Prep Year assessment is only available until 6/30/24. If you would like to move forward with this opportunity, please complete send the Rated License Assessment Request Review form to me. A copy of this form is attached to the email containing this Visit Summary. Please plan to visit https://ncrlap.org/ for more information regarding Rated License and Environment Rating Scale. We discussed Education Points. On your current license, you have seven (7) points in education standards. We discussed the education requirements needed to maintain these points during your Rated License reassessment for Administrator, Teacher and Lead Teacher. We discussed the Quality Point option. You stated that you will be able to maintain your current Quality Point option during the Rated License reassessment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192 or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0701 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 11/16/2023 Number Present: 69 Completed Date: 11/16/2023 Age: From 0 To 5 Total Minutes: 405 Time In: 09:15 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Lisa McKnight, Program Coordinator, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. McKnight was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. Due to time constraints, monitoring of staff files was not completed today. A follow-up visit will be conducted to review existing staff files. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and will be emailed to you upon completion of the follow-up visit. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight (88%) percent as of 11/13/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, YWCA of Asheville and Western North Carolina, Inc., is current/active as of 11/13/23. Permit type – Five (5) star license issued 2/15/21. Special Services/Restrictions – 1st shift (daytime care), meets enhanced ratios, meets enhanced space, children under 2.5 years old in rooms with direct exits only. This facility meets requirements to provide transportation and NC Pre-K. This facility offers a swimming pool, field trips, and serves children with special needs. The last annual compliance visit was conducted on 12/2/22. The last fire drill was practiced on 10/30/23. The last shelter-in-place drill was practiced on 912/23. The last playground inspection was documented on 10/30/23. The last fire inspection was approved on 7/5/23. The last sanitation inspection was conducted on 9/12/23 with fourteen (14) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. The approved formative assessment tool is Teaching Strategies Gold. The center’s Emergency Preparedness and Response plan was updated on 9/12/23. There are seventy-eight (78) children enrolled, including eighteen (18) NC Pre-K children. Eight (8) children’s files were monitored today, including two (2) NC Pre-K children’s files. There are twenty-six (26) staff. Five (5) new staff files were monitored today. Existing staff files will be monitored during the return visit. Upon arrival I was greeted by Dr. Ameris Lavendar, Chief Program Officer, and Lisa McKnight, Program Coordinator. Ms. McKnight accompanied me on the walkthrough of the indoor and outdoor spaces. In classroom space 1, children explored their environment by crawling, cruising and pulling up on furniture. Children were fed by caregivers and explored magnifying glasses. In classroom space 2, children were played outdoors, pushed toys, threw balls and ran down a path. In classroom space 3, children sang and danced to music and built long chains with plastic connectors. I observed a diaper change in which all steps were followed according to sanitation requirements. In classroom space 4, children played outside, climbed on structures and explored acorns with the caregiver. In classroom space 10, children in the NC Pre-K classroom built small houses with magnatiles, prepared pretend food in the dramatic play kitchen, read books, put together Mr. Potato Head, and practice writing their names with teacher and peer support. In classroom space 7, children used rolling pins and cookie cutters to explore clay, prepared pretend food in the dramatic play kitchen, and explored a set of toy horses with riders. Interactions were positive and nurturing. Children were soothed and redirected as needed. Supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. You stated the transportation is only used for field trips. Transportation was not able to be monitored today due to the vehicle needing repairs off site. Transportation will be monitored during the Routine Unannounced visit which will occur in approximately four (4) to six (6) months. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. The NC Pre-K Program Site Monitoring Tool was reviewed today and was completed on 10/27/23 by Lisa McKnight and Millad Nooraei. The classroom operates from 8:30 a.m. to 3:00 p.m. The following violations were documented during today’s visit: Violation Number Comment Rule 811 Potentially hazardous items including but not limited to power tools, nails, chemicals, propane stoves, lawn mowers, gasoline, or kerosene were not stored in locked areas, removed from the premises, or made inaccessible to children. In classroom space 2, one (1) spray bottle of disinfectant was placed in a location accessible to children. .0604(a) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Two (2) staff received a medical report after the date of employment. Five (5) support staff did not have a medical report 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. Two (2) staff received a TB test or screening after the first day of work. One (1) support staff did not have a TB test or screening on file. Please refer to your staff and training worksheet for additional information. .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. One staff, hire date 10/12/23, received the Criminal Background Check qualifying letter on 10/13/23. G.S. 110-90.2(b) 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, hire date 3/6/23, does not have a First Aid certificate on file. .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, hire date 3/6/23, did not have a CPR certificate on file. .1102(d) 1768 The health assessment did not include a hearing screening. One (1) child's file did not include a hearing screening. .3005 (a)(4) 1769 The health assessment did not include a dental screening. One (1) child's file did not include a dental screening. .3005 (a)(5) 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. Three (3) support staff did not complete Recognizing and Responding to Suspicions to Child Maltreatment Training. Please refer to the staff and training worksheet for additional information. .1102(g) Technical assistance was provided as follows: Item #811 The bottle of sanitizing spray in classroom space 2 was moved to a location five (5) feet high during the visit. The closet containing cleaners and an aerosol can was locked during the visit. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (a) In child care centers, potentially hazardous items, including power tools, nails, chemicals, propane stoves, lawn mowers, and gasoline or kerosene, whether or not intended for use by children, shall be stored in locked areas, removed from the premises, or otherwise inaccessible to children. Item #1768 The one (1) NC Pre-K child must have a hearing screening on file. 10A NCAC 09 .3005 CHILD HEALTH ASSESSMENTS (a) A health assessment shall be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment shall include the following: (4) hearing screening; Item # 1769 The one (1) NC Pre-K child must have a dental screening on file. 10A NCAC 09 .3005 CHILD HEALTH ASSESSMENTS (a) A health assessment shall be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment shall include the following: (5) dental screening. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/30/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall 2 Pinehurst Ct. Asheville, NC 28805 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed the Prevention of Shaken Baby Syndrome and Abusive Head Trauma Policy and the Discipline policy requirements. Both of these forms require the child’s date of enrollment to be on the acknowledgement. Plan to update your policy acknowledgement form to include the date of the child’s enrollment. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Your facility has been placed in cohort 1. You are currently in your prep year which ends 6/30/24. Your reassessment year is 7/1/24-6/30/25. We discussed the importance of ensuring all staff are registered for a WORKS account and submit their transcripts to have their education evaluated by WORKS. We discussed the Prep Year Assessment. Information about this option was provided to you in the email containing this Visit Summary. Please note that the Prep Year assessment is only available until 6/30/24. If you would like to move forward with this opportunity, please complete send the Rated License Assessment Request Review form to me. A copy of this form is attached to the email containing this Visit Summary. Please plan to visit https://ncrlap.org/ for more information regarding Rated License and Environment Rating Scale. We discussed Education Points. On your current license, you have seven (7) points in education standards. We discussed the education requirements needed to maintain these points during your Rated License reassessment for Administrator, Teacher and Lead Teacher. We discussed the Quality Point option. You stated that you will be able to maintain your current Quality Point option during the Rated License reassessment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192 or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 11/16/2023 Number Present: 69 Completed Date: 11/16/2023 Age: From 0 To 5 Total Minutes: 405 Time In: 09:15 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Lisa McKnight, Program Coordinator, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. McKnight was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. Due to time constraints, monitoring of staff files was not completed today. A follow-up visit will be conducted to review existing staff files. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and will be emailed to you upon completion of the follow-up visit. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight (88%) percent as of 11/13/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, YWCA of Asheville and Western North Carolina, Inc., is current/active as of 11/13/23. Permit type – Five (5) star license issued 2/15/21. Special Services/Restrictions – 1st shift (daytime care), meets enhanced ratios, meets enhanced space, children under 2.5 years old in rooms with direct exits only. This facility meets requirements to provide transportation and NC Pre-K. This facility offers a swimming pool, field trips, and serves children with special needs. The last annual compliance visit was conducted on 12/2/22. The last fire drill was practiced on 10/30/23. The last shelter-in-place drill was practiced on 912/23. The last playground inspection was documented on 10/30/23. The last fire inspection was approved on 7/5/23. The last sanitation inspection was conducted on 9/12/23 with fourteen (14) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. The approved formative assessment tool is Teaching Strategies Gold. The center’s Emergency Preparedness and Response plan was updated on 9/12/23. There are seventy-eight (78) children enrolled, including eighteen (18) NC Pre-K children. Eight (8) children’s files were monitored today, including two (2) NC Pre-K children’s files. There are twenty-six (26) staff. Five (5) new staff files were monitored today. Existing staff files will be monitored during the return visit. Upon arrival I was greeted by Dr. Ameris Lavendar, Chief Program Officer, and Lisa McKnight, Program Coordinator. Ms. McKnight accompanied me on the walkthrough of the indoor and outdoor spaces. In classroom space 1, children explored their environment by crawling, cruising and pulling up on furniture. Children were fed by caregivers and explored magnifying glasses. In classroom space 2, children were played outdoors, pushed toys, threw balls and ran down a path. In classroom space 3, children sang and danced to music and built long chains with plastic connectors. I observed a diaper change in which all steps were followed according to sanitation requirements. In classroom space 4, children played outside, climbed on structures and explored acorns with the caregiver. In classroom space 10, children in the NC Pre-K classroom built small houses with magnatiles, prepared pretend food in the dramatic play kitchen, read books, put together Mr. Potato Head, and practice writing their names with teacher and peer support. In classroom space 7, children used rolling pins and cookie cutters to explore clay, prepared pretend food in the dramatic play kitchen, and explored a set of toy horses with riders. Interactions were positive and nurturing. Children were soothed and redirected as needed. Supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. You stated the transportation is only used for field trips. Transportation was not able to be monitored today due to the vehicle needing repairs off site. Transportation will be monitored during the Routine Unannounced visit which will occur in approximately four (4) to six (6) months. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. The NC Pre-K Program Site Monitoring Tool was reviewed today and was completed on 10/27/23 by Lisa McKnight and Millad Nooraei. The classroom operates from 8:30 a.m. to 3:00 p.m. The following violations were documented during today’s visit: Violation Number Comment Rule 811 Potentially hazardous items including but not limited to power tools, nails, chemicals, propane stoves, lawn mowers, gasoline, or kerosene were not stored in locked areas, removed from the premises, or made inaccessible to children. In classroom space 2, one (1) spray bottle of disinfectant was placed in a location accessible to children. .0604(a) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Two (2) staff received a medical report after the date of employment. Five (5) support staff did not have a medical report 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. Two (2) staff received a TB test or screening after the first day of work. One (1) support staff did not have a TB test or screening on file. Please refer to your staff and training worksheet for additional information. .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. One staff, hire date 10/12/23, received the Criminal Background Check qualifying letter on 10/13/23. G.S. 110-90.2(b) 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, hire date 3/6/23, does not have a First Aid certificate on file. .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, hire date 3/6/23, did not have a CPR certificate on file. .1102(d) 1768 The health assessment did not include a hearing screening. One (1) child's file did not include a hearing screening. .3005 (a)(4) 1769 The health assessment did not include a dental screening. One (1) child's file did not include a dental screening. .3005 (a)(5) 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. Three (3) support staff did not complete Recognizing and Responding to Suspicions to Child Maltreatment Training. Please refer to the staff and training worksheet for additional information. .1102(g) Technical assistance was provided as follows: Item #811 The bottle of sanitizing spray in classroom space 2 was moved to a location five (5) feet high during the visit. The closet containing cleaners and an aerosol can was locked during the visit. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (a) In child care centers, potentially hazardous items, including power tools, nails, chemicals, propane stoves, lawn mowers, and gasoline or kerosene, whether or not intended for use by children, shall be stored in locked areas, removed from the premises, or otherwise inaccessible to children. Item #1768 The one (1) NC Pre-K child must have a hearing screening on file. 10A NCAC 09 .3005 CHILD HEALTH ASSESSMENTS (a) A health assessment shall be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment shall include the following: (4) hearing screening; Item # 1769 The one (1) NC Pre-K child must have a dental screening on file. 10A NCAC 09 .3005 CHILD HEALTH ASSESSMENTS (a) A health assessment shall be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment shall include the following: (5) dental screening. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/30/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall 2 Pinehurst Ct. Asheville, NC 28805 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed the Prevention of Shaken Baby Syndrome and Abusive Head Trauma Policy and the Discipline policy requirements. Both of these forms require the child’s date of enrollment to be on the acknowledgement. Plan to update your policy acknowledgement form to include the date of the child’s enrollment. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Your facility has been placed in cohort 1. You are currently in your prep year which ends 6/30/24. Your reassessment year is 7/1/24-6/30/25. We discussed the importance of ensuring all staff are registered for a WORKS account and submit their transcripts to have their education evaluated by WORKS. We discussed the Prep Year Assessment. Information about this option was provided to you in the email containing this Visit Summary. Please note that the Prep Year assessment is only available until 6/30/24. If you would like to move forward with this opportunity, please complete send the Rated License Assessment Request Review form to me. A copy of this form is attached to the email containing this Visit Summary. Please plan to visit https://ncrlap.org/ for more information regarding Rated License and Environment Rating Scale. We discussed Education Points. On your current license, you have seven (7) points in education standards. We discussed the education requirements needed to maintain these points during your Rated License reassessment for Administrator, Teacher and Lead Teacher. We discussed the Quality Point option. You stated that you will be able to maintain your current Quality Point option during the Rated License reassessment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192 or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 11/16/2023 Number Present: 69 Completed Date: 11/16/2023 Age: From 0 To 5 Total Minutes: 405 Time In: 09:15 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Lisa McKnight, Program Coordinator, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. McKnight was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. Due to time constraints, monitoring of staff files was not completed today. A follow-up visit will be conducted to review existing staff files. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and will be emailed to you upon completion of the follow-up visit. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight (88%) percent as of 11/13/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, YWCA of Asheville and Western North Carolina, Inc., is current/active as of 11/13/23. Permit type – Five (5) star license issued 2/15/21. Special Services/Restrictions – 1st shift (daytime care), meets enhanced ratios, meets enhanced space, children under 2.5 years old in rooms with direct exits only. This facility meets requirements to provide transportation and NC Pre-K. This facility offers a swimming pool, field trips, and serves children with special needs. The last annual compliance visit was conducted on 12/2/22. The last fire drill was practiced on 10/30/23. The last shelter-in-place drill was practiced on 912/23. The last playground inspection was documented on 10/30/23. The last fire inspection was approved on 7/5/23. The last sanitation inspection was conducted on 9/12/23 with fourteen (14) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. The approved formative assessment tool is Teaching Strategies Gold. The center’s Emergency Preparedness and Response plan was updated on 9/12/23. There are seventy-eight (78) children enrolled, including eighteen (18) NC Pre-K children. Eight (8) children’s files were monitored today, including two (2) NC Pre-K children’s files. There are twenty-six (26) staff. Five (5) new staff files were monitored today. Existing staff files will be monitored during the return visit. Upon arrival I was greeted by Dr. Ameris Lavendar, Chief Program Officer, and Lisa McKnight, Program Coordinator. Ms. McKnight accompanied me on the walkthrough of the indoor and outdoor spaces. In classroom space 1, children explored their environment by crawling, cruising and pulling up on furniture. Children were fed by caregivers and explored magnifying glasses. In classroom space 2, children were played outdoors, pushed toys, threw balls and ran down a path. In classroom space 3, children sang and danced to music and built long chains with plastic connectors. I observed a diaper change in which all steps were followed according to sanitation requirements. In classroom space 4, children played outside, climbed on structures and explored acorns with the caregiver. In classroom space 10, children in the NC Pre-K classroom built small houses with magnatiles, prepared pretend food in the dramatic play kitchen, read books, put together Mr. Potato Head, and practice writing their names with teacher and peer support. In classroom space 7, children used rolling pins and cookie cutters to explore clay, prepared pretend food in the dramatic play kitchen, and explored a set of toy horses with riders. Interactions were positive and nurturing. Children were soothed and redirected as needed. Supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. You stated the transportation is only used for field trips. Transportation was not able to be monitored today due to the vehicle needing repairs off site. Transportation will be monitored during the Routine Unannounced visit which will occur in approximately four (4) to six (6) months. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. The NC Pre-K Program Site Monitoring Tool was reviewed today and was completed on 10/27/23 by Lisa McKnight and Millad Nooraei. The classroom operates from 8:30 a.m. to 3:00 p.m. The following violations were documented during today’s visit: Violation Number Comment Rule 811 Potentially hazardous items including but not limited to power tools, nails, chemicals, propane stoves, lawn mowers, gasoline, or kerosene were not stored in locked areas, removed from the premises, or made inaccessible to children. In classroom space 2, one (1) spray bottle of disinfectant was placed in a location accessible to children. .0604(a) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Two (2) staff received a medical report after the date of employment. Five (5) support staff did not have a medical report 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. Two (2) staff received a TB test or screening after the first day of work. One (1) support staff did not have a TB test or screening on file. Please refer to your staff and training worksheet for additional information. .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. One staff, hire date 10/12/23, received the Criminal Background Check qualifying letter on 10/13/23. G.S. 110-90.2(b) 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, hire date 3/6/23, does not have a First Aid certificate on file. .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, hire date 3/6/23, did not have a CPR certificate on file. .1102(d) 1768 The health assessment did not include a hearing screening. One (1) child's file did not include a hearing screening. .3005 (a)(4) 1769 The health assessment did not include a dental screening. One (1) child's file did not include a dental screening. .3005 (a)(5) 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. Three (3) support staff did not complete Recognizing and Responding to Suspicions to Child Maltreatment Training. Please refer to the staff and training worksheet for additional information. .1102(g) Technical assistance was provided as follows: Item #811 The bottle of sanitizing spray in classroom space 2 was moved to a location five (5) feet high during the visit. The closet containing cleaners and an aerosol can was locked during the visit. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (a) In child care centers, potentially hazardous items, including power tools, nails, chemicals, propane stoves, lawn mowers, and gasoline or kerosene, whether or not intended for use by children, shall be stored in locked areas, removed from the premises, or otherwise inaccessible to children. Item #1768 The one (1) NC Pre-K child must have a hearing screening on file. 10A NCAC 09 .3005 CHILD HEALTH ASSESSMENTS (a) A health assessment shall be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment shall include the following: (4) hearing screening; Item # 1769 The one (1) NC Pre-K child must have a dental screening on file. 10A NCAC 09 .3005 CHILD HEALTH ASSESSMENTS (a) A health assessment shall be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment shall include the following: (5) dental screening. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/30/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall 2 Pinehurst Ct. Asheville, NC 28805 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed the Prevention of Shaken Baby Syndrome and Abusive Head Trauma Policy and the Discipline policy requirements. Both of these forms require the child’s date of enrollment to be on the acknowledgement. Plan to update your policy acknowledgement form to include the date of the child’s enrollment. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Your facility has been placed in cohort 1. You are currently in your prep year which ends 6/30/24. Your reassessment year is 7/1/24-6/30/25. We discussed the importance of ensuring all staff are registered for a WORKS account and submit their transcripts to have their education evaluated by WORKS. We discussed the Prep Year Assessment. Information about this option was provided to you in the email containing this Visit Summary. Please note that the Prep Year assessment is only available until 6/30/24. If you would like to move forward with this opportunity, please complete send the Rated License Assessment Request Review form to me. A copy of this form is attached to the email containing this Visit Summary. Please plan to visit https://ncrlap.org/ for more information regarding Rated License and Environment Rating Scale. We discussed Education Points. On your current license, you have seven (7) points in education standards. We discussed the education requirements needed to maintain these points during your Rated License reassessment for Administrator, Teacher and Lead Teacher. We discussed the Quality Point option. You stated that you will be able to maintain your current Quality Point option during the Rated License reassessment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192 or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 11/16/2023 Number Present: 69 Completed Date: 11/16/2023 Age: From 0 To 5 Total Minutes: 405 Time In: 09:15 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Lisa McKnight, Program Coordinator, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. McKnight was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. Due to time constraints, monitoring of staff files was not completed today. A follow-up visit will be conducted to review existing staff files. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and will be emailed to you upon completion of the follow-up visit. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight (88%) percent as of 11/13/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, YWCA of Asheville and Western North Carolina, Inc., is current/active as of 11/13/23. Permit type – Five (5) star license issued 2/15/21. Special Services/Restrictions – 1st shift (daytime care), meets enhanced ratios, meets enhanced space, children under 2.5 years old in rooms with direct exits only. This facility meets requirements to provide transportation and NC Pre-K. This facility offers a swimming pool, field trips, and serves children with special needs. The last annual compliance visit was conducted on 12/2/22. The last fire drill was practiced on 10/30/23. The last shelter-in-place drill was practiced on 912/23. The last playground inspection was documented on 10/30/23. The last fire inspection was approved on 7/5/23. The last sanitation inspection was conducted on 9/12/23 with fourteen (14) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. The approved formative assessment tool is Teaching Strategies Gold. The center’s Emergency Preparedness and Response plan was updated on 9/12/23. There are seventy-eight (78) children enrolled, including eighteen (18) NC Pre-K children. Eight (8) children’s files were monitored today, including two (2) NC Pre-K children’s files. There are twenty-six (26) staff. Five (5) new staff files were monitored today. Existing staff files will be monitored during the return visit. Upon arrival I was greeted by Dr. Ameris Lavendar, Chief Program Officer, and Lisa McKnight, Program Coordinator. Ms. McKnight accompanied me on the walkthrough of the indoor and outdoor spaces. In classroom space 1, children explored their environment by crawling, cruising and pulling up on furniture. Children were fed by caregivers and explored magnifying glasses. In classroom space 2, children were played outdoors, pushed toys, threw balls and ran down a path. In classroom space 3, children sang and danced to music and built long chains with plastic connectors. I observed a diaper change in which all steps were followed according to sanitation requirements. In classroom space 4, children played outside, climbed on structures and explored acorns with the caregiver. In classroom space 10, children in the NC Pre-K classroom built small houses with magnatiles, prepared pretend food in the dramatic play kitchen, read books, put together Mr. Potato Head, and practice writing their names with teacher and peer support. In classroom space 7, children used rolling pins and cookie cutters to explore clay, prepared pretend food in the dramatic play kitchen, and explored a set of toy horses with riders. Interactions were positive and nurturing. Children were soothed and redirected as needed. Supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. You stated the transportation is only used for field trips. Transportation was not able to be monitored today due to the vehicle needing repairs off site. Transportation will be monitored during the Routine Unannounced visit which will occur in approximately four (4) to six (6) months. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. The NC Pre-K Program Site Monitoring Tool was reviewed today and was completed on 10/27/23 by Lisa McKnight and Millad Nooraei. The classroom operates from 8:30 a.m. to 3:00 p.m. The following violations were documented during today’s visit: Violation Number Comment Rule 811 Potentially hazardous items including but not limited to power tools, nails, chemicals, propane stoves, lawn mowers, gasoline, or kerosene were not stored in locked areas, removed from the premises, or made inaccessible to children. In classroom space 2, one (1) spray bottle of disinfectant was placed in a location accessible to children. .0604(a) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Two (2) staff received a medical report after the date of employment. Five (5) support staff did not have a medical report 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. Two (2) staff received a TB test or screening after the first day of work. One (1) support staff did not have a TB test or screening on file. Please refer to your staff and training worksheet for additional information. .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. One staff, hire date 10/12/23, received the Criminal Background Check qualifying letter on 10/13/23. G.S. 110-90.2(b) 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, hire date 3/6/23, does not have a First Aid certificate on file. .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, hire date 3/6/23, did not have a CPR certificate on file. .1102(d) 1768 The health assessment did not include a hearing screening. One (1) child's file did not include a hearing screening. .3005 (a)(4) 1769 The health assessment did not include a dental screening. One (1) child's file did not include a dental screening. .3005 (a)(5) 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. Three (3) support staff did not complete Recognizing and Responding to Suspicions to Child Maltreatment Training. Please refer to the staff and training worksheet for additional information. .1102(g) Technical assistance was provided as follows: Item #811 The bottle of sanitizing spray in classroom space 2 was moved to a location five (5) feet high during the visit. The closet containing cleaners and an aerosol can was locked during the visit. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (a) In child care centers, potentially hazardous items, including power tools, nails, chemicals, propane stoves, lawn mowers, and gasoline or kerosene, whether or not intended for use by children, shall be stored in locked areas, removed from the premises, or otherwise inaccessible to children. Item #1768 The one (1) NC Pre-K child must have a hearing screening on file. 10A NCAC 09 .3005 CHILD HEALTH ASSESSMENTS (a) A health assessment shall be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment shall include the following: (4) hearing screening; Item # 1769 The one (1) NC Pre-K child must have a dental screening on file. 10A NCAC 09 .3005 CHILD HEALTH ASSESSMENTS (a) A health assessment shall be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment shall include the following: (5) dental screening. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/30/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall 2 Pinehurst Ct. Asheville, NC 28805 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed the Prevention of Shaken Baby Syndrome and Abusive Head Trauma Policy and the Discipline policy requirements. Both of these forms require the child’s date of enrollment to be on the acknowledgement. Plan to update your policy acknowledgement form to include the date of the child’s enrollment. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Your facility has been placed in cohort 1. You are currently in your prep year which ends 6/30/24. Your reassessment year is 7/1/24-6/30/25. We discussed the importance of ensuring all staff are registered for a WORKS account and submit their transcripts to have their education evaluated by WORKS. We discussed the Prep Year Assessment. Information about this option was provided to you in the email containing this Visit Summary. Please note that the Prep Year assessment is only available until 6/30/24. If you would like to move forward with this opportunity, please complete send the Rated License Assessment Request Review form to me. A copy of this form is attached to the email containing this Visit Summary. Please plan to visit https://ncrlap.org/ for more information regarding Rated License and Environment Rating Scale. We discussed Education Points. On your current license, you have seven (7) points in education standards. We discussed the education requirements needed to maintain these points during your Rated License reassessment for Administrator, Teacher and Lead Teacher. We discussed the Quality Point option. You stated that you will be able to maintain your current Quality Point option during the Rated License reassessment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192 or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .3005 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 11/16/2023 Number Present: 69 Completed Date: 11/16/2023 Age: From 0 To 5 Total Minutes: 405 Time In: 09:15 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Lisa McKnight, Program Coordinator, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. McKnight was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. Due to time constraints, monitoring of staff files was not completed today. A follow-up visit will be conducted to review existing staff files. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and will be emailed to you upon completion of the follow-up visit. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight (88%) percent as of 11/13/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, YWCA of Asheville and Western North Carolina, Inc., is current/active as of 11/13/23. Permit type – Five (5) star license issued 2/15/21. Special Services/Restrictions – 1st shift (daytime care), meets enhanced ratios, meets enhanced space, children under 2.5 years old in rooms with direct exits only. This facility meets requirements to provide transportation and NC Pre-K. This facility offers a swimming pool, field trips, and serves children with special needs. The last annual compliance visit was conducted on 12/2/22. The last fire drill was practiced on 10/30/23. The last shelter-in-place drill was practiced on 912/23. The last playground inspection was documented on 10/30/23. The last fire inspection was approved on 7/5/23. The last sanitation inspection was conducted on 9/12/23 with fourteen (14) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. The approved formative assessment tool is Teaching Strategies Gold. The center’s Emergency Preparedness and Response plan was updated on 9/12/23. There are seventy-eight (78) children enrolled, including eighteen (18) NC Pre-K children. Eight (8) children’s files were monitored today, including two (2) NC Pre-K children’s files. There are twenty-six (26) staff. Five (5) new staff files were monitored today. Existing staff files will be monitored during the return visit. Upon arrival I was greeted by Dr. Ameris Lavendar, Chief Program Officer, and Lisa McKnight, Program Coordinator. Ms. McKnight accompanied me on the walkthrough of the indoor and outdoor spaces. In classroom space 1, children explored their environment by crawling, cruising and pulling up on furniture. Children were fed by caregivers and explored magnifying glasses. In classroom space 2, children were played outdoors, pushed toys, threw balls and ran down a path. In classroom space 3, children sang and danced to music and built long chains with plastic connectors. I observed a diaper change in which all steps were followed according to sanitation requirements. In classroom space 4, children played outside, climbed on structures and explored acorns with the caregiver. In classroom space 10, children in the NC Pre-K classroom built small houses with magnatiles, prepared pretend food in the dramatic play kitchen, read books, put together Mr. Potato Head, and practice writing their names with teacher and peer support. In classroom space 7, children used rolling pins and cookie cutters to explore clay, prepared pretend food in the dramatic play kitchen, and explored a set of toy horses with riders. Interactions were positive and nurturing. Children were soothed and redirected as needed. Supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. You stated the transportation is only used for field trips. Transportation was not able to be monitored today due to the vehicle needing repairs off site. Transportation will be monitored during the Routine Unannounced visit which will occur in approximately four (4) to six (6) months. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. The NC Pre-K Program Site Monitoring Tool was reviewed today and was completed on 10/27/23 by Lisa McKnight and Millad Nooraei. The classroom operates from 8:30 a.m. to 3:00 p.m. The following violations were documented during today’s visit: Violation Number Comment Rule 811 Potentially hazardous items including but not limited to power tools, nails, chemicals, propane stoves, lawn mowers, gasoline, or kerosene were not stored in locked areas, removed from the premises, or made inaccessible to children. In classroom space 2, one (1) spray bottle of disinfectant was placed in a location accessible to children. .0604(a) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Two (2) staff received a medical report after the date of employment. Five (5) support staff did not have a medical report 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. Two (2) staff received a TB test or screening after the first day of work. One (1) support staff did not have a TB test or screening on file. Please refer to your staff and training worksheet for additional information. .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. One staff, hire date 10/12/23, received the Criminal Background Check qualifying letter on 10/13/23. G.S. 110-90.2(b) 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, hire date 3/6/23, does not have a First Aid certificate on file. .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, hire date 3/6/23, did not have a CPR certificate on file. .1102(d) 1768 The health assessment did not include a hearing screening. One (1) child's file did not include a hearing screening. .3005 (a)(4) 1769 The health assessment did not include a dental screening. One (1) child's file did not include a dental screening. .3005 (a)(5) 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. Three (3) support staff did not complete Recognizing and Responding to Suspicions to Child Maltreatment Training. Please refer to the staff and training worksheet for additional information. .1102(g) Technical assistance was provided as follows: Item #811 The bottle of sanitizing spray in classroom space 2 was moved to a location five (5) feet high during the visit. The closet containing cleaners and an aerosol can was locked during the visit. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (a) In child care centers, potentially hazardous items, including power tools, nails, chemicals, propane stoves, lawn mowers, and gasoline or kerosene, whether or not intended for use by children, shall be stored in locked areas, removed from the premises, or otherwise inaccessible to children. Item #1768 The one (1) NC Pre-K child must have a hearing screening on file. 10A NCAC 09 .3005 CHILD HEALTH ASSESSMENTS (a) A health assessment shall be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment shall include the following: (4) hearing screening; Item # 1769 The one (1) NC Pre-K child must have a dental screening on file. 10A NCAC 09 .3005 CHILD HEALTH ASSESSMENTS (a) A health assessment shall be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment shall include the following: (5) dental screening. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/30/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall 2 Pinehurst Ct. Asheville, NC 28805 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed the Prevention of Shaken Baby Syndrome and Abusive Head Trauma Policy and the Discipline policy requirements. Both of these forms require the child’s date of enrollment to be on the acknowledgement. Plan to update your policy acknowledgement form to include the date of the child’s enrollment. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Your facility has been placed in cohort 1. You are currently in your prep year which ends 6/30/24. Your reassessment year is 7/1/24-6/30/25. We discussed the importance of ensuring all staff are registered for a WORKS account and submit their transcripts to have their education evaluated by WORKS. We discussed the Prep Year Assessment. Information about this option was provided to you in the email containing this Visit Summary. Please note that the Prep Year assessment is only available until 6/30/24. If you would like to move forward with this opportunity, please complete send the Rated License Assessment Request Review form to me. A copy of this form is attached to the email containing this Visit Summary. Please plan to visit https://ncrlap.org/ for more information regarding Rated License and Environment Rating Scale. We discussed Education Points. On your current license, you have seven (7) points in education standards. We discussed the education requirements needed to maintain these points during your Rated License reassessment for Administrator, Teacher and Lead Teacher. We discussed the Quality Point option. You stated that you will be able to maintain your current Quality Point option during the Rated License reassessment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192 or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 11/16/2023 Number Present: 69 Completed Date: 11/16/2023 Age: From 0 To 5 Total Minutes: 405 Time In: 09:15 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Lisa McKnight, Program Coordinator, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. McKnight was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. Due to time constraints, monitoring of staff files was not completed today. A follow-up visit will be conducted to review existing staff files. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and will be emailed to you upon completion of the follow-up visit. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight (88%) percent as of 11/13/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, YWCA of Asheville and Western North Carolina, Inc., is current/active as of 11/13/23. Permit type – Five (5) star license issued 2/15/21. Special Services/Restrictions – 1st shift (daytime care), meets enhanced ratios, meets enhanced space, children under 2.5 years old in rooms with direct exits only. This facility meets requirements to provide transportation and NC Pre-K. This facility offers a swimming pool, field trips, and serves children with special needs. The last annual compliance visit was conducted on 12/2/22. The last fire drill was practiced on 10/30/23. The last shelter-in-place drill was practiced on 912/23. The last playground inspection was documented on 10/30/23. The last fire inspection was approved on 7/5/23. The last sanitation inspection was conducted on 9/12/23 with fourteen (14) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. The approved formative assessment tool is Teaching Strategies Gold. The center’s Emergency Preparedness and Response plan was updated on 9/12/23. There are seventy-eight (78) children enrolled, including eighteen (18) NC Pre-K children. Eight (8) children’s files were monitored today, including two (2) NC Pre-K children’s files. There are twenty-six (26) staff. Five (5) new staff files were monitored today. Existing staff files will be monitored during the return visit. Upon arrival I was greeted by Dr. Ameris Lavendar, Chief Program Officer, and Lisa McKnight, Program Coordinator. Ms. McKnight accompanied me on the walkthrough of the indoor and outdoor spaces. In classroom space 1, children explored their environment by crawling, cruising and pulling up on furniture. Children were fed by caregivers and explored magnifying glasses. In classroom space 2, children were played outdoors, pushed toys, threw balls and ran down a path. In classroom space 3, children sang and danced to music and built long chains with plastic connectors. I observed a diaper change in which all steps were followed according to sanitation requirements. In classroom space 4, children played outside, climbed on structures and explored acorns with the caregiver. In classroom space 10, children in the NC Pre-K classroom built small houses with magnatiles, prepared pretend food in the dramatic play kitchen, read books, put together Mr. Potato Head, and practice writing their names with teacher and peer support. In classroom space 7, children used rolling pins and cookie cutters to explore clay, prepared pretend food in the dramatic play kitchen, and explored a set of toy horses with riders. Interactions were positive and nurturing. Children were soothed and redirected as needed. Supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. You stated the transportation is only used for field trips. Transportation was not able to be monitored today due to the vehicle needing repairs off site. Transportation will be monitored during the Routine Unannounced visit which will occur in approximately four (4) to six (6) months. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. The NC Pre-K Program Site Monitoring Tool was reviewed today and was completed on 10/27/23 by Lisa McKnight and Millad Nooraei. The classroom operates from 8:30 a.m. to 3:00 p.m. The following violations were documented during today’s visit: Violation Number Comment Rule 811 Potentially hazardous items including but not limited to power tools, nails, chemicals, propane stoves, lawn mowers, gasoline, or kerosene were not stored in locked areas, removed from the premises, or made inaccessible to children. In classroom space 2, one (1) spray bottle of disinfectant was placed in a location accessible to children. .0604(a) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Two (2) staff received a medical report after the date of employment. Five (5) support staff did not have a medical report 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. Two (2) staff received a TB test or screening after the first day of work. One (1) support staff did not have a TB test or screening on file. Please refer to your staff and training worksheet for additional information. .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. One staff, hire date 10/12/23, received the Criminal Background Check qualifying letter on 10/13/23. G.S. 110-90.2(b) 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, hire date 3/6/23, does not have a First Aid certificate on file. .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, hire date 3/6/23, did not have a CPR certificate on file. .1102(d) 1768 The health assessment did not include a hearing screening. One (1) child's file did not include a hearing screening. .3005 (a)(4) 1769 The health assessment did not include a dental screening. One (1) child's file did not include a dental screening. .3005 (a)(5) 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. Three (3) support staff did not complete Recognizing and Responding to Suspicions to Child Maltreatment Training. Please refer to the staff and training worksheet for additional information. .1102(g) Technical assistance was provided as follows: Item #811 The bottle of sanitizing spray in classroom space 2 was moved to a location five (5) feet high during the visit. The closet containing cleaners and an aerosol can was locked during the visit. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (a) In child care centers, potentially hazardous items, including power tools, nails, chemicals, propane stoves, lawn mowers, and gasoline or kerosene, whether or not intended for use by children, shall be stored in locked areas, removed from the premises, or otherwise inaccessible to children. Item #1768 The one (1) NC Pre-K child must have a hearing screening on file. 10A NCAC 09 .3005 CHILD HEALTH ASSESSMENTS (a) A health assessment shall be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment shall include the following: (4) hearing screening; Item # 1769 The one (1) NC Pre-K child must have a dental screening on file. 10A NCAC 09 .3005 CHILD HEALTH ASSESSMENTS (a) A health assessment shall be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment shall include the following: (5) dental screening. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/30/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall 2 Pinehurst Ct. Asheville, NC 28805 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed the Prevention of Shaken Baby Syndrome and Abusive Head Trauma Policy and the Discipline policy requirements. Both of these forms require the child’s date of enrollment to be on the acknowledgement. Plan to update your policy acknowledgement form to include the date of the child’s enrollment. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Your facility has been placed in cohort 1. You are currently in your prep year which ends 6/30/24. Your reassessment year is 7/1/24-6/30/25. We discussed the importance of ensuring all staff are registered for a WORKS account and submit their transcripts to have their education evaluated by WORKS. We discussed the Prep Year Assessment. Information about this option was provided to you in the email containing this Visit Summary. Please note that the Prep Year assessment is only available until 6/30/24. If you would like to move forward with this opportunity, please complete send the Rated License Assessment Request Review form to me. A copy of this form is attached to the email containing this Visit Summary. Please plan to visit https://ncrlap.org/ for more information regarding Rated License and Environment Rating Scale. We discussed Education Points. On your current license, you have seven (7) points in education standards. We discussed the education requirements needed to maintain these points during your Rated License reassessment for Administrator, Teacher and Lead Teacher. We discussed the Quality Point option. You stated that you will be able to maintain your current Quality Point option during the Rated License reassessment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192 or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: YWCA OF ASHEVILLE EARLY LEARNING PROGRAM Facility ID: 11000405 Consultant: KAITLYN MARSHALL Operation Type: Center Case Number: Visit Date: 11/16/2023 Number Present: 69 Completed Date: 11/16/2023 Age: From 0 To 5 Total Minutes: 405 Time In: 09:15 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Kaitlyn Marshall, Child Care Consultant and also signed by Lisa McKnight, Program Coordinator, during the visit. An electronic signed copy of the visit summary was emailed to you. Ms. McKnight was present and available to ask and answer questions throughout the visit today. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. Due to time constraints, monitoring of staff files was not completed today. A follow-up visit will be conducted to review existing staff files. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and will be emailed to you upon completion of the follow-up visit. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight (88%) percent as of 11/13/23. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, YWCA of Asheville and Western North Carolina, Inc., is current/active as of 11/13/23. Permit type – Five (5) star license issued 2/15/21. Special Services/Restrictions – 1st shift (daytime care), meets enhanced ratios, meets enhanced space, children under 2.5 years old in rooms with direct exits only. This facility meets requirements to provide transportation and NC Pre-K. This facility offers a swimming pool, field trips, and serves children with special needs. The last annual compliance visit was conducted on 12/2/22. The last fire drill was practiced on 10/30/23. The last shelter-in-place drill was practiced on 912/23. The last playground inspection was documented on 10/30/23. The last fire inspection was approved on 7/5/23. The last sanitation inspection was conducted on 9/12/23 with fourteen (14) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. The approved formative assessment tool is Teaching Strategies Gold. The center’s Emergency Preparedness and Response plan was updated on 9/12/23. There are seventy-eight (78) children enrolled, including eighteen (18) NC Pre-K children. Eight (8) children’s files were monitored today, including two (2) NC Pre-K children’s files. There are twenty-six (26) staff. Five (5) new staff files were monitored today. Existing staff files will be monitored during the return visit. Upon arrival I was greeted by Dr. Ameris Lavendar, Chief Program Officer, and Lisa McKnight, Program Coordinator. Ms. McKnight accompanied me on the walkthrough of the indoor and outdoor spaces. In classroom space 1, children explored their environment by crawling, cruising and pulling up on furniture. Children were fed by caregivers and explored magnifying glasses. In classroom space 2, children were played outdoors, pushed toys, threw balls and ran down a path. In classroom space 3, children sang and danced to music and built long chains with plastic connectors. I observed a diaper change in which all steps were followed according to sanitation requirements. In classroom space 4, children played outside, climbed on structures and explored acorns with the caregiver. In classroom space 10, children in the NC Pre-K classroom built small houses with magnatiles, prepared pretend food in the dramatic play kitchen, read books, put together Mr. Potato Head, and practice writing their names with teacher and peer support. In classroom space 7, children used rolling pins and cookie cutters to explore clay, prepared pretend food in the dramatic play kitchen, and explored a set of toy horses with riders. Interactions were positive and nurturing. Children were soothed and redirected as needed. Supervision was adequate. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does provide transportation. You stated the transportation is only used for field trips. Transportation was not able to be monitored today due to the vehicle needing repairs off site. Transportation will be monitored during the Routine Unannounced visit which will occur in approximately four (4) to six (6) months. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. The NC Pre-K Program Site Monitoring Tool was reviewed today and was completed on 10/27/23 by Lisa McKnight and Millad Nooraei. The classroom operates from 8:30 a.m. to 3:00 p.m. The following violations were documented during today’s visit: Violation Number Comment Rule 811 Potentially hazardous items including but not limited to power tools, nails, chemicals, propane stoves, lawn mowers, gasoline, or kerosene were not stored in locked areas, removed from the premises, or made inaccessible to children. In classroom space 2, one (1) spray bottle of disinfectant was placed in a location accessible to children. .0604(a) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Two (2) staff received a medical report after the date of employment. Five (5) support staff did not have a medical report 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. Two (2) staff received a TB test or screening after the first day of work. One (1) support staff did not have a TB test or screening on file. Please refer to your staff and training worksheet for additional information. .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. One staff, hire date 10/12/23, received the Criminal Background Check qualifying letter on 10/13/23. G.S. 110-90.2(b) 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, hire date 3/6/23, does not have a First Aid certificate on file. .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, hire date 3/6/23, did not have a CPR certificate on file. .1102(d) 1768 The health assessment did not include a hearing screening. One (1) child's file did not include a hearing screening. .3005 (a)(4) 1769 The health assessment did not include a dental screening. One (1) child's file did not include a dental screening. .3005 (a)(5) 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. Three (3) support staff did not complete Recognizing and Responding to Suspicions to Child Maltreatment Training. Please refer to the staff and training worksheet for additional information. .1102(g) Technical assistance was provided as follows: Item #811 The bottle of sanitizing spray in classroom space 2 was moved to a location five (5) feet high during the visit. The closet containing cleaners and an aerosol can was locked during the visit. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (a) In child care centers, potentially hazardous items, including power tools, nails, chemicals, propane stoves, lawn mowers, and gasoline or kerosene, whether or not intended for use by children, shall be stored in locked areas, removed from the premises, or otherwise inaccessible to children. Item #1768 The one (1) NC Pre-K child must have a hearing screening on file. 10A NCAC 09 .3005 CHILD HEALTH ASSESSMENTS (a) A health assessment shall be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment shall include the following: (4) hearing screening; Item # 1769 The one (1) NC Pre-K child must have a dental screening on file. 10A NCAC 09 .3005 CHILD HEALTH ASSESSMENTS (a) A health assessment shall be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment shall include the following: (5) dental screening. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/30/23. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: kaitlyn.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Kaitlyn Marshall 2 Pinehurst Ct. Asheville, NC 28805 Please call me at 828-713-8192, or email kaitlyn.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed the Prevention of Shaken Baby Syndrome and Abusive Head Trauma Policy and the Discipline policy requirements. Both of these forms require the child’s date of enrollment to be on the acknowledgement. Plan to update your policy acknowledgement form to include the date of the child’s enrollment. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Your facility has been placed in cohort 1. You are currently in your prep year which ends 6/30/24. Your reassessment year is 7/1/24-6/30/25. We discussed the importance of ensuring all staff are registered for a WORKS account and submit their transcripts to have their education evaluated by WORKS. We discussed the Prep Year Assessment. Information about this option was provided to you in the email containing this Visit Summary. Please note that the Prep Year assessment is only available until 6/30/24. If you would like to move forward with this opportunity, please complete send the Rated License Assessment Request Review form to me. A copy of this form is attached to the email containing this Visit Summary. Please plan to visit https://ncrlap.org/ for more information regarding Rated License and Environment Rating Scale. We discussed Education Points. On your current license, you have seven (7) points in education standards. We discussed the education requirements needed to maintain these points during your Rated License reassessment for Administrator, Teacher and Lead Teacher. We discussed the Quality Point option. You stated that you will be able to maintain your current Quality Point option during the Rated License reassessment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at kaitlyn.marshall@dhhs.nc.gov or 828-713-8192 or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times